Report Details Corneal Infection Tied to Sleeping in Contacts

FRIDAY, Aug. 17, 2018 — Six cases of corneal infections associated with sleeping in contact lenses are described in a case report published in the Aug. 17 issue of the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

Jennifer R. Cope, M.D., from the CDC in Atlanta, and colleagues present six cases of contact lens-related corneal infection that were diagnosed in the last two years, in which sleeping in lenses was reported as the main risk factor.

All patients reported sleeping in lenses on a regular basis. The authors note that the consequences of infection included the need for frequent administration of antibiotic eye drops, multiple follow-up appointments, and permanent eye damage. All patients needed treatment with antibiotic eye drops, which was sometimes needed hourly for a period of weeks or months. Two patients required surgery and most had vision loss or permanent eye damage. Examination findings, including stromal opacification, anterior chamber reaction, and hypopyon, were indicative of active infection. Various organisms were identified in cultures and diagnostic testing, including Pseudomonas aeruginosa and Acanthamoeba species. Contact lenses were purchased without a valid prescription in three cases; in one case the lenses were decorative.

“Health education measures directed toward contact lens wearers should emphasize raising awareness of the risks of sleeping in contact lenses as well as adherence to all recommendations for the wear and care of contact lenses,” the authors write.

Abstract/Full Text

Posted: August 2018

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Genetic Testing for Cancer Lacking for Women on Medicare: Study

FRIDAY, Aug. 17, 2018 — Testing for gene mutations linked to breast and ovarian cancer is rare among some Medicare patients who have the cancers and qualify for such tests, a new study finds.

Researchers analyzed data from 12 southeastern states between 2000 and 2014. Only 8 percent of 92 women who met Medicare criteria for BRCA1 and BRCA2 gene testing received it within five years of their cancer diagnosis, the study found.

No patients in Arkansas, Louisiana, Tennessee, Virginia and West Virginia got the tests, according to the study published Aug. 14 in the Journal of the American Medical Association.

Breast cancer patients with BRCA mutations are more likely to develop cancer in a second breast and are also at increased risk for ovarian cancer. Ovarian cancer patients with the gene changes are more likely to get breast cancer.

Relatives who also have the mutations also face a higher cancer risk, the Vanderbilt University Medical Center researchers said.

“Women who carry one of these mutations but don’t know their mutation status are not able to take advantage of preventive or early detection interventions that we have available, so they miss out on the opportunity to reduce their risk for these cancers and potentially reduce their overall mortality,” study author Amy Gross said in a university news release.

“They are also not able to inform family members who might be affected,” Gross added. She is an epidemiologist at the Vanderbilt Institute for Clinical and Translational Research in Nashville.

The study covered a broad age range: More than half of the women were under age 65 and qualified for Medicare due to disabilities.

The researchers said lack of patient interest and physician recommendations might explain the low genetic testing rate. None of the patients had received a doctor referral for genetic counseling, they added.

More information

The U.S. National Cancer Institute has more on BRCA gene mutations.

Posted: August 2018

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Authorities Respond to Over 80 Overdoses from Synthetic Marijuana in New Haven Park

Emergency responders in New Haven, Conn. are dealing with over 80 overdose cases from a synthetic marijuana that authorities said was passed out in a local park.

They found dozens of people who had overdosed on the synthetic marijuana, also known as K2, on Wednesday morning on the New Haven Green, near the Yale University campus. 25 of the overdose cases came in that morning during a three-hour time span, officials told ABC News.

Over the next two days, that number swelled to over 80. Officials expect that more will come in as people who saved the K2 for later use take the drug.

“It’s very reminiscent of a mass casualty incident,” New Haven Office of Emergency Management Director Rick Fontana told the New Haven Register.

Most victims were sent to the hospital, while some declined to undergo additional care. One victim did not respond to Naloxone, the drug used to treat overdoses, when they were injected at the scene and is “very sick,” Fontana said in a press release. Otherwise, the other patients are not in life-threatening condition.

