Last update Aug. 8, 2024

Caffeine

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

Trimethylxanthine stimulant of the central nervous system which is present in many compounds like decongestant or pain relief drugs (50 to 100 mg per unit) ( (Mitchell 1999). It is also used to treat primary apnea in the premature newborn. It is present in many infusion beverages (coffee, tea, mate, guarana), in cocoa/chocolate and other drinks with cola or allegedly energizing properties. (Barone 1996, Fulton 1990).

Mean Caffeine content (Myo 2022, González 2015, Santos 2012):

  • Per cup (240 ml): - coffee: 90 mg (30 ml espresso: 60 mg), - black tea: 40 mg, - green tea: 30 mg, - chocolate: 5-10 mg.
  • 1 liter of cola & soda: 100-150 mg, 1 liter of energizers beverages 300 to 800 mg.

Caffeine is excreted in human milk in moderate but potentially significant amounts. (Calvaresi 2016, Stavchansky 1988, Ryu 1985, Bucher 1985, Berlin 1984, Findlay 1981, Tyrala 1979)

Moderate coffee consumption does not produce significant levels of caffeine in plasma or urine of infants, and may be undetectable or below therapeutic levels in the neonatal period. (Blanchard 1992, Fulton 1990, Berlin 1984, Hildebrandt 1983, Bailey 1982, Rivera 1977)

Doses greater than 300 - 500 mg of caffeine daily can cause nervousness, irritability and insomnia in the infant (Santos 2012, Martin 2007, Clement 1989, Rustin 1989), as well as decreased iron levels in breast milk and anemia in the infant (Muñoz 1988). Also has been related to the Raynaud's phenomenon in the nipple of nursing women. (McGuinness 2013)

One study found no problems in infants whose mothers consumed 500 mg of caffeine daily for 5 days. (Ryu 1985)

There is insufficient evidence on the recommended amount of caffeine during lactation. (McCreedy 2018)

The elimination half-life, of a few hours in adults, can be 10 times longer in preterm infants and during the neonatal period, reaching adult values by 3-5 months of age. (McNamara 2004, Oo 1995)

The high doses (500 - 1,000 mg) that are used intravenously to treat post-epidural headache would be compatible with breastfeeding for the first few days, while the milk comes in. To watch for irritability in the infant.

The elimination half-life, of a few hours in adults, can be 10 times longer in preterm infants and during the neonatal period, reaching adult values by 3-5 months of age. (McNamara 2004, Oo 1995)

The moderate use of caffeine during breastfeeding is considered compatible or probably compatible by various experts (Hale 2019, Briggs 2017, Bordini 2016, Davanzo 2014, Rowe 2013). The American Academy of Pediatrics rates caffeine compatible with breastfeeding. (AAP 2001)

 


See below the information of these related products:

  • Coffee (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Guarana (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Mate (Safe product and/or breastfeeding is the best option.)
  • Tea (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Theobromine (Safe product and/or breastfeeding is the best option.)

Alternatives

We do not have alternatives for Caffeine.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Caffeine is also known as


Caffeine in other languages or writings:

Groups

Caffeine belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Caffeine in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 100 %
Molecular weight 194 daltons
Protein Binding 10 - 36 %
VD 0.6 l/Kg
Tmax 0.5 - 2 hours
5 (3 - 7) hours
M/P ratio 0.1 - 0.8 -
Theoretical Dose 0.12 - 0.93 mg/Kg/d
Relative Dose 5.2 - 22.7 %
Ped.Relat.Dose 1.2 - 18.6 %

