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Can Pregnant Women Drink Coffee?

Can Pregnant Women Drink Coffee?

Pregnancy makes you tired — and let’s face it, it’s tempting to try to rev yourself up with a cup of java if you feel like you are really dragging!  Before you reach for that next latte, though, you’d better read on to find out about the great caffeine debate — and whether or not it is dangerous for pregnant women to drink up.

The Debate Goes On

The debate over the use of caffeine during pregnancy is nothing new — doctors have actually be arguing about it for decades and have issued warnings about it going back to the 1970s. But even after decades of research, much remains unclear. There is evidence to show, for instance that women who are trying to get pregnant should not be slugging down cappuccinos right and left. And because some studies have linked excessive caffeine to bad outcomes for the baby, the March of Dimes — one of America’s leading organizations that promotes the health of unborn babies — recommends that, to be on the safe side, women limit their caffeine intake to around 200mg a day.

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The Argument Against Caffeine During Pregnancy

While some coffee addicts will groan to hear this, there really is serious clinical evidence to show that high levels of caffeine really are bad for baby.

  • In one, highly publicized study which was published in the British Medical Journal in 2008, it was found that women who regularly consumed more than 200mg of caffeine daily doubled their risk for miscarriage.
  • In another study in Denmark, where coffee consumption among women is considered to be higher than average, researchers discovered that women who consumed 8 or more cups of coffee a day also doubled their risk for stillbirths.
  • Yet another study found that consumption of over 500mg of caffeine daily lead to an adverse effect on fetal heart rate and respiration; it also found that these infants had more problems getting to sleep in the first few days of life.

These studies have focused in on the negative effects that caffeine can have on the baby. But it can have an effect on the mother as well. Research has found another problem with a caffeine: it makes it harder for a woman’s body to absorb iron, which she desperately needs when she is pregnant, both for herself and her baby. A decrease in the ability to absorb iron can easily lead to anemia, which is dangerous for pregnant women. Caffeine can also increase the mother’s heart rate and cause jitteriness and insomnia.

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The Other Side of the Coin

They call the debate over caffeine in pregnancy a controversy for a reason. For one thing, evidence over the years has sometimes been conflicted and though the 2008 study got a lot of media attention, other studies which looked at caffeine in pregnancy did not find a relationship between caffeine usage and miscarriage. It should also be pointed out that the link between caffeine and low birth weight is inconclusive at best and that there is no link between caffeine and premature birth or adverse maternal conditions like gestational high blood pressure or pre-eclampsia.

It is this evidence that has lead many to argue that caffeine does not pose as much of a health threat as many women seem to think.

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Even a position statement issued by the American Congress of Obstetricians and Gynecologists is a little ambivalent. In this statement, based on the latest evidence, the committee concluded:

  1. Caffeine consumption of under 200mg a day has not been linked to miscarriage, stillbirth or other adverse fetal outcomes.
  2. The relationship between caffeine consumption and fetal growth has yet to be proven either way.
  3. Further evidence is needed to determine if high levels of caffeine consumption are a risk factor for miscarriage.

The Best Ways to Cut Down on Caffeine if You’re Pregnant

If you are pregnant and have decided to at least cut down on your caffeine consumption, you might be wondering just how to go about doing this. Here are some tips to help you out:

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  • Don’t stop caffeine all at once. Getting cut off from the daily supply of java can be really stressful for your body — and lead to some pretty epic headaches. If you are wanting to cut down, do it gradually by adding some decaffeinated coffee to the regular coffee when you brew it up, or simply making the coffee a little weaker.
  • Consider switching to teas like green teas which have less caffeine — and offer a great array of antioxidants for you and your baby.
  • Read the labels on the foods and drinks you buy. It’s not just coffee that you have to worry about! Non-herbal teas, soft drinks, energy drinks, some medications and chocolate in any form has caffeine as well — and it can really add up! An 8-ounce cup of regular brewed coffee, for example, has around 95-200mg of caffeine, while a cup of green tea has 75 mg and just one ounce of dark chocolate has 23mg. If you are trying for a 200mg/day limit, that can add up in a hurry if you don’t keep track!
  • Don’t start drinking any herbal teas until you talk to your ob-gyn first. Some teas such as ginger tea are great for pregnancy as they can help with motion sickness – but some can be bad for your growing baby. Always make sure before you buy.
  • Make sure that you are drinking an adequate amount of water everyday and not replacing water with coffee, tea or other caffeinated beverages. Staying hydrated while you are pregnant is extremely important for the health of the baby.

So can pregnant women drink coffee? The safest answer is probably yes — in moderation. The restriction should be considered to be part of a wider plan for good nutrition during pregnancy, which should include plenty of water as the main beverage as well as fruits, vegetables, lean proteins, dairy and whole grain products. So far, clinical evidence has not shown consumption under 200mg a day to be unsafe for an unborn baby, so women following the March of Dimes recommendation can be somewhat assured that this habit will not have an adverse impact on their growing child.