Some of the patients had fentanyl, the highly addictive opioid, in their system. Several had been treated at the hospital two or more times after they went back to the park and took the K2 again.

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New Haven Police have arrested three people in connection with the case, and the investigation is currently ongoing, New Haven Police Chief Anthony Campbell said in a press conference.

One of the three suspects allegedly did not charge people for the K2 and was “just handing it out,” Campbell said, possibly to start a clientele. Other victims reported paying for the drugs.

Campbell alleged that two of the suspects are known for selling K2 and have been arrested in the past. Their charges, if convicted, are not known at this time.

PEOPLE has contacted the New Haven Police Department for comment.

The overdoses came as a dire new report from the Centers for Disease Control on Wednesday showed that drug overdoses killed around 72,000 people in the U.S. in 2017, a record-breaking rise of about 10 percent.

The rise in deaths is thought to be from the increased use of opioids, and that the drugs themselves are more deadly, reports the New York Times. Overdose deaths are now higher than the highest yearly death totals from H.I.V., car crashes or guns.

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Whole blood test for toxoplasmosis is sensitive, specific

Transmission of toxoplasmosis from mother to fetus can lead to severe congenital problems and fetal death, and tests for the parasitic infection during pregnancy are critical. Now, researchers reporting in PLOS Neglected Tropical Diseases have showed the efficacy of a low-cost whole blood test for toxoplasmosis.

Toxoplasmosis results from infection with the Toxoplasma gondii parasite, usually transmitted to humans from eating undercooked contaminated meat or through exposure to infected cat feces. Existing tests for the infection are serum tests, which require blood samples to be processed using infrastructure and technology which can be prohibitive in developing areas and unaffordable in developed countries like the United States.

Rima McLeod of the University of Chicago and her colleagues, including Joseph Lykins and Karen Leahy, tested 205 individuals. The individuals tested included patients, volunteers, and obstetrical patients from Chicago and Morocco known to be infected with T. gondii. A team led by coauthor Dr. El Bissati tested the pregnant patients in Morocco, and Dr. McLeod’s team tested the patients in Chicago. The blood was tested for T. gondii infection status using reference tests, standard-of-care serum tests and the new whole-blood point-of-care (POC) test obtained by finger stick.

The whole blood POC test had 100% agreement with the reference and serum-variant testing, and proved highly sensitive and specific, with a sensitivity of 100% and a specificity of 100%. The scores held true even for women with lower levels of anti-Toxoplasma antibodies. However, the test cannot distinguish between acute and chronic infections.

The authors note, “Our work establishes a new point of care test in the outpatient setting at very low cost enabling diagnosis and prompt treatment for toxoplasma infections acquired for the first time during pregnancy. This enables life, sight and cognition saving treatments. If combined with multiplexed testing for other congenital infections and markers associated with premature birth, it will markedly improve maternal child outcomes and save lives.”

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First biomarker evidence of DDT-autism link: National birth cohort study finds DDT metabolites in the blood of pregnant women are associated with elevated odds of autism in offspring

A study of more than 1 million pregnancies in Finland reports that elevated levels of a metabolite of the banned insecticide DDT in the blood of pregnant women are linked to increased risk for autism in the offspring. An international research team led by investigators at Columbia University’s Mailman School of Public Health and the Department of Psychiatry published these results in the American Journal of Psychiatry. The study, conducted in collaboration with investigators at the University of Turku and the National Institute of Health and Welfare in Finland, is the first to connect an insecticide with risk for autism using maternal biomarkers of exposure.

Researchers identified 778 cases of childhood autism among offspring born from 1987 to 2005 to women enrolled in the Finnish Maternity Cohort, representing 98 percent of pregnant women in Finland. They matched these mother-child pairs with control offspring of mothers and offspring without autism. Maternal blood taken during early pregnancy was analyzed for DDE, a metabolite of DDT, and PCBs, another class of environmental pollutants.

