McCreedy, Aimee, Bird, Sumedha, Brown, Lucy J., Shaw-Stewart, James and Chen, Y-F.‏‎ (2018) Effects of maternal caffeine consumption on the breastfed child : a systematic review. Swiss medical weekly, 148 . w14665. doi:10.4414/smw.2018.14665 ISSN 1424-3997.

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Abstract

Background:
Nutrition in the first 1000 days between pregnancy and 24 months of life is critical for child health, and exclusive breastfeeding is promoted as the infant’s best source of nutrition in the first 6 months. Caffeine is a central nervous system stimulant occurring naturally in some foods and used to treat primary apnoea in premature babies. However high caffeine intake can be harmful, and caffeine is transmitted into breastmilk.

Aim:
To systematically review the evidence on the effects of maternal caffeine consumption during breastfeeding on the breastfed child.

Method: A systematic search was conducted to October 2017 in MEDLINE, EMBASE, Web of Science, CINAHL, and Cochrane Library. The British Library catalogue, which covers doctoral theses, was searched and PRISMA guidelines followed. Two reviewers screened for experimental, cohort, or case-control studies and performed independent quality assessment using the Newcastle-Ottawa scale. The main reviewer performed data extraction, checked by the second reviewer.

Results:
Two cohort, two crossover studies, and one N-of-1 trial were included for narrative synthesis. One crossover and two cohort studies of small sample sizes directly investigated maternal caffeine consumption. No significant effects on 24-hour heart rate, 24-hour sleep time, or frequent night waking of the breastfed child were found. One study found a decreased rate of full breastfeeding at 6 months postpartum. Two studies indirectly investigated caffeine exposure. Maternal chocolate and coffee consumption was associated with increased infant colic, and severe to moderate exacerbation of infant atopic dermatitis. However, whether caffeine was the causal ingredient is questionable. The insufficient and inconsistent evidence available had quality issues impeding conclusions on the effects of maternal caffeine consumption on the breastfed child.

Conclusion: Evidence for recommendations on caffeine intake for breastfeeding women is scant, of limited quality and inconclusive. Birth cohort studies investigating the potential positive and negative effects of various levels of maternal caffeine consumption on the breastfed child and breastfeeding mother could improve the knowledge base and allow evidence-based advice for breastfeeding mothers.

Item Type:	Journal Article
Subjects:	R Medicine > RJ Pediatrics
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School Faculty of Science, Engineering and Medicine > Engineering > WMG (Formerly the Warwick Manufacturing Group)
Library of Congress Subject Headings (LCSH):	Caffeine -- Physiological effect, Infants -- Nutrition, Breastfeeding, Breast milk, Coffee drinking
Journal or Publication Title:	Swiss medical weekly
Publisher:	E M H Schweizerischer Aerzteverlag AG
ISSN:	1424-3997
Official Date:	28 September 2018
Dates:	Date Event 28 September 2018 Published 30 July 2018 Accepted
Volume:	148
Article Number:	w14665
DOI:	10.4414/smw.2018.14665
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	10 October 2018
Date of first compliant Open Access:	10 October 2018

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