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Brian Wu

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Published on November 30, 2018

Signs of Postnatal Depression And What to Do When It Strikes

Signs of Postnatal Depression And What to Do When It Strikes

Postpartum depression (PPD) strikes about 15% of women around childbirth.[1] Moreover, this mood disorder is estimated to affect 1% to 26% of new fathers.[2] The causes of which are thought to be linked to hormonal changes, genetics, previous mental illness and the obvious change in circumstance.

The stigma of mental health – with or without support from family members and health professionals – often deters women from seeking help for their PPD. In this article, I will show you 10 ways to begin overcoming PPD.

Symptoms of Postnatal Depression

Postnatal depression is defined as depressive disorder, beginning anytime within pregnancy up to the first year of the child’s life. The symptoms of post natal depression are the same as those of depression. In order to receive a diagnosis from the doctor, 5 symptoms must be shown over a two week period. The symptoms and criteria are:

  • Feelings of sadness, emptiness, or hopelessness, nearly every day, for most of the day or the observation of a depressed mood made by others
  • Loss of interest or pleasure in activities
  • Weight loss or decreased appetite
  • Changes in sleep patterns
  • Feelings of restlessness
  • Loss of energy
  • Feelings of worthlessness or guilt
  • Loss of concentration or increased indecisiveness
  • Recurrent thoughts of death, with or without plans of suicide
  • Lack of interest or pleasure in usual activities
  • Low libido
  • Fatigue, decreased energy and motivation
  • Poor self-care
  • Social withdrawal
  • Insomnia or excessive sleep
  • Diminished ability to make decisions and think clearly
  • Lack of concentration and poor memory
  • Fear that you can not care for the baby or fear of the baby
  • Worry about harming self, baby, or partner

Should you, a friend or your partner be showing any of these signs, I recommend you to seek medical advice.

Causes of Post Natal Depression

It is worth noting here that there is a difference between what is commonly known as ‘The Baby Blues’ and post natal depression.

Postpartum blues, commonly known as “baby blues,” is a transient postpartum mood disorder characterized by milder depressive symptoms than postpartum depression. This type of depression can occur in up to 80% of all mothers following delivery. The Baby Blues should clear within 14 days, if not it is likely an indicator of something more in depth.

It is not known exactly what causes post natal depression, however there are some correlating factors. These factors have a close correlation and haven’t been shown to cause PPD:

  • Prenatal depression or anxiety
  • A personal or family history of depression
  • Moderate to severe premenstrual symptoms
  • Stressful life events experienced during pregnancy
  • Maternity blues
  • Birth-related psychological trauma
  • Birth-related physical trauma
  • Previous stillbirth or miscarriage
  • Formula-feeding rather than breast-feeding
  • Cigarette smoking
  • Low self-esteem
  • Childcare or life stress
  • Low social support
  • Poor marital relationship or single marital status
  • Low socioeconomic status
  • Infant temperament problems/colic
  • Unplanned/unwanted pregnancy
  • Elevated prolactin levels
  • Oxytocin depletion

One of the strongest predictors of paternal PPD is having a partner who has PPD, with fathers developing PPD 50% of the time when their female partner has PPD. [3]

Ways to Overcome Post Natal Depression

1. Seek Medical Help

As knowledge of PPD grows, more and more physicians are becoming aware of the indicators and risk factors. This means that health care providers are looking for signs as early as their first prenatal care visit.

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If you are at risk, letting your provider know early in your pregnancy means that you’ll be given extra support and care throughout the process. It is best to seek treatment as soon as possible.

If it’s detected late or not at all, the condition may worsen. Experts have also found that children can be affected by a parent’s untreated PPD. Such children may be more prone to sleep disturbances, impaired cognitive development, insecurity, and frequent temper tantrums.

2. Therapy

This is the first line of defence against post natal depression and will commonly be prescribed alongside medication. Around 90% of post natal depression cases in women are treated with a combination of the two treatments.

You don’t need to do anything special to prepare. Your counselor will ask questions about your life, and it’s important you answer honestly. You won’t be judged for what you tell, and whatever you talk about will be just between the two of you. Your counselor will teach you how to look at some things differently, and how to change certain habits to help yourself feel better.

Therapy is personalized for everyone, but women in counselling for postpartum depression often discuss topics including; who you’re feeling, your behaviour, your actions and your life. (If you need immediate support please call the San Diego Access and Crisis Line at (888) 724-7240. The toll-free call is available 24 hours a day, seven days a week.)

3. Medication

There have been a few studies of medications for treating PPD, however, the sample sizes were small, thus evidence is generally weak.

Some evidence suggests that mothers with PPD will respond similarly to people with major depressive disorder. There is evidence which suggests that selective serotonin reuptake inhibitors (SSRIs) are effective treatment for PPD.

However, a recent study has found that adding sertraline, an SSRI, to psychotherapy does not appear to confer any additional benefit. Therefore, it is not completely clear which antidepressants are most effective for treatment of PPD.