The investigators found the odds of autism with intellectual disability in offspring were increased by greater than twofold for the mother’s DDE levels in the top quartile. For the overall sample of autism cases, the odds were nearly one-third higher among offspring exposed to elevated maternal DDE levels. The findings persisted after adjusting for several confounding factors such as maternal age and psychiatric history. There was no association between maternal PCBs and autism.

While DDT and PCBs were widely banned in many nations over 30 years ago, including the U.S. and Finland, they persist in the food chain because their breakdown occurs very slowly, as long as several decades, resulting in continuing exposure to populations. These chemicals are transferred across the placenta in concentrations greater than those seen in the mother’s blood.

“We think of these chemicals in the past tense, relegated to a long-gone era of dangerous 20th Century toxins,” says lead author Alan S. Brown, MD, MPH, professor of Epidemiology at Columbia University’s Mailman School of Public Health and of Psychiatry at Columbia University Medical Center. “Unfortunately, they are still present in the environment and are in our blood and tissues. In pregnant women, they are passed along to the developing fetus. Along with genetic and other environmental factors, our findings suggest that prenatal exposure to the DDT toxin may be a trigger for autism.”

The researchers offer two reasons for their observation that maternal exposure to DDE was related to autism while maternal PCB exposure was not. First, maternal DDE is associated with low birthweight, a well-replicated risk factor for autism. In contrast, maternal PCB exposure has not been related to low birthweight. Second, they point to androgen receptor binding, a process key to neurodevelopment. A study in rats found DDE inhibits androgen receptor binding, an outcome also seen in a rat model of autism. In contrast, PCBs increase androgen receptor transcription.

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Hospitals make £260,000 from vending machines

Hospitals make £260,000 from vending machines packed with high-calorie snacks

Ker-ching! Hospitals make a whopping £260,000 from vending machines packed with high-calorie snacks – and that’s just in Leeds!

  • Leeds Teaching Hospitals NHS Trust has 43 vending machines across five sites
  • They made £60,000 from the machines in 2017 and £260,000 from 2013-2018
  • Each device serves predominately soft drinks, chocolate, crisps and/or sweets

Cash-strapped NHS hospitals are making thousands of pounds by selling sugary drinks, crisps and chocolate in vending machines – despite a Government crackdown.

Leeds Teaching Hospitals NHS Trust earned a staggering £260,000 through vending machine sales between 2013 and 2018, an investigation found.

Each of the automated dispensers serve an array of sugary drinks, chocolate, crisps and sweets alongside healthier options such as fruit.

The revelation of the trust’s extra income comes amid an NHS crackdown on the ‘epidemic of flab’, led by the chief of the health service.

Simon Stevens, head of NHS England, last year announced he would cut funding for trusts if they failed to remove super-sized confectionary from premises.

And he threatened to stop hospitals selling sugar-laden fizzy drinks if sales weren’t dramatically slashed.

Collectively, the UK’s 232 NHS trusts would create nearly £14 million from vending machines, each year.

On site: Leeds Teaching Hospitals NHS Trust, which runs St James’ Hospital and Leeds General Infirmary (pictured), has 43 vending machines across five sites – making £60,000 annually

The Yorkshire trust, which operates 43 vending machines at five sites, stressed only a fifth of their drinks sold in the dispensers contain added sugar.

And it added that each confectionary item is limited to 250 calories per portion – the same amount found in a hamburger from McDonalds.

The trust’s extra income – £60,000 last year – was uncovered by a Freedom of Information Request by the Yorkshire Evening Post. But there are 232 NHS trusts, so the total figure for the health service is likely to be much higher.

Stewart Golton, a member of Leeds City Council’s health and wellbeing board, slammed the newspaper’s revelations.

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He said: ‘Hospital trusts are already under fire for their car parking charges, but this is an even more controversial money-raising move.

‘The trust is signed up to the obesity prevention work commissioned through the Leeds Health & Wellbeing Board.

‘But the provision of high calorie snacks in vending machines throughout its buildings smacks of double standards.’

