The Basics
What is Caffeine?
A central nervous system stimulant found naturally in foods and beverages such as coffee, tea, colas, energy and chocolate.
Brand names for Caffeine
Caffeine And Sodium Benzoate
How Caffeine is classified
Central Nervous System Stimulants, Phosphodiesterase Inhibitors, Xanthines, Foodborne Diseases
Caffeine During Pregnancy
Caffeine pregnancy category
Category CNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Caffeine while pregnant
Animal reproduction studies have not been conducted with Caffeine and Sodium Benzoate Injection. It is also not known whether Caffeine and Sodium Benzoate Injection (caffeine alkaloid) can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Caffeine and Sodium Benzoate Injection (caffeine alkaloid) should be given to a pregnant woman only if clearly needed
Taking Caffeine While Breastfeeding
What are recommendations for lactation if you're taking Caffeine?
Caffeine appears in breastmilk rapidly after maternal ingestion. Insufficient high-quality data are available to make good evidence-based recommendations on safe maternal caffeine consumption.[1] Fussiness, jitteriness and poor sleep patterns have been reported in the infants of mothers with very high caffeine intakes equivalent to about 10 or more cups of coffee daily. Studies in mothers taking 5 cups of coffee daily found no stimulation in breastfed infants 3 weeks of age and older. A maternal intake limit of 300 to 500 mg daily might be a safe level of intake for most mothers.[2][3] However, preterm and younger newborn infants metabolize caffeine very slowly and may have serum levels of caffeine and other active caffeine metabolites similar to their mothers’ levels,[2][4][5] so a lower intake level preferable in the mothers of these infants. Other sources of caffeine, such as cola and energy drinks, yerba mate or guarana, will have similar dose-related effects on the breastfed infant. Coffee intake of more than 450 mL daily may decrease breastmilk iron concentrations and result in mild iron deficiency anemia in some breastfed infants.[6]
Maternal / infant drug levels
Caffeine appears in breastmilk rapidly after maternal ingestion. Insufficient high-quality data are available to make good evidence-based recommendations on safe maternal caffeine consumption.[1] Fussiness, jitteriness and poor sleep patterns have been reported in the infants of mothers with very high caffeine intakes equivalent to about 10 or more cups of coffee daily. Studies in mothers taking 5 cups of coffee daily found no stimulation in breastfed infants 3 weeks of age and older. A maternal intake limit of 300 to 500 mg daily might be a safe level of intake for most mothers.[2][3] However, preterm and younger newborn infants metabolize caffeine very slowly and may have serum levels of caffeine and other active caffeine metabolites similar to their mothers’ levels,[2][4][5] so a lower intake level preferable in the mothers of these infants. Other sources of caffeine, such as cola and energy drinks, yerba mate or guarana, will have similar dose-related effects on the breastfed infant. Coffee intake of more than 450 mL daily may decrease breastmilk iron concentrations and result in mild iron deficiency anemia in some breastfed infants.[6]
Possible effects of Caffeine on milk supply
Relevant published information was not found as of the revision date.
Possible alternatives to Caffeine
None listed
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. 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. PMID: 30294771
2. James J, Lawrence R. Can consuming caffeine while breastfeeding harm your baby? An interview with Ruth Lawrence, PhD. J Caffeine Res. 2011;1:192-4.
3. Ryu JE. Effect of maternal caffeine consumption on heart rate and sleep time of breast-fed infants. Dev Pharmacol Ther. 1985;8:355-63. PMID: 4075934
4. McNamara PJ, Abbassi M. Neonatal exposure to drugs in breast milk. Pharm Res. 2004;21:555-66. PMID: 15139511
5. Oo CY, Burgio DE, Kuhn RC et al. Pharmacokinetics of caffeine and its demethylated metabolites in lactation: predictions of milk to serum concentration ratios. Pharm Res. 1995;12:313-6. PMID: 7784352
6. Munoz LM, Lonnerdal 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;48:645-51. PMID: 3414579
7. Knutti R, Rothweiler H, Schlatter CH. Effect of pregnancy on the pharmacokinetics of caffeine. Eur J Clin Pharmacol. 1981;21:121-6. PMID: 7341280
8. Berlin CM Jr, Denson HM, Daniel CH, Ward RM. Disposition of dietary caffeine in milk, saliva, and plasma of lactating women. Pediatrics. 1984;73:59-63. PMID: 6691042
9. Findlay JW, DeAngelis RL, Kearney MF et al. Analgesic drugs in breast milk and plasma. Clin Pharmacol Ther. 1981;29:625-33. PMID: 7214793
10. Stavchansky S, Combs A, Sagraves R et al. Pharmacokinetics of caffeine in breast milk and plasma after single oral administration of caffeine to lactating mothers. Biopharm Drug Dispos. 1988;9:285-99. PMID: 3395670
11. Tyrala EE, Dodson WE. Caffeine secretion into breast milk. Arch Dis Child. 1979;54:787-800. PMID: 507903
12. Bailey DN, Welbert RT, Naylor A. A study of salicylate and caffeine excretion in the breast milk of two nursing mothers. J Anal Toxicol. 1982;6:64-8. PMID: 7098450
13. Ryu JE. Caffeine in human milk and in serum of breast-fed infants. Dev Pharmacol Ther. 1985;8:329-37. PMID: 4075932
14. Calvaresi V, Escuder D, Minutillo A et al. Transfer of nicotine, cotinine and caffeine into breast milk in a smoker mother consuming caffeinated drinks. J Anal Toxicol. 2016;40:473-7. PMID: 27129353
15. Hildebrandt R, Gundert-Remy U. Lack of pharmacological active saliva levels of caffeine in breast-fed infants. Pediatr Pharmacol (New York). 1983;3:237-44. PMID: 6677875
16. Vohra V, Marraffa JM. Maternal use of acetaminophen-butalbital-caffeine product resulting in neonate butalbital exposure through breast milk. Clin Toxicol. 2019;57:549. Abstract. doi:10.1080/15563650.2019. PMID: 1598646
17. Rivera-Calimlim L. Drugs in breast milk. Drug Ther (NY). 1977;7:59-6. PMID: 12336945
18. Clement MI. Personl view: Caffeine and babies. Br Med J. 1989;298:1461. PMC: PMC1836572
19. Rustin J. Caffeine and babies. Br Med J. 1989;299:121. Letter. PMC: PMC1837125
20. Martin I, Lopez-Vilchez MA, Mur A et al. Neonatal withdrawal syndrome after chronic maternal drinking of mate. Ther Drug Monit. 2007;29:127-9. PMID: 17304161
21. Santos IS, Matijasevich A, Domingues MR. Maternal caffeine consumption and infant nighttime waking: prospective cohort study. Pediatrics. 2012;129:860-8. PMID: 22473365
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