There are currently no antidepressants that are FDA approved for use during lactation. Most antidepressants are excreted in breast milk. However, there are limited studies showing the effects and safety of these antidepressants on breastfed babies.

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4. Communication with Partner

Don’t blame yourself, your partner, close friends or relatives. Life is tough at this time, and tiredness and irritability can lead to quarrels.

‘Having a go’ at your partner can weaken your relationship when it needs to be at its strongest. It can be a huge relief to talk to someone understanding.

By spending time with your partner doing activities that you both enjoy, like going for a walk, can really help. This change of state, from moving location, can significantly elevate mood whilst providing ‘neutral ground’ in which to open up communication.

Be honest with your partner and show ways in which they can support you best through this time, even if it’s just talking or letting you have time to go take a shower.

5. Self Care and Rest

Don’t try to be ‘superwoman’. Try to do less and make sure that you don’t get over-tired. It’s common that women are the experts at ‘being busy’ and ‘doing it all’.

Rest whilst the baby is sleeping, and really take time to prioritise yourself. Throughout life, if you’re constantly giving out energy, you will be left feeling unbalanced. It’s important to become aware of one’s energy and making sure to give yourself energy first, before giving out is imperative.

Your body has just been through the trauma of the birth, which is very stressful. It therefore needs time to recover so taking time to yourself is important. Things as simple as a cup of tea, or shower or listening to music will really help.

6. Supplementation (especially DHA)

St John’s Wort is a herbal remedy available from chemists. There is evidence that it is effective in mild to moderate depression. It seems to work in much the same way as some antidepressants, but some people find that it has fewer side-effects.

One problem is that St John’s Wort can interfere with the way other medications work. If you are taking other medication, you should discuss it with your doctor. This is very important if you are taking the oral contraceptive pill. St John’s Wort might stop your pill working. This can lead to an unplanned pregnancy.

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It is also worth noting that fish oil (containing DHA) is being shown to correlate with lower instances of PPD. DHA consumption during pregnancy — at levels that are reasonably attained from foods — has the potential to decrease symptoms of postpartum depression,” conclude study researchers led by Michelle Price Judge, PhD, RD, a faculty member at the University of Connecticut School of Nursing.

7. Movement

Before starting any exercise program, you should consult with your doctor and find a fully qualified pre and post natal specialist. That being said, there is plenty of movement that can be done prior to ‘hitting the gym’, such as walking.

Not only does being outside positively benefit you by getting some fresh air and vitamin D. The same is said for your baby, who will likely sleep better once they’ve been outside. Exercise gets your endorphins going, which helps alleviate depression symptoms, It can also get you focused on something for yourself. In an analysis of data from 1996 to 2016, researchers discovered that moms who stayed physically active after birth experienced fewer depressive symptoms.[4] In contrast, one study found women who led a more sedentary lifestyle were, in general, more likely to experience postpartum depression in the first place. [5]

The type of workout doesn’t matter much. Yoga for pregnant women, stretching, and cardio are essentially equal in terms of making you feel better.

8. Socializing and Support Groups

Do go to local groups for new mothers or postnatal support groups. Your health visitor can tell you about groups in your area. You may not feel like going to these groups if your are depressed.

See if someone can go with you. You may find the support of other new mothers helpful. You may find some women who feel the same way as you do.

9. Accept Help

Some cultures believe that the symptoms of postpartum depression or similar illnesses can be avoided through protective rituals in the period after birth. Chinese women participate in a ritual that is known as “doing the month” (confinement) in which they spend the first 30 days after giving birth resting in bed, while the mother or mother-in-law takes care of domestic duties and childcare.

Whilst this may seem extreme, it’s worth noting that being able to accept help from your friends, partner and family can be extremely beneficial.

10. Avoid Smoking, Drink and Drugs

Which may seem common sense, however you may be tempted by the short term ‘fix’.

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Don’t use alcohol or drugs. They may make you feel better for a short time, but it doesn’t last. Alcohol and drugs can make depression worse. They are also bad for your physical health.

Final Thoughts

Most women will get better without any treatment within 3 to 6 months. One in four mothers with PND are still depressed when their child is one-year-old. However, this can mean a lot of suffering.

PND can spoil the experience of new motherhood. It can strain your relationship with your baby and partner. You may not look after your baby, or yourself, as well as you would when you are well.

PND can affect your child’s development and behaviour even after the depression has ended. So the shorter it lasts, the better.

Sometimes there is an obvious reason for PND, but not always. You may feel distressed, or guilty for feeling like this, as you expected to be happy about having a baby. However, PND can happen to anyone and it is not your fault.

It’s never too late to seek help. Even if you have been depressed for a while, you can get better. The help you need depends on how severe your illness is. Mild PND can be helped by increased support from family and friends.

Featured photo credit: Derek Thomson via unsplash.com

Reference

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