Is Starbucks Caramel Macchiato Safe During Pregnancy? What Experts Say

The bigger concern for many pregnant women is the sugar content. A single Grande Caramel Macchiato contains 33 g of sugar—more than the 25 g daily limit recommended by the American Heart Association (AHA) for women. While an occasional sugary drink is unlikely to cause harm, regular high sugar intake is linked to an increased risk of gestational diabetes, excessive weight gain, and larger birth weights, which can complicate delivery.

The NHS (UK) advises pregnant women to limit caffeine to 200 mg per day and to be mindful of added sugars, which can contribute to unhealthy weight gain. They note that while small amounts of sugar are fine, it's best to prioritize nutrient-dense foods and drinks.

Bottom line: one Caramel Macchiato a few times a week is unlikely to pose a risk, but daily consumption—especially in larger sizes—may push you over the recommended limits for caffeine and sugar. If you have gestational diabetes, hypertension, or a history of preterm labor, you may need to be even more cautious. Always check with your provider for personalized advice.

Safety by trimester

Is Starbucks Caramel Macchiato safe to drink during the first trimester?

Yes, but with extra caution. The first trimester is when your baby's organs are forming, and caffeine sensitivity is highest. Your body metabolizes caffeine more slowly during pregnancy, which means it stays in your system—and your baby's—longer. ACOG recommends limiting caffeine to 200 mg per day, but some providers suggest even less (100-150 mg) in the first trimester.

A 12-oz (Tall) Caramel Macchiato contains about 75 mg of caffeine, while a 16-oz (Grande) has 150 mg. If you're also drinking tea, soda, or chocolate, it's easy to exceed the limit. Additionally, the high sugar content can worsen nausea for some women. If you're struggling with morning sickness, a sugary drink might make it worse.

If you choose to drink a Caramel Macchiato in the first trimester, opt for the smallest size (Tall) and consider asking for fewer pumps of vanilla syrup to reduce sugar. Pair it with a protein-rich snack to help stabilize blood sugar.

Is Starbucks Caramel Macchiato safe in the second trimester?

Yes, with fewer restrictions than the first trimester. By the second trimester, your body has adjusted to pregnancy, and caffeine metabolism improves slightly. However, the 200 mg daily limit still applies. A Grande Caramel Macchiato (150 mg caffeine) leaves little room for other sources of caffeine, so plan accordingly.

The sugar content remains a concern. The second trimester is when insulin resistance can start to develop, increasing the risk of gestational diabetes. The CDC recommends that pregnant women limit added sugars to reduce this risk. If you're craving a Caramel Macchiato, consider having it as an occasional treat rather than a daily habit.

If you have gestational diabetes or are at high risk, ask your provider about sugar-free or low-sugar customizations. Starbucks offers sugar-free vanilla syrup and can reduce the number of pumps in your drink.

Is Starbucks Caramel Macchiato safe in the third trimester?

Yes, but watch for heartburn and blood pressure. In the third trimester, your growing uterus puts pressure on your stomach, making heartburn more likely. Caffeine can relax the lower esophageal sphincter, worsening acid reflux. If you're prone to heartburn, you might want to skip the Caramel Macchiato or opt for a smaller size.

High blood pressure is another concern. While caffeine doesn't cause hypertension, it can temporarily raise your blood pressure. If you have preeclampsia or gestational hypertension, your provider may advise limiting caffeine. The sugar content can also contribute to excessive weight gain, which is linked to complications like preeclampsia and larger babies.

If you're still craving a Caramel Macchiato, try a Tall size with almond milk (lower in sugar) and fewer pumps of vanilla syrup. You can also ask for half the caramel drizzle to cut back on sugar.

Is Starbucks Caramel Macchiato safe while breastfeeding?

