Can I drink coffee and breastfeed?

YES, YOU CAN DRINK COFFEE & BREASTFEED

PSA you’re too tired to read this blogpost and desperate for a cup of coffee, you can watch this video:

As a NICU Nurse and IBCLC, I've noticed a gap between current literature on maternal caffeine intake and the guidelines we follow within the NICU for premature infants. This confusion arises from cautionary language regarding caffeine's potential impact on baby sleep (insomnia?!) and irritable behaviour.  I would like to challenge this perspective…

Lets break it down:

• Caffeine is indeed transferred into breast milk, but in MINIMAL amounts. 

Comparing doses:

• I've directly compared the dose of 125mg of caffeine from a cup of coffee to what we administer intravenously to premature infants in the NICU.

• 125mg caffeine from coffee = approx 0.4mg caffeine transfer in 100ml of breast milk.

• Target dose for a neonate of approx 2.5kg = 25mg, with daily administration thereafter.

Benefits of Caffeine for premature infants:

The findings from the Caffeine for Apnoea and Prematurity Study (CAP) with >2000 premature infants showed numerous neuroprotective positive effects of caffeine administration:

• Prevents apnoea of prematurity, improving oxygenation and ventilation.

• Reduces the incidence of cerebral palsy and motor impairment.

• Reduced cognitive delay

• - Facilitates early extubation for ventilated infants.

•  It was also found that caffeine has a wide therpautic window, minimising side effects for premature infants!

 Safety and Guidelines:

• The American Academy of Pediatrics suggests up to 300mg is safe for breastfeeding parents.

• One study showed up to 5 cups of coffee a day wasnt associated with changes in infant behaviour.

• Chronic coffee drinking (10-20 cups): Reports of fussiness and poor sleep patterns in infants. (This is a large amount of caffeine and was also consumed alongside softdrink!)

  Point of the story!

• If you’re desperate for a cup of coffee, please enjoy one

• Your coffee intake is not likely to impact on your baby’s sleep (though it may impact on your sleep if you consume it late in the day!)

Feel free to share your thoughts or let me know if you'd like more information! 🌟

If you’re struggling with your baby’s sleep, colic, irritable behaviour or feeding – please contact me for personalised advice.

References

1. American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. *Pediatrics, 108*, 776.

2. McCreedy A, Bird S, Brown LJ, et al. Effects of maternal caffeine consumption on the breastfed child: A systematic review. *Swiss Med Wkly 2018;148:w14665*. [PubMed]

3. Santos IS, Matijasevich A, Domingues MR. Maternal caffeine consumption and infant nighttime waking: prospective cohort study. *Pediatrics 2012;129:860-8*. [PMC free article] [PubMed]

4. Schmidt B, Anderson PJ, Doyle LW, et al. Survival without disability to age 5 years after neonatal caffeine therapy for apnea of prematurity. *JAMA 2012; 307:275*.

5. Doyle LW, Ranganathan S, Cheong JLY. Neonatal Caffeine Treatment and Respiratory Function at 11 Years in Children under 1,251 g at Birth. *Am J Respir Crit Care Med 2017; 196:1318*.

6. Amaro CM, Bello JA, Jain D, et al. Early Caffeine and Weaning from Mechanical Ventilation in Preterm Infants: A Randomized, Placebo-Controlled Trial. *J Pediatr 2018; 196:52*.

7. Dobson NR, Patel RM, Smith PB, et al. Trends in caffeine use and association between clinical outcomes and timing of therapy in very low birth weight infants. *J Pediatr 2014; 164:992*.

8. Supcun S, Kutz P, Pielemeier W, Roll C. Caffeine increases cerebral cortical activity in preterm infants. *J Pediatr 2010; 156:490*.

9. Bauer J, Maier K, Linderkamp O, Hentschel R. Effect of caffeine on oxygen consumption and metabolic rate in very low birth weight infants with idiopathic apnea. *Pediatrics 2001; 107:660*.

10. Schmidt B, Roberts RS, Anderson PJ, et al. Academic Performance, Motor Function, and Behavior 11 Years After Neonatal Caffeine Citrate Therapy for Apnea of Prematurity: An 11-Year Follow-up of the CAP Randomized Clinical Trial. *JAMA Pediatr

11. Maitre, N. L. & Stark, A. R. (2012). Neuroprotection for Premature Infants?. *JAMA: The Journal of the American Medical Association, 307*(3), 304-305. doi: 10.1001/jama.2011.2026.