Thursday, August 27, 2015

Your baby, on caffeine

New moms wonder whether caffeine's OK when they're nursing. The advice they get is all over the map. Expert and breastfeeding advocate Ruth Lawrence, M.D., offers some wisdom.

Your baby, on caffeine

Babies don’t metabolize caffeine the way you do. Soft drinks, coffee and tea, chocolate - they are all contributors. <br />(AP Photo/Pat Roque)
Babies don’t metabolize caffeine the way you do. Soft drinks, coffee and tea, chocolate - they are all contributors. (AP Photo/Pat Roque) (AP Photo/Pat Roque)

I caffeinated my baby. It happened one Monday night, after I’d worked very late at my magazine job and eaten a lot of chocolate cake left in the office fridge (there was nothing else for dinner!). I came home, nursed my daughter … and we were up til 4 a.m. I don’t know who was more irritated and cranky. But I added “large amounts of chocolate” to the list of foods and beverages I avoided during my breastfeeding time.

I thought about that long night in the rocking chair recently while reading an interview about caffeine and breastfeeding in the Journal of Caffeine Research. New moms wonder whether caffeine’s OK when they're nursing – how much ends up in breast milk, anyway? The advice they get is all over the map. Some experts say up to three cups of coffee a day may be OK, others caution that less is better.

Expert and breastfeeding advocate Ruth Lawrence, M.D., a professor of pediatrics, obstetrics and gynecology at the University of Rochester, is a voice of reason who cuts through the craziness. In her interview, she advises new moms to “consume all things in moderation and try to avoid the excesses that might really add up to a lot of caffeine." Translation: A little’s OK – but be smart and watch your baby’s reaction. What you should know:

  • Babies don’t metabolize caffeine the way you do. Dr. Lawrence notes that a baby’s body develops the ability to break down caffeine during the first year of life. Until then, it may take several days to metabolize the caffeine. (Your body gets rid of half of it in just five hours.) That means small amounts can add up to a big dose in a baby.
  • Caffeine’s biggest danger for babies: Wakefulness and irritability. And when they’re not sleeping, neither are you. Worries about bigger problems seem unfounded. In fact, some premature babies get a jolt of caffeine in the ICU to help protect against cerebral palsy – with no apparent downsides when kids’ intelligence was tested five years later in one study.
  • It takes 40 minutes to 2 hours for caffeine to show up in breast milk. But coffee (at 115 milligrams per 5-ounce cup) and black tea (about 75 mg) aren’t the only sources. Others include dark chocolate (31 mg in 1.5 ounces), iced tea, some sodas — Mountain Dew (54 mg in 12 ounces), orange soda (31 mg), root beer (22 mg in 12 ounces), coffee ice cream (58-84 mg. per cup) — and over-the-counter migraine pain relievers (130 mg in two tablets). It all adds up.

What do you think? Do you avoid caffeine if you’re nursing, or try to work in a cup of coffee or tea once in a while?

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Anna Nguyen Healthy Kids blog Editor
Sarah Levin Allen, Ph.D., CBIS Assistant Professor of Psychology at Philadelphia College of Osteopathic Medicine
Stephen Aronoff, M.D., M.B.A. Chair of the Department of Pediatrics at Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist of The Anxiety Behaviors Clinic at Children's Hospital of Philadelphia
Gary A. Emmett, M.D., F.A.A.P Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Magee DeFelice, M.D. Division Chief of Allergy and Immunology at Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Chief of Pediatric Emergency Services at Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Adolescent Medicine Specialist at Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Registered Dietitian at Children's Hospital of Philadelphia
Emiliano Tatar, M.D. Pediatrician at Einstein Healthcare Network Roxborough Plaza
Jeanette Trella, Pharm.D Managing Director at The Poison Control Center at CHOP
W. Douglas Tynan, Ph.D., ABPP Director of Integrated Health Care for American Psychological Association
Flaura Koplin Winston, M.D., Ph.D. Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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