5.8 Caffeine
Large quantities of caffeine restrict fetal development, and it is recommended that pregnant
women not exceed 200 mg/day. The amount of caffeine in foods and drinks varies; however,
two cups of coffee or four small mugs of tea contain 200 mg caffeine. Caffeine-‐containing
energy drinks should be avoided during pregnancy.
5.9 Alcohol
Consumption of alcohol during pregnancy is harmful for the fetus. Children heavily exposed to
alcohol antenatally may suffer from a number of physical and mental disorders before and after
delivery and during their life course. They have a higher risk for impaired growth and may have
neural disorders, resulting in serious learning and behavioural problems. Children exposed to
smaller quantities of alcohol may develop similar but milder symptoms.
Professionals tend to disagree about whether drinking small quantities of alcohol during
pregnancy harms the child. Although it has been demonstrated that heavy consumption of
alcohol is associated with a high risk for the fetus, the “safe” dose of alcohol, which would not
harm the child, has not been determined or standardized. There is evidence that consumption
of more than one alcoholic drink per day during pregnancy increases the risk for premature
birth and low birth weight. Therefore, the only “safe” level is complete abstinence during
pregnancy and lactation.
The consequences of alcohol consumption depend on the period of the pregnancy. During the
first 3 months, the risk for structural malformations is increased, whereas later, the risks for
stunting and abnormal brain development increase. Reduced IQ has been observed in
genetically susceptible descendants even after consumption of small quantities of alcohol
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during pregnancy. Women who assume that small amounts of alcohol will not harm their child
may tend to conceal their drinking, which may result in excessive consumption. Doctors should
address this problem and clarify the patterns of use.
In the present state of knowledge and in view of the absence of a safe threshold for alcohol use,
alcohol in any form or quantity should be excluded during pregnancy planning, pregnancy and
lactation.
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