C₈ H₁₀ N₄ O₂

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 substance 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 substance and/or breastfeeding is the best option.)