Yes, but with limits. Caffeine passes into breastmilk, and newborns metabolize it very slowly—it can take up to 4 days for a baby to eliminate caffeine from their system. This can make some babies fussy, jittery, or have trouble sleeping. The American Academy of Pediatrics (AAP) states that moderate caffeine intake (up to 300 mg per day) is generally safe for breastfeeding mothers, but they recommend timing your caffeine consumption to minimize your baby's exposure.

Aim to have your Caramel Macchiato right after a feeding, so the caffeine has time to metabolize before the next one. A Tall or Grande size (75-150 mg caffeine) is a safer choice than a Venti (225 mg). If you notice your baby seems unusually fussy or has trouble sleeping after you've had caffeine, consider cutting back or switching to decaf.

The sugar content is less of a concern while breastfeeding, but it's still a good idea to limit added sugars for your own health. If you're trying to lose pregnancy weight, a high-sugar drink can make it harder to stay in a calorie deficit.

How many Starbucks Caramel Macchiatos can a pregnant woman have per day?

Most obstetricians recommend limiting yourself to one 12-oz (Tall) Caramel Macchiato per day, or two to three per week if you're drinking the 16-oz (Grande) size. Here's why:

• Caffeine: A Tall Caramel Macchiato has about 75 mg of caffeine, while a Grande has 150 mg. The ACOG's 200 mg daily limit leaves little room for other sources of caffeine (tea, soda, chocolate, etc.). If you're also drinking a cup of coffee in the morning, a Grande Caramel Macchiato could push you over the limit.
• Sugar: A Tall has 28 g of sugar, and a Grande has 33 g—both exceeding the AHA's recommended daily limit of 25 g for women. Regular high sugar intake is linked to gestational diabetes, excessive weight gain, and larger babies.

If you're craving more than one Caramel Macchiato in a day, consider these alternatives:

• Split a Grande with a friend.
• Order a Tall and pair it with a decaf coffee or tea later in the day.
• Ask for fewer pumps of vanilla syrup to reduce sugar.
• Opt for a decaf version (more on that below).

Here's a quick reference table for caffeine and sugar content by size:

What are the caffeine and sugar risks of Starbucks Caramel Macchiato in pregnancy?

Caffeine risks

Caffeine is a stimulant that crosses the placenta and can affect your baby's heart rate and movement. While the research on caffeine and pregnancy is mixed, most experts agree that moderate intake (less than 200 mg per day) is unlikely to cause harm. However, some studies have linked higher caffeine intake to an increased risk of miscarriage, low birth weight, and preterm birth. Here's what you need to know:

• Miscarriage: A 2020 study published in BMJ Evidence-Based Medicine found that consuming more than 200 mg of caffeine per day was associated with a higher risk of miscarriage. However, the study noted that the risk was small and that other factors (like maternal age and smoking) played a larger role.
• Low birth weight: Some research suggests that high caffeine intake (more than 300 mg per day) may increase the risk of low birth weight. However, other studies have found no link. The World Health Organization (WHO) recommends limiting caffeine to 300 mg per day to reduce this risk.
• Preterm birth: Most studies have found no link between moderate caffeine intake and preterm birth. However, a 2018 study in American Journal of Obstetrics & Gynecology suggested that high caffeine intake (more than 400 mg per day) might slightly increase the risk.

The bottom line: while the evidence isn't conclusive, it's best to err on the side of caution and limit caffeine to 200 mg per day. A Grande Caramel Macchiato contains 150 mg, so if you're also drinking coffee, tea, or soda, you could easily exceed the limit.

Sugar risks

The sugar in a Starbucks Caramel Macchiato comes from the vanilla syrup and caramel drizzle. A Grande has 33 g of sugar—more than the AHA's recommended daily limit of 25 g for women. Here's why that matters during pregnancy:

