Is Kombucha Safe During Pregnancy? According To Experts

Kombucha is a non-alcoholic, effervescent, fermented tea originating from Asia. It has a long anecdotal history of health benefits that have only recently been partly supported by scientific evidence. For example, unpasteurized kombucha is a potent probiotic beverage that replenishes the gut flora with healthy bacteria and may exert anti-microbial, antioxidant, anti-diabetic, immune-enhancing, and anti-obesity properties.

But is kombucha safe to drink during pregnancy? Although kombucha is labeled non-alcoholic per the FDA’s labeling guidelines, it still contains 0.5% alcohol and homemade brew may contain 1%- 8% alcohol. It is also an acidic drink, potentially aggravating heartburn, and contains caffeine. The bacteria may not all be friendly, posing a food safety hazard for susceptible pregnant people with unpasteurized kombucha.

Like asking if raspberry leaf is safe during pregnancy, many people want answers to kombucha safety questions.

Let’s explore the world of kombucha and why you should avoid it during pregnancy.

What is kombucha?

Mythological History Of Kombucha

Ancient myth cites the first instance of kombucha, called The Tea of Immortality, also called The Elixir of Life, in 220 B.C. The tea got its name from Dr. Kombu, who brought it to Japan’s Emperor in 414 A.D. Kombucha was famous for saving an entire Russian village from an epidemic in 1913. 

After that, the medicinal treatment was adopted by Germany in 1915, followed by the U.S. in 1917.

Composition Of Kombucha

Kombucha is a highly acidic fermented black, white, or green tea made from bacteria, yeast, and sugar. Depending on the preparation method, the bacteria may not all be good, but the live bacterial culture makes up the probiotic nature of this beverage.

Probiotics are beneficial for gut and metabolic health. Since probiotics are live cultures, pasteurization by heat kills them. Many kombucha products are pasteurized for food safety reasons. However, pasteurization removes the beverage’s probiotic nature, adversely influencing its health benefits.

Kombucha is naturally highly acidic, with a pH of 2.5-3.5. Acetic acid results from the fermentation process used to make the beverage. Acetic acid makes kombucha tangy and effervescent, and some manufacturers use a second fermentation process to influence taste and texture, sometimes adding spices and fruit juice.

Many kombucha products on the market contain more than the legal alcohol threshold. They must be labeled and taxed as alcohol products when their content exceeds 0.5% in the U.S. and 1.1% in Canada. However, several U.S. studies have found that non-alcoholic commercially labeled kombucha products contain > 0.5% alcohol by volume when measured in the lab, obviously with inaccurate labeling and a questionable testing process.

Kombucha tea also has 14.8 grams of added sugar, 40.9 mg of caffeine, and almost 60 empty kcals per 12-ounce can. It contains beneficial polyphenols and organic acids such as phenolic acid, which has anti-inflammatory actions and other antioxidants but lacks significant nutritional value, except B-complex.

Is Kombucha Safe During Pregnancy?

There are five reasons why we don’t recommend kombucha consumption during pregnancy. These five reasons include

• High acidity.
• Potential presence of foodborne pathogens.
• Presence of caffeine.
• Presence of alcohol.
• Unnecessary non-nutritive sugar.

High Acidity

Kombucha contains an abundance of organic acids, and while some are pretty therapeutic, they may also aggravate the frequent heartburn associated with pregnancy. Heartburn is a common troublesome complaint in pregnancy, affecting 17%- 45% of pregnancies and up to 71% of third-trimester pregnancies.

Drinking a beverage with a pH of 2.5-3.5 will aggravate acid reflux. It should be avoided if heartburn is one of your typical symptoms associated with hormonal changes and a growing uterus.

In addition, the beverage’s acidity causes heavy metals to leach from metal-containing vessels it might come in contact with, leading to heavy metal toxicity.

Presence Of Live Cultures

Kombucha is infamous for being a probiotic with a rich microbiota diversity that has yet to be entirely classified. Depending on the method of preparation, not all the bacteria in the drink may be good, posing an increased food-borne poisoning risk to pregnant people.

Don’t get me wrong; live cultures are typically okay during pregnancy. What is in question is whether the method of preparation is reliable and whether all the bacteria ending up in the live cultures are good since the process of preparation is the determining factor. Harmful bacteria can lead to epigenetic mutation in the fetal placenta and cause other foodborne pathogenic outcome problems in pregnancy.

Homemade brews are particularly suspect because they may contain pathogenic bacteria. While pasteurization may make the beverage safer during pregnancy, it also compromises many of the purported health benefits.

Caffeine

While many practitioners allow up to 200 mg of caffeine per day, more recent research indicates that any caffeine consumption during pregnancy may be problematic for maternal/fetal outcomes. Current evidence suggests that any caffeine intake by those wishing to become pregnant or who are pregnant should be avoided altogether.

This means that kombucha, with its varying levels of caffeine, is off-limits based on current safety guidelines. Of course, you can always check with your doctor. They should evaluate the current research for academic rigor to decide if it applies to their patient population, as sometimes professional organizations take time to assess and catch up on their standards of practice recommendations.

Alcohol

The bottom line here is that no safe levels of alcohol during pregnancy have ever been established. Even 0.5% alcohol is alcohol, and depending on a variety of factors, even that tiny amount may have a daunting effect on the pregnancy outcome. Avoid all alcohol when pregnant.

Since 1981, the Surgeon General has advised pregnant people to avoid alcohol. Not only is one exposure during critical gestation periods detrimental to the developing fetus, but any amount of alcohol can be linked to fetal alcohol syndrome disorder, cognitive deficits, and behavioral abnormalities.

Sugar

An average serving of kombucha contains almost 15 grams of sugar or 60 calories. Historically, the American Heart Association recommends limiting sugar intake to 100 calories ( 25 grams) per day for those assigned females at birth or AFAB, which is about 6% of your calories for a 2,000-calorie diet. The World Health Organization recommends limiting 10% of total calories to added sugars due to the risk of adverse pregnancy outcomes; furthermore, they say that an additional reduction to less than 5% would provide extra health benefits.

Pasteurized kombucha contains a good share of allowable added sugars without extra benefits. These added sugars need to be calculated into your daily allowance. Overconsuming sugars increases your risk for gestational diabetes, stillbirth, preterm delivery, low birth weight infants, and miscarriages.

Risks Of Drinking Kombucha While Pregnant

The risks of consuming kombucha during pregnancy are:

• Fetal alcohol syndrome disorder.
• Increased risk for gestational diabetes. 
• The possibility of contracting a foodborne illness. 
• Preterm delivery. 
• Miscarriage. 
• Stillbirth. 
• Low birth weight.
• Aggravation of heartburn symptoms.

Conclusion

Kombucha may be a therapeutic beverage for some conditions, but scientific evidence does not conclusively support the health claims made for this ancient brew. Some preliminary research suggests that the vast diversity of microbial life gives this elixir its reputation for medicinal use in various medical disorders.

Five characteristics of this magical elixir clarify its lack of suitability for a well-balanced, healthy pregnancy diet. It is a highly acidic drink fermented with bacteria to yield alcohol and live cultures that may contain pathogenic bacteria. It also includes a good amount of caffeine and over half of the day’s average sugar allowance, according to the guidelines set by the AHA.

Kombucha may be safer in a pasteurized form but loses many of its anecdotal health benefits when processed with heat. Always check with your doctor if you have a question related to your pregnancy and adding questionable foods.