Is it safe to consume cocoa drinks during pregnancy?

Can You Drink Cocoa During Pregnancy?

Yes, you can safely drink cocoa beverages during pregnancy in moderation, but you must limit your total daily caffeine intake to no more than 200 mg per day to avoid adverse reproductive outcomes. 1

Caffeine Limits During Pregnancy

The critical issue with cocoa drinks is their caffeine content, not the cocoa itself:

• The European Food Safety Authority and U.S. Dietary Guidelines for Americans recommend pregnant women limit caffeine to 200 mg/day 1
• Some evidence suggests up to 300 mg/day may be acceptable, but the more conservative 200 mg/day limit is widely endorsed 1
• A typical cup of hot cocoa contains approximately 5-10 mg of caffeine, significantly less than coffee (95 mg per cup) or tea (47 mg per cup) 1

Safety of Cocoa Itself

The cocoa component is not problematic:

• Dark chocolate and cocoa are not listed among foods pregnant women should avoid 2
• Chocolate consumption during pregnancy has been studied and shows no teratogenic effects (does not cause birth defects) 3
• Some studies even suggest potential benefits, including blood pressure reduction in mothers and positive effects on fetal reactivity 3

Practical Recommendations

When consuming cocoa drinks during pregnancy:

• Track your total daily caffeine from all sources (coffee, tea, chocolate, soft drinks, energy drinks) to stay under 200 mg/day 1
• Choose water as your primary beverage, with cocoa drinks as an occasional treat 4
• Be mindful of added sugar content in commercial cocoa drinks, as excessive sugar should be limited during pregnancy 2, 5
• If you have gestational diabetes, consult your healthcare provider about chocolate/cocoa consumption due to sugar content 2, 5

Important Caveats

The evidence on caffeine safety is actually more concerning than current guidelines suggest:

• A 2021 comprehensive review found that maternal caffeine consumption was reliably associated with miscarriage, stillbirth, low birth weight, and other negative outcomes, with no clear safe threshold identified 6
• However, this conflicts with the consensus guidelines from major health organizations that support the 200-300 mg/day limit 1
• Given this uncertainty, staying well below 200 mg/day is the most prudent approach 1

Bottom Line Algorithm

1. Calculate your daily caffeine intake from all sources
2. If total caffeine < 200 mg/day: Cocoa drinks are safe in moderation
3. If you have gestational diabetes: Limit cocoa drinks due to sugar content, not caffeine 2
4. When in doubt: Choose water or naturally caffeine-free beverages 4

The key is that cocoa drinks themselves are safe—it's the cumulative caffeine exposure that requires monitoring during pregnancy.