• Gestational diabetes: High sugar intake can increase insulin resistance, which raises the risk of gestational diabetes. The CDC estimates that 2-10% of pregnancies in the U.S. are affected by gestational diabetes each year. If you develop gestational diabetes, you'll need to monitor your blood sugar closely and may require medication or insulin.
• Excessive weight gain: Pregnancy is not a time to diet, but gaining too much weight can increase the risk of complications like preeclampsia, gestational diabetes, and larger babies. The Institute of Medicine (IOM) recommends that women with a normal pre-pregnancy BMI gain 25-35 pounds during pregnancy. A high-sugar diet can make it harder to stay within this range.
• Larger babies: High sugar intake is linked to larger birth weights, which can increase the risk of complications during delivery, such as shoulder dystocia (when the baby's shoulders get stuck) or the need for a C-section.
• Childhood obesity: Some research suggests that high sugar intake during pregnancy may increase the risk of childhood obesity. A 2017 study in Pediatrics found that mothers who consumed more sugar-sweetened beverages during pregnancy were more likely to have children with higher body fat levels at age 7.

If you're craving a Caramel Macchiato, consider customizing it to reduce sugar. Ask for fewer pumps of vanilla syrup, skip the caramel drizzle, or opt for sugar-free syrup. You can also pair it with a protein-rich snack to help stabilize blood sugar.

Are there low-caffeine or sugar-free alternatives to Starbucks Caramel Macchiato for pregnant women?

Yes! Starbucks offers several customizations and alternative drinks that are lower in caffeine and sugar. Here are some of the best options for pregnant women:

If you're not sure what to order, ask your barista for help. They can suggest lower-caffeine or sugar-free options based on your preferences. You can also check the Starbucks nutrition calculator online to compare drinks before you order.

Does the Starbucks Caramel Macchiato recipe differ in other countries and affect pregnancy safety?

Yes, the Starbucks Caramel Macchiato recipe can vary by country, which may affect its caffeine and sugar content. Here are some key differences to be aware of:

• Caffeine content: In some countries, Starbucks uses a different espresso blend or serving size, which can change the caffeine content. For example:
  • UK: A Grande Caramel Macchiato has about 120 mg of caffeine (vs. 150 mg in the U.S.).
  • Canada: A Grande has 150 mg of caffeine, same as the U.S.
  • Australia: A Grande has about 110 mg of caffeine.
  • Japan: A Grande has about 100 mg of caffeine.
• Sugar content: The amount of vanilla syrup and caramel drizzle can vary by country. For example:
  • UK: A Grande Caramel Macchiato has 30 g of sugar (vs. 33 g in the U.S.).
  • Canada: A Grande has 33 g of sugar, same as the U.S.
  • Australia: A Grande has 28 g of sugar.
  • Japan: A Grande has 25 g of sugar.
• Milk options: In some countries, Starbucks offers different milk options by default. For example:
  • UK: Semi-skimmed milk is the standard option.
  • Australia: Full-cream milk is the standard option.
  • Japan: Soy milk is a popular alternative.
• Customizations: Some countries offer unique customizations that can affect pregnancy safety. For example:
  • UK: You can order a "skinny" Caramel Macchiato, which is made with skim milk and sugar-free syrup.
  • Canada: You can ask for "light" caramel drizzle to reduce sugar.
  • Australia: You can order a "short" size (8 oz), which has less caffeine and sugar.

If you're traveling or ordering from a Starbucks in another country, check the local nutrition information online or ask your barista for details. The NHS (UK) and ACOG (U.S.) both recommend limiting caffeine to 200 mg per day and added sugars to 25 g per day, so keep these guidelines in mind no matter where you are.

Can Starbucks Caramel Macchiato cause pregnancy complications such as gestational diabetes?

While an occasional Starbucks Caramel Macchiato is unlikely to cause gestational diabetes, regular high sugar intake can increase your risk. Gestational diabetes is a type of diabetes that develops during pregnancy and affects how your cells use sugar (glucose). It can lead to complications like larger babies, preterm birth, and an increased risk of type 2 diabetes later in life.

