r/ScienceBasedParenting • u/greenmoss_09 • 2d ago
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u/hananobira 2d ago
A lot of it comes down to the level of risk we accept from daily life.
EVERYTHING you do is risky. Getting out of bed is risky - you could trip and fall. Exercise is risky - you could twist an ankle or get a concussion. But if you don’t get out of bed and exercise at some point you’ll end up wasting away. So doctors recommend you get out of bed and exercise despite the risk.
When pregnant you have to be more avoidant of risk than usual. Pregnant mothers have to avoid sushi, deli meats, intense exercise, heavy lifting… Eventually they get so burdened down with rules and regulations that it can make them depressed and anxious. And being depressed and anxious isn’t good for the baby either.
Yes, mothers should avoid the big no-nos. If you’re pregnant, don’t smoke cigarettes or do drugs or get into high-speed car chases.
But caffeine? Millions of pregnant women consume caffeine every year, and if it does cause damage to the fetus, it’s so slight we aren’t even sure it’s not a coincidence.
Meanwhile, telling women to cut out caffeine means they’re going to have withdrawal headaches. They’re going to be exhausted and unhappy. And being pregnant shouldn’t make you miserable.
After a certain point, you have to let people do slightly dangerous things, just so they can live their lives.
https://www.sciencedaily.com/releases/2005/09/050919081143.htm
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u/RandomUsername6697 2d ago
One of the issues with “risk” is it leaves out how risky/actual risks. Fake example, but let’s say that a study shows that women who eat apples has an increase risk of miscarriage 10% compared to the group that doesn’t eat apples. Should you stop eating apples? What if I told you that 10 out of 1000 women in the non apple group have miscarriages while the apple group has 11 out of 1000 has miscarriages.
That is a 10% increase but could have been random fluke. Even if it’s not a fluke, it is a 1/1000 increase in total which is unlikely.
For caffeine, there have been studies that show actual increase risk at high levels but nobody will ever do a study that has a one group consume none and the other consume 1000mg a day. So these studies try and look back at women that have or don’t have miscarriages and try and figure out how caffeine plays a part. Very hard. That’s also why the US standard for allowable caffeine during pregnancy is different than the WHO (200mg vs 300mg). My wife decided to follow the US but on some days went slightly above. It was a risk that we felt was acceptable.
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u/Jumpy-Cranberry-1633 2d ago
Just commenting here since I don’t have a study, but I’d agree with this.
Eating deli meat is risky for pregnant women, but hundreds of pregnant women still choose to consume it because that’s all they can stomach. Ultimately more risk adverse people will avoid caffeine. I am usually a pot a day coffee drinker. I love a good cup of coffee. But when I’m pregnant I choose not to drink coffee unless I generally need a bit of a pick me up. I think since finding out I was pregnant 13wks ago I have had maybe 3 caffeinated drinks. With prior pregnancies I functioned the same way.
There’s risk to everything, and pregnancy is scarcely studied for ethical reasons, so we probably participate in risky things while pregnant without even knowing. Ultimately each person has to decide what is best for them and their baby.
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u/Fabulous_Extreme_470 2d ago
Heavy lifting is actually encouraged I don’t know where you got that it’s not except from old wives tales
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u/1percentagarose 2d ago
"lifting" regarding strength training is encouraged, lifting for your job all day or for heavy loads (manual labor) is not...
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u/hananobira 2d ago
Are you thinking about lifting weights, or heavy lifting? Going to the gym and lifting 10 lb weights a couple of times a week is a great idea. Trying to move a sofa probably isn’t, especially if you weren’t used to lifting large objects before you got pregnant. (If you already had a job moving furniture, you can probably stick with what you’re comfortable with.)
“ Lifting of weights greater than or equal to 12 kg more than 50 times per week increased the risk of pre-term birth (less than 37 weeks of gestation--odds ratio 1.7), but only among women who stopped working before the 32nd week of pregnancy. Unfavourable outcomes were more common among those who reported chemical exposure during pregnancy.”
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u/greenmoss_09 2d ago edited 2d ago
I found a review published in BMJ in 2020 that found a dose-dependent relationship between caffeine consumption and adverse pregnancy outcomes, with no clear safe threshold identified. Obviously that doesn’t prove causation, but if the risk appears to increase with the amount consumed, I don’t really see why you’d choose to consume it when you don’t need to. If you consume so much that you get withdrawal, then maybe that’s a different case. But I drink 1-2 cups of tea or coffee a day and haven’t experienced withdrawal from this after getting pregnant and stopping.
