Chemistry Reference
In-Depth Information
quarter of infants are breast fed for 6 months, and only about 17% of infants
are breast fed for a full year (CDC, 2010). Thus, only a relatively small number
of infants have the potential to be exposed to caffeine via breast milk for an
extended period of time.
Nevertheless, it has been reported that withdrawal symptoms have been
observed in newborns whose mothers regularly consumed 300-400 mg per day
during pregnancy. These infants were reportedly irritable, affectively labile,
and had difficulties with sleep, whereas others appeared to be unaffected
(Higdon and Frei 2006; Hildebrandt and Gundert-Remy 1983; Nawrot et al
2003; Ryu 1985). These symptoms began shortly after birth and spontaneously
remitted within a short period of time (McGowan et al 1988; Nehlig and Debry
1994).
Conflicting reports of the impact of breast milk is not surprising, given that
some variance in the effect of caffeine in very young children (,6 months of
age) is to be expected. The half-life of caffeine is extended in neonates; as
physiological maturation occurs, the rate of metabolic elimination of caffeine
reaches a level similar to that of adults at approximately six months of age
(Nawrot et al 2003). Therefore, it is likely that the effects of caffeine are more
pronounced in younger infants than in older, and may vary within the same
infant as she or he matures.
Generally speaking, lower amounts of caffeine do not appear to impact
infants, and are considered safe provided the child is healthy. For infants who
were premature, low birth weight, or have other health difficulties, the
ingestion of even relatively small amounts of caffeine by the mother is
hypothesized to cause some negative behavioral and physiological effects
(American Academy of Pediatrics Committee on Drugs 2001). Overall,
however, the effect of caffeine on infants appears to be time-limited and
symptoms remit when caffeine levels decrease. Research to date has not
identified a conclusive link between caffeine exposure in infants and long-term
health consequences (Nawrot et al 2003), and as such, the American Academy
of Pediatrics has listed caffeine as a drug that is compatible with breastfeeding
when consumed in moderate doses (i.e., #300 mg per day).
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19.8 Recommended Intake
Although the US Food and Drug Administration has not provided guidelines
for caffeine intake, other countries and professional associations have made
recommendations for presumably safe levels of caffeine consumption. The
American Congress of Obstetricians and Gynecologists (ACOG) concluded
that consuming less than 200 mg per day of caffeine during pregnancy was
unlikely to cause an adverse effect in the form of miscarriage or preterm birth
(ACOG 2010). Similarly, the United Kingdom has also issued a 200 mg per
day maximum consumption for pregnant women (Food Standards Agency
2008). Several countries have issued guidelines regarding caffeine consumption
and the disclosure of caffeine amounts in beverages and foods. Health Canada
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