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Q: I'm pregnant, and while I know that caffeine isn't good for my baby-to-be, I have a slight addiction to the caffeinated sodas I drink daily. I've tried to stop drinking caffeinated beverages entirely, but then I experience migraines if I don't intake some caffeine. Exactly how bad is caffeine for my unborn child? Should I just quit caffeine cold turkey, and deal with the migraines?

A: New insights into the possible harmful effects of caffeine on a developing fetus have led obstetricians to increasingly discourage caffeine consumption during pregnancy. Some studies have shown that the offspring of pregnant animals given caffeine displayed a higher incidence of malformations. Excessive caffeine consumption (defined as drinking three or more cups of coffee or tea daily during the first trimester) has been also associated with a higher incidence of miscarriage and low birth weight. Plus, as it does in adults, caffeine can increase a baby's heart rate. Also, because a fetus' immature liver can't rid itself of the caffeine as quickly as an adult liver, the caffeine may remain in the fetus' bloodstream longer, and at higher levels. A further caution is that caffeine has similar metabolic effects as the stress hormone adrenaline; both can theoretically reduce blood flow to the uterus.

Besides being harmful for your developing baby, caffeine -- at least in high doses -- could be harmful to you. Research suggests that pregnant women detoxify caffeine at a slower rate while pregnant, allowing the caffeine to build up to higher levels in the bloodstream and remain in the system longer, compounding its effects. Caffeine also has a diuretic effect, which can increase the frequency of urination (increasing your already- frequent nighttime trips to the bathroom) and can possibly lead to dehydration. Also, it can lessen the absorption of iron from foods in your diet during pregnancy.

It sounds like you're not so much "addicted" to caffeine, as you are using it as a "medicine" to relieve the headaches. It's natural to want to stick with your daily soda intake if that's what works for you. However, for your health and that of your baby, consider trying the following alternatives.

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