The abstract for the recently published study by Thorlton, Ahmed & Colby (2016) starts out:
"Breastfeeding women may experience disrupted sleep schedules and be tempted to turn to popular energy drinks to reduce fatigue and enhance alertness, prompting the question: What are the maternal and child health implications for breastfeeding mothers consuming energy drinks?
Caffeine and vitamin-rich energy drinks contain a variety of herbal ingredients and vitamins; however, ingredient amounts may not be clearly disclosed on product labels. Interactions between herbal ingredients and caffeine are understudied and not well defined in the literature. Some infants can be sensitive to caffeine and display increased irritability and sleep disturbances when exposed to caffeine from breastmilk. Breastfeeding women who consume energy drinks may be ingesting herbal ingredients that have not undergone scientific evaluation, and if taking prenatal vitamins, may unknowingly exceed the recommended daily intake. Caffeinated products are marketed in newer ways, fueling concerns about health consequences of caffeine exposure," (p 179).
Initially introduced into the market in 1960, the consumption of energy drinks has skyrocketed, increasing 10-fold between 2001 and 2010. "There is no consistent definition for an energy drink; however, most contain a blend of caffeine, herbal ingredients, vitamins, amino acids, and sugar or sugar derivatives," (p 180). These drinks range from a concentrated "shot" to a large container that has 3 servings. Combining taurine, guarana, ginseng, gingko biloba, yerba mate, B vitamins and other herbs, they are meant to stimulate the central nervous and cardiovascular systems. Excess consumption can lead to toxic effects: agitation, cardiac arrhythmias, hypertension, sleep disturbances, digestive problems, seizures, acute renal failure, and even death. When combined with medications (anticoagulants, cardiovascular drugs, oral hypoglycemic agents and antiretrovirals, they may increase or negate the effects of the medications.
Caffeine concentrations do not need to be declared on product labels, since energy drinks may be considered a "dietary supplement" or a "conventional food." Generally considered safe for consumption, caffeine for breastfeeding mothers should be in moderation--about 2 cups per day. The average half-life of caffeine in the adult system is 3 to 7 hours. However, in the newborn, it rises to "up to 120 hours," (p 181). Infants generally ingest 1% of the maternal dose of caffeine, increasing the risk of irritability and sleep pattern changes. And the chronic use of caffeine by the mother can reduce the iron content in her milk.
So can breastfeeding mothers take these energy drinks? Those mothers on medications or drinking alcohol should be counseled not to exceed 300mg per day of caffeine, as well as to closely read ingredient labels. "...they should exercise caution where energy drinks are concerned," (p184), due to the unknown effects of the stimulants, herbs, and vitamin content, which vary from one manufacturer to another.
To those of you who reside outside of the US I would ask to share what your experiences with energy drinks are in your area. I look forward to following this discussion.
Kathy Parkes, MSN-Ed, BSPsy, RN, IBCLC, RLC, FILCA
Professional Development Educator
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