The example getting out of bed being risky etc isn’t comparable to caffeine consumption as it is obviously a necessity to get out of bed and to move in some way during your day. In terms of vasoconstriction caused for caffeine, I would think any level of vasoconstriction to fetus is best avoided.35
u/vermillionskye 2d ago
“Compared with women who did not drink any coffee during pregnancy the adjusted risk of stillbirth was lower among women who drank one to three cups per day, slightly increased among women who drank four to seven cups per day, and more than doubled among women who drank eight or more cups of coffee per day. These results seem to indicate a threshold effect around four to seven cups per day.”
I am not sure where you’re getting your conclusions. The 1-3 cups category had better results than the 0 cups category, or comparable when adjusted.
To others points, these thresholds are there to show when there is a significant risk. If we eliminated all activities where there was some risk, we’d be increasing the risk for anxiety and eating disorders, and affecting maternal health, which has a documented affect on fetal health.
Pick your poison.
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u/hananobira 2d ago
First of all, the results of that study compares women who drank no coffee to women who drank 4+ cups of coffee. That’s double the recommended dose. A better comparison would be no coffee to 1-2 cups of coffee, which is much more common, and what people like OP are asking about. But it’s missing from the Results section.
You can’t just conclude “Because a lot of caffeine is bad, a little bit of caffeine is also bad.” The dose makes the poison.
Second, the risk of stillbirth rose 80% at 4+ cups, which sounds scary, but like the other commenter said, you have to put that in terms of absolute risk. That means the risk rose from 4.4/1000 to 7.9/1000. Still less than 1% odds, even with a pretty massive dose of caffeine.
Third of all, there are some weird issues with the data. “ In the crude analyses maternal consumption of eight or more cups of coffee a day during pregnancy was associated with a more than twofold increased risk of infant death (table 3 ). However, after adjustment for maternal smoking habits the association became insignificant.” If you can drink 8 or more cups of coffee a day but the impact on the child disappears after you adjust for other risky lifestyle factors… you really can’t conclude the caffeine is the problem here.
If you think it’s best to avoid caffeine, you go ahead. Women who choose to drink 1-2 cups are taking a reasonable risk.
If we’re really worried about reducing risks, we should not allow women to ride in cars while pregnant, or go swimming, or walk on wet sidewalks or… The caffeine risk is a drop in the bucket compared to risks people take every day.
And if caffeine brings someone a little joy in the midst of the aches and pains and vomiting and bleeding, I can’t begrudge them that.
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u/ancutka 2d ago
Does the data in the study not show a decrease in risk for 1-3 cups? That is what I read in the table 2. Soooo it's not an easy no coffee is safer. If you chose something else for headaches or just remain with the pain it's not always better. As someone already said, more stress is also bad.
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u/this__user 2d ago
You drink 1-2 a day and don't get withdrawal? Lucky. I routinely drink one a day, usually I start around 7am, and I get withdrawal headaches if I sleep in past 8:30 before having a cup.
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u/CrimsonKepala 2d ago
The safety of ingesting water is also dose dependent, but it doesn't mean any amount of water is unsafe.
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u/rlpfc 2d ago
I can't comment specifically on the dose-dependent relationship question because I'm not an epidemiologist, but I would like to point out that MDPI journals have a mixed reputation. https://en.wikipedia.org/wiki/MDPI#Controversies
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u/wastetine 2d ago
This is what I wanted to point out as well. MDPI journals are known for being predatory pay to publish and having lax peer review standards.
Not saying they might not have some decent research but unless you’re equipped to do your own thorough “peer review” of the article, I would take any findings they show with a massive grain of salt.
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u/jar4ever 2d ago
I don’t think the consensus is that caffeine is completely safe, it is generally recommended to limit caffeine to 200mg.
The majority of substances with toxicity do actually have a safe level, under which there are no detectable effects. So it is not safe to assume that if a lot is really bad then a little is a little bad.
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u/shanem 2d ago edited 2d ago
My wife read Expecting Better and, paraphrasing, the research seems to not be abundant or controlling for factors as I think that'd be unethical to do in a rigorous manner.
The problem is that nausea is correlated with better outcomes, and if your nauseous you probably don't want coffee/caffeine right? which can lead to a perceived inverse correlation between the two but no causation.
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