Here's how the sugar in a Caramel Macchiato could contribute to gestational diabetes:

• Insulin resistance: Pregnancy hormones can make your body more resistant to insulin, the hormone that helps regulate blood sugar. High sugar intake can worsen this resistance, leading to higher blood sugar levels.
• Excessive weight gain: Gaining too much weight during pregnancy can increase the risk of gestational diabetes. A Grande Caramel Macchiato has 250 calories and 33 g of sugar—if you're drinking one daily, those calories can add up quickly.
• Inflammation: Some research suggests that high sugar intake may increase inflammation in the body, which is linked to insulin resistance and gestational diabetes.

A 2018 study in Diabetes Care found that women who consumed more sugar-sweetened beverages during pregnancy were more likely to develop gestational diabetes. The risk was highest for women who drank one or more servings per day. However, the study noted that other factors (like pre-pregnancy BMI and family history) played a larger role in gestational diabetes risk.

If you're at high risk for gestational diabetes (e.g., you have a family history, are overweight, or had gestational diabetes in a previous pregnancy), your provider may advise limiting sugary drinks like Caramel Macchiatos. You can still enjoy the drink occasionally by customizing it to reduce sugar—ask for fewer pumps of vanilla syrup, skip the caramel drizzle, or opt for sugar-free syrup.

If you're diagnosed with gestational diabetes, you'll need to monitor your blood sugar closely and may need to cut out sugary drinks entirely. Your provider or a registered dietitian can help you create a meal plan that keeps your blood sugar in check.

Is Starbucks Caramel Macchiato safe for pregnant women with hypertension?

If you have hypertension (high blood pressure) or preeclampsia during pregnancy, you may need to be more cautious with caffeine and sugar. Here's what you need to know:

Caffeine and hypertension

Caffeine can cause a temporary increase in blood pressure, which may be a concern if you already have hypertension. However, the effect is usually small and short-lived. The American Heart Association (AHA) states that moderate caffeine intake (up to 200 mg per day) is unlikely to cause long-term blood pressure problems for most people. However, if you're sensitive to caffeine or have uncontrolled hypertension, your provider may advise limiting or avoiding it.

A Grande Caramel Macchiato has 150 mg of caffeine, which could temporarily raise your blood pressure. If you have hypertension, consider opting for a smaller size (Tall, 75 mg caffeine) or a decaf version (15 mg caffeine).

Sugar and hypertension

High sugar intake is linked to inflammation and weight gain, both of which can worsen hypertension. A Grande Caramel Macchiato has 33 g of sugar, which is more than the AHA's recommended daily limit of 25 g for women. If you have hypertension, it's best to limit sugary drinks and opt for lower-sugar alternatives.

Preeclampsia

Preeclampsia is a serious pregnancy complication characterized by high blood pressure and damage to organs like the liver and kidneys. It usually develops after 20 weeks of pregnancy and can lead to complications like preterm birth, placental abruption, and seizures (eclampsia).

While caffeine and sugar don't cause preeclampsia, they can worsen its symptoms. If you have preeclampsia, your provider will likely advise limiting caffeine and added sugars to help manage your blood pressure. You may need to avoid Caramel Macchiatos entirely or opt for a decaf, sugar-free version.

If you have hypertension or preeclampsia, talk to your provider about whether a Caramel Macchiato is safe for you. They can help you create a plan to manage your blood pressure and keep you and your baby healthy.

Side effects and risks

While an occasional Starbucks Caramel Macchiato is unlikely to cause harm, regular consumption can lead to some side effects and risks during pregnancy. Here's what to watch for:

Caffeine-related side effects

• Jitters or anxiety: Caffeine is a stimulant that can make you feel jittery or anxious, especially if you're sensitive to it. If you notice these symptoms, consider cutting back or switching to decaf.
• Insomnia: Caffeine can interfere with sleep, which is already a challenge for many pregnant women. Avoid drinking Caramel Macchiatos in the afternoon or evening to minimize sleep disruption.
• Increased heart rate: Caffeine can temporarily raise your heart rate, which may feel uncomfortable if you're already experiencing pregnancy-related palpitations.
• Dehydration: Caffeine is a mild diuretic, which means it can increase urine output and contribute to dehydration. Make sure to drink plenty of water alongside your Caramel Macchiato.
• Heartburn: Caffeine can relax the lower esophageal sphincter, worsening acid reflux. If you're prone to heartburn, you may want to skip the Caramel Macchiato or opt for a smaller size.

