Is Caffeine safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Caffeine. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
Jitteriness in a 6-week-old breastfed infant reported by a mother who claimed to drink 4 to 5 cups of coffee and 2 to 3 bottles (about 480 mL each) of cola daily as well as occasional tea and cocoa. Upon examination, the infant was gaining weight appropriately, but had trembling and increased muscle tone. The infant's symptoms decreased markedly 2 weeks after his mother stopped all caffeine-containing beverages.[ 23 ] Restlessness and irritability were reported in a breastfed (extent not stated) 5-month-old infant whose mother drank 20 cups of coffee a day.[ 15 ] A physician who reported drinking at least 5 mugs of coffee, 4 mugs of tea and 1 can of cola daily breastfed 2 infants. The first slept for only brief periods and woke up easily. The second baby was fretful and jumpy and also had poor sleep patterns until his mother stopped her caffeine intake.[ 24 ] Another physician who reportedly drank 1.7 to 2 liters of decaffeinated coffee daily had premature twins (age and extent of nursing not stated) who both seemed to be irritable, although the larger infant was partially supplemented with formula and seemed less affected. When her coffee consumption increased further, the smaller infant suffered convulsive-like episodes. All symptoms resolved 24 hours after coffee consumption ceased.[ 25 ] Parents of a 24-day old infant reported restlessness and irritability in their breastfed infant whose mother reported drinking about 0.5 liters of mate every other day.[ 26 ] Eleven nursing mothers randomly consumed 5 cups of decaffeinated coffee or 5 cups of decaffeinated coffee with 500 mg of added caffeine daily for 5 days in a randomized, double- blinded study. Their infants averaged 47 days (range 22 to 71 days) of age; the extent of nursing was not reported. At the end of each 5-day period, no effects of caffeine on sleep time and heart rate were found.[ 3 ] A cohort study of mothers' caffeine intake and its effect on nighttime awakening asked mothers to provide their caff
Effects on milk supply
Relevant published information was not found as of the revision date.
Levels in milk
The half-life of caffeine in late pregnancy is much longer than in nonpregnant women; however, the maternal half-life returns to normal within the first week postpartum.[ 10 ] Smokers have more rapid clearance of caffeine and shorter half-lives than nonsmokers because smoking induces CYP1A2. Caffeine clearance is very low in preterm and newborn infants, but reaches adult values by 3 to 5 months of age.[ 6 ] Maternal Levels. Caffeine appears in breastmilk with a peak usually occurring about 1 hour after a dose.[ 11 - 13 ] Most studies did not measure active metabolites in milk. Five women who were 4 months to 1 year postpartum were given a dose of 150 mg of caffeine orally as caffeine sodium benzoate solution 2 hours after breakfast. Average caffeine levels at 30, 60 and 120 minutes after the dose were 1.6, 1.5, and 0.9 mg/L, respectively. One woman also received a 300 mg dose on a separate occasion and her milk caffeine levels were about double those after her 150 mg dose.[ 14 ] Two nursing mothers who were 7 and 13 weeks postpartum ingested tablets containing a total of 128 mg of caffeine. Milk samples were taken over 12 and 48 hours in the 2 women, respectively. Peak milk levels of 1.3 and 1.6 mg/L occurred at 1.5 and 2 hours, respectively.[ 12 ] A mother who drank 3 cups of coffee over a 1-hour period and then coffee at will throughout the day had milk caffeine concentrations ranging from 0.32 to 1.15 mg/L in 8 milk samples taken over a 10.5 hour period.[ 15 ] Fifteen women ingested a caffeine-containing beverage of their choice (coffee or tea) containing caffeine in amounts ranging from 35 to 336 mg. Their breastfed infants ranged from 2 weeks to 9 months of age. Eleven of the women had caffeine detectable in their breastmilk with peak levels ranging from 2.1 to 7.2 mg/L. The 4 mothers with undetectable caffeine ( 0.2 mg/L) had ingested less than 100 mg of caffeine. The mean half-life of caffeine in milk was 6.1 hours.[ 11 ] Nine nursing mothers ingested 750 mg
Source: NIH LactMed (National Library of Medicine).
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.