Effects of Caffeine on Breastfeeding Mothers and Infants: A Scoping Review

Objectives: Breastfeeding mothers often consume caffeine in varied quantities. The common dietary sources of caffeine include tea, coffee, chocolate, energy drinks, and sodas. Over time, caffeine has become a widely accepted substance to use throughout pregnancy and lactation. As the range of volumes of caffeine is variable in various beverages, it is essential to explore the positive and negative effects of caffeine on breastfeeding mothers and their babies. Methods: A scoping review of evidence-based literature was undertaken to examine the effects of caffeine on breastfeeding mothers and their babies. We searched major databases using the key terms "caffeine," "breast milk," "newborns," "infants," "mothers," and "breastfeeding." Altogether, 21 articles were shortlisted for this review based on their relevance to the topic. Results: Caffeine travels in small amounts from the mother to the infant, and the infant is typically unaffected in amounts less than 300 mg/d. Caffeine is reported to reduce postnatal depression and fatigue among breastfeeding mothers and has been found useful in treating acute morbidities in neonates like apnea of prematurity, patent ductus arteriosus, and bronchopulmonary dysplasia. A high intake of caffeine (450 mg or more of caffeine per day) in a short time is reported to have detrimental biochemical and neurodevelopmental effects in breastfed infants, contribute to anemia, and may result in low iron levels in breast milk. Controversy exists surrounding the effects of caffeine on breastfeeding duration of mothers. Recommendations include education and counseling for breastfeeding mothers on the dangers of caffeine consumption, avoidance of frequent and high intake of caffeine during lactation, and monitoring caffeine levels in various beverages/products. Conclusion: The use of caffeine has shown both positive and negative effects on breastfeeding mothers and infants. As a high intake of caffeine (450 mg or more of caffeine per day) is reported to have negative effects, breastfeeding mothers and infants must be protected from the detrimental effects of caffeine through increased education, counseling, and psychosocial support. Clinical practice guidelines are needed on the safe consumption of caffeine by breastfeeding mothers. Future research must examine the effects of varied levels of caffeine found in different products on breast milk composition, duration, health status, and breastfeeding outcomes of term and preterm newborns.