References

  1. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consulted on April 10, 2024 Full text (link to original source)
  2. Mayo Clinic Contenido de cafeína del café, el té, las gaseosas y más. Nutrición y comida saludable. 2022 Full text (link to original source)
  3. DGA 2020 - U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. Dietary Guidelines for Americans, 2020-2025. 9th Edition. - 2020 Full text (link to original source)
  4. McCreedy A, Bird S, Brown LJ, Shaw-Stewart J, Chen YF. Effects of maternal caffeine consumption on the breastfed child: a systematic review. Swiss Med Wkly. 2018 Sep 28;148:w14665. Abstract
  5. Bordini CA, Roesler C, Carvalho Dde S, Macedo DD, Piovesan É, Melhado EM, Dach F, Kowacs F, Silva Júnior HM, Souza JA, Maciel JA Jr, Carvalho JJ, Speciali JG, Barea LM, Queiroz LP, Ciciarelli MC, Valença MM, Lima MM, Vincent MB. Recommendations for the treatment of migraine attacks - a Brazilian consensus. Arq Neuropsiquiatr. 2016 Abstract Full text (link to original source) Full text (in our servers)
  6. Calvaresi V, Escuder D, Minutillo A, Bastons-Compta A, García-Algar O, Pallás Alonso CR, Pacifici R, Pichini S. Transfer of Nicotine, Cotinine and Caffeine Into Breast Milk in a Smoker Mother Consuming Caffeinated Drinks. J Anal Toxicol. 2016 Jul;40(6):473-7. Abstract
  7. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
  8. González Reyes AB, Hardisson de la Torre A, Gutiérrez Fernández AJ, Rubio Armendáriz C, Frías Tejera I, Revert Gironés C. Cafeína y quinina en bebidas refrescantes; contribución a la ingesta dietética. [CAFFEINE AND QUININE IN SOFT DRINKS; CONTRIBUTION TO THE DIETARY INTAKE]. Nutr Hosp. 2015 Abstract Full text (link to original source) Full text (in our servers)
  9. Davanzo R, Bua J, Paloni G, Facchina G. Breastfeeding and migraine drugs. Eur J Clin Pharmacol. 2014 Abstract
  10. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  11. McGuinness N, Cording V. Raynaud's phenomenon of the nipple associated with labetalol use. J Hum Lact. 2013 Abstract Full text (link to original source)
  12. Santos IS, Matijasevich A, Domingues MR. Maternal caffeine consumption and infant nighttime waking: prospective cohort study. Pediatrics. 2012 Abstract Full text (link to original source) Full text (in our servers)
  13. Martín I, López-Vílchez MA, Mur A, García-Algar O, Rossi S, Marchei E, Pichini S. Neonatal withdrawal syndrome after chronic maternal drinking of mate. Ther Drug Monit. 2007 Abstract
  14. McNamara PJ, Abbassi M. Neonatal exposure to drugs in breast milk. Pharm Res. 2004 Abstract
  15. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  16. Mitchell JL. Use of cough and cold preparations during breastfeeding. J Hum Lact. 1999 Abstract
  17. Barone JJ, Roberts HR. Caffeine consumption. Food Chem Toxicol. 1996 Abstract
  18. Oo CY, Burgio DE, Kuhn RC, Desai N, McNamara PJ. Pharmacokinetics of caffeine and its demethylated metabolites in lactation: predictions of milk to serum concentration ratios. Pharm Res. 1995 Abstract
  19. Blanchard J, Weber CW, Shearer LE. Methylxanthine levels in breast milk of lactating women of different ethnic and socioeconomic classes. Biopharm Drug Dispos. 1992 Apr;13(3):187-96. Abstract
  20. Fulton B. The galactopharmacopedia. Recreational drug use in the breastfeeding mother. Part 2: Licit drugs. J Hum Lact. 1990 Abstract
  21. Clement MI. Personl view: Caffeine and babies. Br Med J. 1989;298:1461. Full text (link to original source)
  22. Rustin J. Caffeine and babies. Br Med J. 1989;299:121. Full text (link to original source)
  23. Muñoz LM, Lönnerdal B, Keen CL, Dewey KG. Coffee consumption as a factor in iron deficiency anemia among pregnant women and their infants in Costa Rica. Am J Clin Nutr. 1988 Abstract Full text (link to original source) Full text (in our servers)
  24. 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 Abstract
  25. Bucher HU, Gautschi K. [Detection of caffeine, theophylline and theobromine in the umbilical cord blood and breast milk]. Helv Paediatr Acta. 1985 Jul;40(2-3):163-7. German. Abstract
  26. Ryu JE. Caffeine in human milk and in serum of breast-fed infants. Dev Pharmacol Ther. 1985 Abstract
  27. Ryu JE. Effect of maternal caffeine consumption on heart rate and sleep time of breast-fed infants. Dev Pharmacol Ther. 1985 Abstract
  28. Berlin CM Jr, Denson HM, Daniel CH, Ward RM. Disposition of dietary caffeine in milk, saliva, and plasma of lactating women. Pediatrics. 1984 Abstract
  29. Hildebrandt R, Gundert-Remy U. Lack of pharmacological active saliva levels of caffeine in breast-fed infants. Pediatr Pharmacol (New York). 1983 Abstract
  30. Bailey DN, Weibert RT, Naylor AJ, Shaw RF. A study of salicylate and caffeine excretion in the breast milk of two nursing mothers. J Anal Toxicol. 1982 Abstract
  31. Findlay JW, DeAngelis RL, Kearney MF, Welch RM, Findlay JM. Analgesic drugs in breast milk and plasma. Clin Pharmacol Ther. 1981 May;29(5):625-33. Abstract
  32. Tyrala EE, Dodson WE. Caffeine secretion into breast milk. Arch Dis Child. 1979 Abstract Full text (link to original source) Full text (in our servers)
  33. Rivera-calimlim L. Drugs in breast milk. Drug Ther (NY). 1977 Abstract

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