Sugar-related side effects

• Blood sugar spikes: The high sugar content in a Caramel Macchiato can cause your blood sugar to spike and then crash, leaving you feeling tired or irritable. Pair your drink with a protein-rich snack to help stabilize blood sugar.
• Increased thirst: High sugar intake can make you feel thirstier, which may lead to drinking more sugary beverages. Stick to water or unsweetened drinks to stay hydrated.
• Weight gain: Regular high sugar intake can contribute to excessive weight gain during pregnancy, which is linked to complications like gestational diabetes and preeclampsia.
• Gestational diabetes: As mentioned earlier, high sugar intake can increase your risk of developing gestational diabetes. If you're at high risk, your provider may advise limiting sugary drinks.

Other risks

• Dairy sensitivity: If you're lactose intolerant or sensitive to dairy, the milk in a Caramel Macchiato could cause bloating, gas, or diarrhea. Opt for almond milk or another dairy-free alternative.
• Artificial ingredients: Some pregnant women prefer to avoid artificial flavors or sweeteners. The vanilla syrup in a Caramel Macchiato contains natural and artificial flavors, while the caramel drizzle contains artificial colors. If you're concerned, ask your barista for details or opt for a drink with fewer additives.

If you experience any of these side effects, consider cutting back on Caramel Macchiatos or switching to a lower-caffeine, lower-sugar alternative. Always talk to your provider if you have concerns about your symptoms.

Safer alternatives to Starbucks Caramel Macchiato during pregnancy

If you're looking to cut back on caffeine or sugar, or just want a change of pace, here are some safer alternatives to Starbucks Caramel Macchiato that you can enjoy during pregnancy:

• Decaf vanilla latte: Made with decaf espresso and steamed milk, this drink has all the creamy, vanilla flavor of a Caramel Macchiato without the caffeine. Ask for fewer pumps of vanilla syrup to reduce sugar, or opt for sugar-free syrup if you prefer.
• Hot chocolate (non-caffeinated): A cozy, chocolatey treat with no caffeine. Ask for it made with water or almond milk to reduce calories, and skip the whipped cream to keep it lighter. Note that hot chocolate still contains sugar, so enjoy it in moderation.
• Herbal caffeine-free tea: Starbucks offers several caffeine-free herbal teas, like Mint Majesty (peppermint) or Passion Tango (hibiscus, lemongrass, and apple). These are naturally sweet and refreshing, with no caffeine or added sugar. Add a splash of coconut milk for creaminess.
• Almond milk latte (decaf): Almond milk is lower in sugar and calories than 2% milk, making it a great option for pregnant women. Ask for decaf espresso and a shot of sugar-free vanilla syrup for extra flavor.
• Iced green tea (unsweetened): If you're craving something cold, iced green tea is a refreshing option with about 25 mg of caffeine per 16 oz. Ask for it unsweetened to avoid added sugar, and add a splash of lemonade or coconut milk for flavor.
• Fruit smoothie with no added sugar: Starbucks offers several smoothies made with real fruit and no added sugar, like the Strawberry Banana or Mango Carrot. These are packed with vitamins and fiber, making them a nutritious choice. Pair it with a protein box for a balanced snack.
• Steamed milk with honey: A simple, comforting drink made with steamed milk and a drizzle of honey. It's naturally sweet, caffeine-free, and easy to customize with flavors like cinnamon or vanilla.
• Caffeine-free chai latte: Made with decaf chai concentrate and steamed milk, this drink has all the spicy, warming flavors of chai without the caffeine. Ask for fewer pumps of chai to reduce sugar, or opt for almond milk to cut calories.

