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Home > Is This Safe When Breastfeeding? > Lifestyle Choices Breastfeeding and CaffeineBy Kelly Bonyata, IBCLC
IntroductionMost breastfeeding mothers can drink caffeine in moderation. Some babies, particularly those under 6 months, may be more sensitive to mom's caffeine intake. Babies whose mothers avoided caffeine completely during pregnancy seem to react more to caffeine in mom's diet. Even if baby is sensitive to the caffeine now, he may not be when he's a little older -- so if you do have to stop or limit your caffeine intake, you can try again when baby is older. Caffeine is approved by the American Academy of Pediatrics for use in breastfeeding mothers. Per Medications and Mother's Milk (Hale 2002, p. 100-102) caffeine is in Lactation Risk Category L2 (safer); milk levels are quite low (0.06-1.5% of maternal dose) and usually peak 1 hour after ingestion. One study has indicated that chronic coffee drinking might decrease iron content of breastmilk (Nehlig & Debry, 1994). If your baby is sensitive to caffeine, it will typically become less of an issue as baby gets older. Newborns have a much harder time metabolizing caffeine than older infants. Preterm or ill infants might also have more problems with mom's caffeine intake.
Is baby sensitive to my caffeine intake?According to the Breastfeeding Answer Book (LLLI 2003, p. 599-600), excessive caffeine consumption by the mother (more than 750 mL per day) can result in a baby who shows signs of caffeine stimulation. "A baby who is being overstimulated by caffeine is a wide-eyed, active, alert baby who doesn't sleep for long. He may also be unusually fussy." If your baby seems particularly wakeful or fussy and there is a significant amount of caffeine in your diet, you might want to cut back or stop the caffeine for 2-3 weeks to see if it makes a difference. If you cut out caffeine, consider decreasing it slowly since abruptly stopping caffeine can result in headaches or other symptoms. If caffeine stimulation is a problem for baby, it may take a few days to a week after mom eliminates caffeine for baby to become less fussy.
Does caffeine decrease milk supply?There is no evidence that caffeine decreases milk supply. The myth that caffeine will decrease milk supply is widespread. Many moms consume caffeine, and it ought to be easy to document any adverse effects of caffeine on milk supply. No such effect has been observed, however, despite a number of studies of caffeine intake in breastfeeding mothers and years of clinical observations. In fact, one study (Nehlig & Debry, 1994) indicates that caffeine can stimulate milk production. A baby who is fussy and jittery from caffeine stimulation may not nurse well, however, which could lead to a decreased milk supply over time (due to decreased nursing, rather than the mother's caffeine intake).
Caffeine SourcesCaffeine can be found in coffee, tea, soft drinks, sports/energy drinks (including the "sports water" products), some over-the-counter and prescription medications, and foods containing coffee or chocolate. Herbal products containing guarana/paullinea cupana, kola nut/cola nitida, yerba maté, or green tea also contain caffeine. Following is information on caffeine content of various foods.
How much caffeine is too much?Watching your baby is the only way to get an individual answer to this question. As stated above, the amount of caffeine that might affect baby will vary widely depending upon the specific baby and the baby's age and health. The estimate we often hear is "less than five 5-oz cups of coffee" or 500 mg/day. Various sources suggest an upper limit for caffeine intake ranging from 300-750 mg/day. During pregnancy: Most sources suggest a 300 mg/day upper limit on caffeine for pregnant moms. However, one source (Motherisk) recommends an upper of limit 150 mg caffeine per day during pregnancy. The table below shows various suggested upper limits for caffeine in terms of amounts of coffee, tea, soda, etc.
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03/05/2005
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ReferencesNawrot P, et al. Effects of caffeine on human health. Food Addit Contam. 2003 Jan;20(1):1-30. This review article suggest that reproductive-aged women should limit thei caffeine intake to no more than 300 mg per day. Koren G. Caffeine during pregnancy? In moderation. Can Fam Physician. 2000 Apr;46(4):801-3. Nehlig A, Debry G. Consequences on the newborn of chronic maternal consumption of coffee during gestation and lactation: a review. J Am Coll Nutr. 1994 Feb;13(1):6-21. "We conclude in this review that maternal caffeine consumption in moderate amounts during gestation and lactation has no measurable consequences on the fetus and newborn infant. Pregnant mothers, however, should be advised to consume coffee and caffeinated beverages in moderation [300 mg caffeine/day], especially because of the prolonged half-life of caffeine both during the last trimester of pregnancy and in the newborn infant." Stavchansky S, Combs A, Sagraves R, Delgado M, Joshi A. Pharmacokinetics of caffeine in breast milk and plasma after single oral administration of caffeine to lactating mothers. Biopharm Drug Dispos. 1988 May-Jun;9(3):285-99. Ryu JE. Effect of maternal caffeine consumption on heart rate and sleep time of breast-fed infants. Dev Pharmacol Ther. 1985;8(6):355-63. This small study showed no significant changes in breastfed baby's heart rates and sleep time when the mothers ingested 500 mg/day of caffeine. This is the "5 cups of coffee" study. Berlin CM Jr, Denson HM, Daniel CH, Ward RM. Disposition of dietary caffeine in milk, saliva, and plasma of lactating women. Pediatrics. 1984 Jan;73(1):59-63. Hildebrandt R, Gundert-Remy U. Lack of pharmacological active saliva levels of caffeine in breast-fed infants. Pediatr Pharmacol (New York). 1983;3(3-4):237-44. Tyrala EE, Dodson WE. Caffeine secretion into breast milk. Arch Dis Child. 1979 Oct;54(10):787-800.
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