By Nicole Peluso, IBCLC
Safety
Breastfeeding is one of the only areas of health where healthcare providers have to look at a dyad – you and your baby. Either you or your baby could have different reactions to a substance, so it’s important to consider both of you when assessing safety.
In general, for most people, caffeine is a safe substance, but either you or your baby could have difficulty tolerating it.1 After birth, some mothers find that they have different tolerances to foods and substances than they had pre-pregnancy. You should observe your baby’s and your own behavior and sleep patterns to find clues as to whether or not you or your baby is struggling. Agitation, crankiness, difficulty falling asleep or staying asleep,2 and a change in stool consistency or stooling patterns are common side effects that you might see in your baby or even yourself. Some caffeine side effects would be more difficult for you to observe in your baby such as heart arrhythmias.
The more caffeine, the more pronounced sensitivities to it might be, so it is generally best to stay away from heavily caffeinated or “turbo” energy drinks.3
While caffeine is generally safe2, and pumping and dumping is not recommended, as with any unnecessary drug, cutting caffeine out or decreasing your intake is preferable. Similarly, opting to only drink coffee and other caffeinated beverages in the morning (before noon) will give both you and your baby the best chance of getting restful nighttime sleep.
Recommended Quantities
There is no recommended quantity of coffee that all mothers should drink while breastfeeding as it does not enhance the breastfeeding relationship. However, you wouldn’t want to consume more than 200-300 mg of caffeine per day which is about 2-3 cups of coffee 1 16-oz. energy drink, 8 12-oz cans of soda and 6 8-oz. cups of tea.4
Caffeine does pass into breastmilk at .06% – 1.5% of the maternal dose.3
The younger the baby, the longer it takes the baby to metabolize the caffeine.5 If caffeine must be consumed, you should do so after a feeding to allow it to get as far from the next feeding as possible.
Cutting Back
Caffeine can stay in the body for up to 10 hours. Additionally, each person has a personal sensitivity factor to caffeine, which is thought to be genetic. Caffeine peaks at 1 hour in the blood and 1-2 hours in breastmilk. One risk factor while breastfeeding is that caffeine tends to accumulate in the babies’ plasma in the neonatal period, so even if it peaks in the milk at 1-2 hours, it will accumulate in the baby’s blood with each feeding.3 There are also some reports of reduced iron content in milk due to chronic caffeine intake which can lower hemoglobin and hematocrit levels causing iron-deficiency anemia.2 These are all great reasons for you as a mother to cut back on your caffeine intake.
If you are the type of coffee drinker that uses caffeine to fully wake up in the morning, cutting out coffee might seem impossible. Adding the needs of your baby to your life can compound the challenge. Remembering to sleep while your baby sleeps in those early weeks can provide enough rest to you if you prioritize rest and not the crutch of coffee. Also, some mothers will often use this new season of baby to adjust their own health behaviors that they have been wanting to modify but never found the time to do. Having a baby can be The Great Reset you never expected. Cutting out coffee when your baby arrives can be the perfect time to try!
To reduce intake, you should start slowly so as not to induce withdrawal symptoms if you have been chronically ingesting caffeine.6 Reducing consumption in small quantities every 2-3 days until you have reached a desired level of caffeine intake for you and your baby would be better than quitting cold turkey. The best place to look for caffeine content is the food label. Here is a comprehensive list of amounts of caffeine in different beverages and foods: https://www.cspinet.org/caffeine-chart.
References:
- Can Consuming Caffeine While Breastfeeding Harm Your Baby? An Interview with Ruth Lawrence, PhD. (2011). Journal of Caffeine Research, 1(4), 192–194. https://doi.org/10.1089/jcr.2011.1212
- National Institute of Child Health and Human Development. (2022, June 20). Caffeine. Drugs and Lactation Database (LactMed®) – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK501467/
- Infant Risk Center-Texas Tech University, Hecox, E., Garner, C., & Krutsch, K. (2021). Breastfeeding, Caffeine, and Energy Drinks | InfantRisk Center. infantrisk.com. Retrieved May 18, 2023, from https://infantrisk.com/content/breastfeeding-caffeine-energy-drinks
- Diet considerations for breastfeeding mothers. (2023, April 17). Centers for Disease Control and Prevention. https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/diet-and-micronutrients/maternal-diet.html
- Nehlig, A. (2018). Interindividual Differences in Caffeine Metabolism and Factors Driving Caffeine Consumption. Pharmacological Reviews, 70(2), 384–411. https://doi.org/10.1124/pr.117.014407
- Food and Drug Administration: Office of the Commissioner. (2018). Spilling the Beans: How Much Caffeine is Too Much? U.S. Food And Drug https://www.fda.gov/consumers/consumer-updates/spilling-beans-how-much-caffeine-too-much
- Caffeine chart. (2022, August 31). Center for Science in the Public Interest. https://www.cspinet.org/caffeine-chart