If you're not sure what to order, ask your barista for help. They can suggest lower-caffeine or sugar-free options based on your preferences. You can also check the Starbucks nutrition calculator online to compare drinks before you order.

Related drinks: Safety at a glance

If you're wondering how other popular Starbucks drinks compare to the Caramel Macchiato in terms of pregnancy safety, here's a quick reference table:

Pregnancy safety of popular Starbucks drinks

Drink	Verdict	Notes
Starbucks Pumpkin Spice Latte	⚠️ Safe with limits	Similar caffeine content to Caramel Macchiato, but higher in sugar (38 g in a Grande). Ask for fewer pumps of syrup to reduce sugar.
Starbucks Latte	✅ Generally safe	Lower in sugar than Caramel Macchiato (18 g in a Grande), but same caffeine content. Opt for unsweetened or sugar-free syrup.
Starbucks Mocha	⚠️ Safe with limits	Higher in sugar (33 g in a Grande) and caffeine (175 mg Editor's pick for this topic Prenatal pick Ritual — Ritual Essential Prenatal Choline + DHA + folate from methylfolate (not synthetic). $39Check prenatal → Prenatal pick Nordic Naturals — Nordic Naturals Prenatal DHA (Strawberry Softgels) Premium fish-oil DHA in strawberry softgels — gentle on the stomach. $55Check prenatal → Not sure about the label on Is Starbucks Caramel Macchiato Safe During Pregnancy products? Snap the ingredients list and SafeFilter checks every ingredient for your stage — only 3 free scans this month, then you're locked until reset. Unlimited from $7/mo or $50/yr. Use a free scan See $7 / $50 plans Informational only — not medical advice. About the Author When Shubhra Mishra was expecting her first child in 2016, she was overwhelmed by conflicting food advice — one site said yes, another said never. By the time her second baby arrived in 2019, she realized millions of mothers face the same confusion. That sparked a five-year journey through clinical nutrition papers, cultural diets, and expert conversations — all leading to BumpBites: a calm, compassionate space where science meets everyday motherhood. Her long-term vision is to build a global community ensuring safe, supported, and free deliveriesfor every mother — because no woman should face pregnancy alone or uninformed. 🌿 🌍 Stand with mothers, shape safer guidance Join a small circle of experts who review BumpBites articles so expecting parents everywhere can decide with confidence. Apply via web formoremail contact@bumpbites.health ⚠️ Always consult your doctor for medical advice. This content is informational only. Long-form pregnancy guides Hand-curated deep-dive guides — go beyond the article above. Complete Pregnancy Nutrition Master GuideTrimester-by-trimester pregnancy nutrition — the orchestrating hub. Foods to Avoid in PregnancyThe full pregnancy food-avoidance list with the science behind each. First Trimester Survival GuideEating through nausea, fatigue + aversions in T1. More Pregnancy guides Is Starbucks cold brew safe during pregnancy? Find out now Is Starbucks Frappuccino Safe During Pregnancy? What Experts Say Is Starbucks Nitro Cold Brew Safe During Pregnancy? Find Out Is Starbucks Pink Drink Safe During Pregnancy? Find Out Is Starbucks Pumpkin Spice Latte Safe During Pregnancy? What Experts Say Is Starbucks Refreshers Safe During Pregnancy? Expert Guide Is Starburst Safe During Pregnancy? What You Need to Know Is Steak Safe During Pregnancy? A Guide to Doneness & Risks Is Stevia Safe for Pregnancy? What Experts Say About Dosage and Risks is stool softener docusate safe during pregnancy See all Pregnancy guides → ⬆️ Back to Top Recommended picks Prenatal pick Ritual — Ritual Essential Prenatal Choline + DHA + folate from methylfolate (not synthetic). $39Check prenatal → Prenatal pick Nordic Naturals — Nordic Naturals Prenatal DHA (Strawberry Softgels) Premium fish-oil DHA in strawberry softgels — gentle on the stomach. $55Check prenatal →