Maternal Caffeine Consumption and Infant Nighttime Waking: Prospective Cohort Study

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Fetus and infants until 3 months of age are unable to metabolize caffeine, which crosses the placenta and in adults has a somnolytic effect. Little is known about the effect of caffeine consumption by pregnant or nursing mothers over infant sleeping. WHAT THIS STUDY ADDS:In this setting where caffeine is largely consumed in pregnancy and by nursing mothers, heavy consumption ($300 mg/day) did not increase the number of nighttime awakenings by their 3-month-old infants.abstract OBJECTIVE: Coffee and other caffeinated beverages are commonly consumed in pregnancy. In adults, caffeine may interfere with sleep onset and have a dose-response effect similar to those seen during insomnia. In infancy, nighttime waking is a common event. With this study, we aimed to investigate if maternal caffeine consumption during pregnancy and lactation leads to frequent nocturnal awakening among infants at 3 months of age.METHODS: All children born in the city of Pelotas, Brazil, during 2004 were enrolled on a cohort study. Mothers were interviewed at delivery and after 3 months to obtain information on caffeine drinking consumption, sociodemographic, reproductive, and behavioral characteristics. Infant sleeping pattern in the previous 15 days was obtained from a subsample. Night waking was defined as an episode of infant arousal that woke the parents during nighttime. Multivariable analysis was performed by using Poisson regression. RESULTS:The subsample included 885 of the 4231 infants born in 2004. All but 1 mother consumed caffeine in pregnancy. Nearly 20% were heavy consumers ($300 mg/day) during pregnancy and 14.3% at 3 months postpartum. Prevalence of frequent nighttime awakeners (.3 episodes per night) was 13.8% (95% confidence interval: 11.5%-16.0%). The highest prevalence ratio was observed among breastfed infants from mothers consuming $300 mg/day during the whole pregnancy and in the postpartum period (1.65; 95% confidence interval: 0.86-3.17) but at a nonsignificant level.CONCLUSIONS: Caffeine consumption during pregnancy and by nursing mothers seems not to have consequences on sleep of infants at the age of 3 months. Pediatrics 2012;129:860-868