Popularly used for everything from morning sickness and restless legs at night to mocktails, tonic water is seltzer’s more flavorful cousin. Though the drink has been credited with alleviating many common pregnancy symptoms, there’s more than meets the eye when it comes to safety- especially during pregnancy.
Bubbly tonic water may sound refreshing, especially as a replacement for traditionally boozy beverages or if dealing with symptoms of morning sickness. But, because the drink contains quinine, which can be harmful to the baby, tonic water should be avoided while pregnant.
Though tonic water is not considered to be a safe drink during pregnancy, there are alternatives that offer similar flavors and possible benefits. Quinine-free tonic water is also available in some regions, and has a slightly different safety profile.
I’ll break down the research behind the recommendation to avoid tonic water and give you some suggestions for pregnancy-safe alternatives.
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Is Tonic Water Safe for Pregnant Women?
Crafting mocktails as part of a fun night out or just to get a break from drinking plain water makes the 9 (or more) months of abstaining from alcohol more fun for many expecting mothers. Tonic water is one of the most popular ingredients in both alcoholic and virgin mixed drinks.
The main safety consideration with tonic water has to do with one of its ingredients: quinine. I’ll take a deeper look into the safety of quinine, specifically, below.
Unlike many other popular drinks, there is not much in the way of official government health organization recommendations on the safety of tonic water during pregnancy.
One organization that has taken an official stance is the German Federal Institute for Risk Assessment, part of their Federal Ministry for Food and Agriculture (akin to the FDA in the US).
According to their experts, tonic water should be avoided during pregnancy, due to reports of the baby experiencing withdrawal symptoms after birth from the quinine in the water (source: BfR).
An added consideration is that tonic water is actually sweetened! While many folks assume that tonic water is unsweet, much like its cousin club soda, a 12-ounce bottle typically includes between 25-35 grams of added sugar. This is only slightly less sweetener than an equally-sized cola, which has around 40 grams of added sugar.
Drinking 4-5 servings of soda and other sugar-sweetened beverages daily was found to carry higher risk of pregnancy complications, including pre-eclampsia, low-birth weight, and preterm birth (source: Proceedings of the Nutrition Society).
While the negative effects of quinine-containing tonic water are thought to be associated more so with drinking large amounts of tonic water on a regular basis, it’s best to remain on the safe side and avoid tonic water while pregnant (source: BfR).
For tonic water lovers in Scotland, the local brand Cushiedoos offers a quinine-free tonic drink. Other international brands, including Schweppes, Canada Dry, and Fever-Tree all do contain quinine and should be reserved until after pregnancy.
Occasionally, women turn to tonic water due to its thirst-quenching combination of carbonation and slight bitter taste. While quinine-containing tonic water isn’t safe during pregnancy, there are also other alternatives such as plain sparkling water/club soda. If you’re after the bitter taste, look for lemon, lime, or grapefruit flavored bubbly drinks.
For more information on safe alternatives to tonic water, check out our articles covering soda and 10 Drinks to Enjoy Besides Water
Does Tonic Water Help With Restless Leg or Cramps in Pregnancy?
Experiencing restless legs and/or leg cramps at night while pregnant is common, albeit not beneficial for restful sleep. Tonic water is sometimes advised as a home remedy for these symptoms, mainly due to the quinine in the water.
Quinine is effective in decreasing nerve activity, therefore calming your legs and any cramps (source: Canadian Medical Association Journal).
When it comes to treating leg cramping or restlessness, the dosage of quinine required is quite high, much over 2-3 times that of tonic water and so any actual benefit from drinking tonic water is questionable at best.
While quinine was shown to be effective in treating these types of complaints, the FDA warns that the benefits do not outweigh the risks.
Not only is tonic water advised against during pregnancy due to quinine as one of its ingredients, but quinine itself has been deemed an unsafe treatment for nighttime leg woes after leading to nausea, low blood pressures, vision loss, altered heart rhythm, and even blood disorders, to name a few (source: Canadian Medical Association Journal).
Can Tonic Water Help With Morning Sickness?
Much like other fizzy drinks, such as ginger ale or white sodas, many pregnant women turn to tonic water in order to settle their stomachs when morning sickness strikes.
Likely, the relief felt after drinking tonic water is not specific to the drink, but rather due to the carbonation. Carbonation decreases stomach acidity, which can make more of an impact on nausea than plain water alone (source: Wall Street Journal).
Ultimately, as tonic water should be avoided during pregnancy, it’s best to stick to other methods to calm your nausea. Check out our dedicated article on nausea-fighting foods for safer alternatives.
Is Quinine Safe When Pregnant?
Quinine is a bitter liquid that is made from bark of the cinchona tree (source: PubChem). The liquid is an ingredient in two popular drinks, tonic water and bitter lemon, and contributes the classic bitter taste to both beverages.
Due to the risk of harm for your unborn child, quinine-containing beverages should be avoided during pregnancy (source: BfR).
Though we typically think of quinine as a food ingredient, it is traditionally a medicine that has long been used as a treatment for malaria (source: PubChem, Michigan Medicine).
Quinine is classified by the FDA as a Category C medication, and so it is only provided in certain circumstances and under the careful direction of medical providers (source: CHEMM, Michigan Medicine).
Quinine tablets are also available as an over-the-counter solution to leg cramps. This use is not FDA approved and should be avoided- especially while pregnant (source: Cleveland Clinic).
Overall, tonic water, along with other quinine-containing beverages such as bitter lemon, should be avoided during pregnancy. The ingredient quinine is known to be unsafe during this time and can possibly lead to withdrawal symptoms for the baby after birth.
While the drink is rumored to alleviate morning sickness and restless legs, any possible benefits aren’t worth the risk. Plain or flavored sparkling waters are a much safer alternative, with a similarly fizzy flavor.
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