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Caffeine, Alcohol, and Pregnancy

Your baby needs a plentiful supply of fluids every day. The fluids in water, juices, ices, and soups are all vital for good health. But there are two kinds of drinks that are just plain bad for you: caffeinated drinks and alcohol.


I've heard it a million times: "I can't give up coffee—I'll never be able to stay awake!" I can't argue that the caffeine in coffee doesn't give a mental and physical boost—after all, it's a central nervous stimulant that excites the brain to keep it alert and awake. That's the upside. The downside is that caffeine is an addictive drug that passes quickly to the fetal bloodstream and stays there in higher concentrations than is found in the mother. Did you know that babies have been born addicted to caffeine? It's true.

Caffeine is found not only in coffee but also in other beverages and foods. It's in tea, sodas, chocolate, and coffee ice cream. But no matter where you get it, caffeine has nothing good to offer your baby. Caffeine is known to…

So what do you think? Maybe it's time to use good foods, plenty of rest, and exercise to give your body what it needs to stay alert. Caffeine-containing foods and drinks just don't fit into a healthy pregnancy diet.

Hey Mom!

Watch out for caffeine in pain-relief products!

Hey Mom!

You can make your own herbal tea without worrying about any negative effects. Add fruits such as orange, pineapple, or apple to boiling water or to decaffeinated tea. You can also add fruit jams, mint leaves, cinnamon, nutmeg, or cloves. Be creative; there are lots of ways to flavor tea.

If you give up coffee or tea, it's best to do it slowly. If you go cold turkey, you'll suffer withdrawal symptoms such as severe headaches, irritability, fatigue, and nervousness. To avoid this you can either reduce the amount of caffeine you take in each day (by having only two cups of coffee instead of four, for example) and then gradually cut back until you're down to none. Or, you can start cutting your coffee or tea with decaffeinated substitutes. Use half decaf and half regular for a while and then gradually build up the amount of decaf until all caffeine is gone. If you're a big cola drinker, slowly switch to caffeine-free varieties or try fruit-flavored seltzers.

If you switch to decaffeinated drinks, you should know that they're not really "caffeine-free." Decaffeinated coffees and teas are about 97 percent caffeine-free. If you drink only a moderate amount each day, they should have no bad effect on your baby.

If you're a tea drinker, you might try switching to decaffeinated or herbal teas. But be careful with herbals. Brand-name teas sold in the supermarket are generally safe for pregnant women (look for "no caffeine" on the label). But you should probably stay away from strong teas brewed with fresh herb leaves that are used for medicinal purposes. Talk to your doctor before switching to any herbal tea.


The great debate over whether or not moderate use of alcohol is bad for the developing fetus rages on. Some physicians still recommend an alcoholic drink to calm Braxton Hicks contractions and to "relax"; others forbid even a sip. The fact is that too much alcohol is definitely bad for the fetus. No one argues with that, but defining the line between some alcohol and too much alcohol is an ongoing subject of debate.

Consider first what we know about drinking too much alcohol during pregnancy:

Daddy Alert!

If your partner makes the decision to give up alcohol for the sake of your baby, guess what? That's right—you should, too. Watching you unwind with an evening cocktail will not only break down your partner's determination to do what's best for the baby, but it will also paint you as a selfish, insensitive you-know-what. Parenting is a partnership. Support your partner's decision to abstain by doing the same (when you are in her presence, at the very least!).

Women who abuse alcohol during pregnancy by drinking three or more ounces of absolute alcohol a day (eight beers, one pint of whiskey, or one bottle of wine) have a 40 percent chance of giving birth to a baby afflicted with fetal alcohol syndrome (FAS). This is a condition that causes gross malformation, growth retardation, and permanent intellectual and psychomotor defects. FAS babies wear their mother's alcohol abuse in their appearance. They have a small head circumference, underdeveloped jawbones, low-set ears, abnormalities of the eyelids, and an underdeveloped bridge of the nose. In addition to these obvious signs, the majority of these babies also have bone and joint abnormalities, abnormal creases in the palms, cardiac defects, kidney abnormalities, and female genital abnormalities. One study found that children affected by FAS had an average IQ of 65, low enough to cause learning and psychological disorders throughout their lifetime.

Birth defects that are related to the mother's intake of alcohol but are not as severe as those seen in FAS, are called fetal alcohol effects (FAE). These include mental retardation and minor congenital abnormalities of the skin, heart, urinary tract, and musculoskeletal system.

Even moderate drinking has been connected to birth problems. Researchers tell us that women who drink during pregnancy are much more likely to have a miscarriage, a stillbirth, or babies with a low birthweight. One study found that women who consumed as little as one drink twice a week had a significantly higher rate of miscarriage. Other new research shows that drinking in the last six months of pregnancy can increase the risk of leukemia in the baby. What a tragedy for these children when all of this heartache can be prevented.

If you think you've found the perfect solution to the alcohol problem in nonalcoholic beers and wines, think again. These beverages are not alcohol-free. They all contain some level of alcohol, and that alcohol will go straight to your baby. If you are in the habit of having a drink each day, you might be able to safely "trick" your senses by drinking an alcohol-free substitute in your favorite glass at the usual time. Try a virgin Bloody Mary (without the alcohol), sparkling cider or grape juice, or a juice spritzer (half juice, half seltzer). Get creative and enjoy.

Hey Mom!

Alcohol use is the major cause of mental retardation and a leading cause of birth defects in the United States. If you have a problem giving up alcohol during your pregnancy, talk to your health-care provider right away. Now is a very good time to get the help you need.

No matter how you define "heavy," "moderate," or "light" drinking, the fact is that alcohol is a drug that is toxic to the fetus. When you drink, the alcohol enters the baby's bloodstream in about the same concentrations present in your own, but the fetus doesn't have the enzymes necessary to metabolize it. So your baby gets more alcohol out of every drink than you do. Because no safe level of alcohol intake has been established for pregnant women, the surgeon general advises that pregnant women should avoid all beverages, foods, and drugs that contain alcohol. (However, you do not have to avoid foods cooked with alcohol because the alcohol content evaporates when heated. Any alcohol left over is present in such a small amount it will not harm you or a fetus.)

Creating a healthful pregnancy diet that stays away from empty calories and foods that contain chemicals and drugs could be the best thing that ever happens to you. Not only will it make you feel good about giving your baby only the best, but it might also change your eating habits for the better forever.

Excerpted from The Complete Idiot's Guide to Pregnancy and Childbirth © 2004 by Michele Isaac Gliksman, M.D. and Theresa Foy DiGeronimo. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.

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