Caffeine plays a special role in daily life. It is a pick-me-up in the mornings when you need the energy, a good way to relax on a date, a comfort food on a hard day. It gives the needed boost and wakefulness for nighttime activities, and works just as well the next day. In other words, one does not need to be a coffee-fiend to enjoy a daily dose of caffeine in whatever amount.

However, breastfeeding mothers are predictably more cautious about their food and fluid intake. For a breastfeeding mother who loves her daily coffee, the overriding question is: Do coffee and breastfeeding mix? Can I drink coffee while breastfeeding? Will the caffeine harm her baby? Does she need to give up coffee as long as she is breastfeeding?

Worst Case Scenarios of Mixing Coffee and Breastfeeding

First and foremost, yes, there is such a thing as too much caffeine for breastfeeding mothers. Unregulated caffeine intake can cause dehydration, since caffeine turns solids into water and flushes them out. Too much caffeine can also have adverse effects on breastfeeding babies.

While some websites assure mothers they have nothing to worry about and to continue their caffeine dosages, care must still be exercised. An article reviews the possible dangers of too much caffeine to breastfeeding babies.  

Scenario #1: Jitteriness in Babies

A study by Rivera-Calimlim called “Drugs in Breast Milk” in Drug Ther, looked at a 6 weeks old breastfed baby. His mother was drinking 1500 to 2000 mL of caffeine-containing drinks (coffee and cola) daily, supplemented by tea and cocoa.

While the baby was gaining the appropriate weight for his age, he was trembling excessively. This stopped when the mother was completely taken off caffeine. A similar study by Bailey, Welbert, and Naylor looked at a 5 months old baby whose mother drank 20 cups of coffee a day. The baby was observed to be unusually restless.

A doctor wrote her personal experience with caffeine and breastfeeding. While drinking an average of 10 caffeine-containing drinks daily, neither of her breastfeeding babies could sleep deeply or for long periods of time. They were also restless, and fretted easily. Another doctor, who drank up to 2 L of decaf a day, had a premature baby who went into episodic convulsions. These convulsions stopped when the coffee intake stopped.

Scenario #2: Not Enough Iron in Breastmilk

According to a study by Munoz, Lonnerdal, Keen, and Dewey, mothers who drank over 450 mL of coffee a day had lower levels of iron in their breast milk as compared to non-drinkers. Because of this, their babies had lower hemoglobin (carries oxygen to tissues and carbon dioxide out) and hematocrit (percentage of red blood cells inside the blood) levels compared to the babies of non-drinkers. This negatively impacted their overall growing health.

Does That Mean You Cannot Have Coffee While Breastfeeding?

No. It means that if you drink coffee and caffeinated drinks excessively, there will be definite harm to your child. However, if you are aware of certain facts and regulate your coffee intake, the baby should not even be wakeful throughout the night. There are exceptions to this rule as there are to every other, but these facts generally hold in most cases.

Fact #1: Baby’s Age Matters

According to IBCLC (International Board Certified Lactation Consultant) Kelly Bonyata, babies can only metabolize (absorb and eject) caffeine at the same rate as adults at a certain age. Until they are 3 months old, babies metabolize caffeine in up to 5.4 days. In other words, the caffeine can compound in their bodies.

From 3 to 5 months old, a baby will take around 14 hours, more than half a day, to metabolize caffeine. Past 5 months, however (give or take up to 9 months), the baby will metabolize the caffeine in 3 to 7 hours. That is the same rate as an adult. This does not lower the risks of caffeine in a baby’s system, only reduces its processing length.

Fact #2: The Recommended Caffeine Intake is 300 mg

Nutritionists did not pull that amount out of a hat. A study by Santos, Matijasevich, and Domingues looked at babies’ sleeping patterns when they were 3 months old. Mothers who took over 300 mg of caffeine in a day had more reports of their babies waking in the middle of the night. Mothers who took less reported normal wakefulness in their babies.

Because of this study, nutritionists advise 300 mg of caffeine a day or less is safe enough for both mother and baby. Breastfeeding mothers should consult on the appropriate amounts that they can drink in a single day.

How To Test Your Baby’s Reaction

Some babies will be more reactive to caffeine than the normal baby. If your baby is exhibiting wakefulness and restlessness even when you are drinking below 300 mg of coffee a day, take yourself off caffeine for a week or so. See if there are any changes to your baby’s behavior. If he begins to sleep well and is no longer jittery, re-introduce caffeine for a brief period.

If the earlier symptoms return, then your baby is definitely reacting to the caffeine content in your drinks. Consult to see if there are fall-back alternatives you would like, or if you can find the happy medium of caffeine intake that will not disturb your baby. If you are not sure how to check your baby’s symptoms, consult on that as well.

Why Ask a Lactation Consultant About Coffee and Breastfeeding?

Lactation Consultants have a minimum requirement of 14 health science courses, 90 hours of lactation-specific education, and a minimum of 300 to 500 clinical practice hours. All of those requirements, plus a board exam, are fulfilled to enable them to become IBCLCs. Lactation consultants have one specialized job: to look after a breastfeeding mother and her child.

Lactation consultants are theoretically and clinically equipped to counsel, educate, and advise you on any questions you may have about breastfeeding. They can help you test the effects of caffeine on your baby, suggest caffeine alternatives, or find the daily caffeine intake that still ensures your baby’s comfort. Unlike general practitioners and pediatricians, their knowledge is highly specialized. They are more than equipped to answer questions on coffee and breastfeeding.