Mr Golton added: ‘The hospital has a responsibility to make sure people often already struggling with their weight are not left relying on a vending machine.

Food for thought: Hospitals, which increasingly treat obese patients with weight-related problems, are making millions from the sale of sugary snacks 


Simon Stevens, chief executive of NHS England, threatened last April to stop hospital sites selling fizzy drinks if sales weren’t slashed to just 10 per cent of all possible drink sales.

It was hoped the controversial move – which has since led to sales of sugary drinks in hospitals being halved – would improve the diets of both patients and staff.

The reduction in sales, revealed in June, is equivalent to 1.1million cans of fizzy drink, ten million teaspoons of sugar or 160million calories.

Bosses ordered hospital shops last October to take super-size chocolate bars and ‘grab bags’ of sugary snacks off their shelves.

WH Smith announced this April it sold 1.1 million less chocolate bars since last April after it axed promotions – and removed a further 275,000 family-sized ones.

Other retailers such as Costa, Compass Group and The Royal Voluntary Service have also all curbed calories across their stores on NHS premises.

And NHS England figures show 175,000 more pieces of fruit had been sold in hospital stores across the country since the crackdown on flab began.

MailOnline has contacted both Public Health England and Leeds Teaching Hospitals NHS Trust for comment.

The UK is currently battling an obesity epidemic, which has led to children being fatter than ever before.

Figures in 1993 showed just 15 per cent of adults were obese – compared to 26 per cent in 2016.

If this trend continues, half of the population could be obese by 2030, which would place even greater burden on the NHS.

In 2016/7, there were 617,000 admissions in NHS hospitals where obesity was a factor, an increase of 18 per cent on 2015/16.

Mr Stevens threatened last April to stop hospital sites selling fizzy drinks if sales weren’t slashed to just 10 per cent of all possible drink sales.

It was hoped the controversial move – which has since led to sales of sugary drinks in hospitals being halved – would improve the diets of both patients and staff.

The reduction in sales, revealed in June, is the equivalent to 1.1 million cans of fizzy drink, ten million teaspoons of sugar or 160 million calories.

Bosses ordered hospital shops last October to take super-size chocolate bars and ‘grab bags’ of sugary snacks off their shelves.

WH Smith announced this April it sold 1.1 million less chocolate bars since last April after it axed promotions – and removed a further 275,000 family-sized ones.

Other retailers such as Costa, Compass Group and The Royal Voluntary Service all have also curbed calories across their stores on NHS premises.

And NHS England figures show 175,000 more pieces of fruit had been sold in hospital stores across the country since the crackdown on flab began.

Almost 700,000 NHS employees out of 1.3 million are thought to be overweight or obese. 


The UK is officially the fat man of Western Europe.

Government figures reveal that, on average, men from across the home nations tip the scales at 13st 3lb (84kg).

Only Americans, who weigh roughly 14st (89kg) and Australians, around the 13st 5lbs (86kg) mark, are heavier.

The figures, compiled today by Forza Supplements, add to the body of evidence that highlights the worrying obesity epidemic in the UK.

Rotund: Government figures reveal that, on average, men from across the home nations tip the scales at 13st 3lb

Organisation for Economic Co-operation and Development figures already show the UK has the second worst obesity rates in Europe – behind just Hungary.

The new report, using official data from the health boards of 10 countries, confirms the problem – and found men in the UK to be heavier than those in the Netherlands, Germany, Ireland, Italy, France and Spain. Spanish men weigh the least at 11st 11lbs (74.8kg).

The figures also delved into the life expectancy of men across the countries and how tall they are, on average.

Data also showed a stark difference in life expectancy, with men in the US expected to die four years earlier than men in some countries.

American men can expect to reach 76.9 years old – which experts have repeatedly blamed on the burgeoning obesity epidemic.

In contrast, life expectancy is 80.9 in both Japan and Australia – despite the latter also having a problem with bulging waistlines.

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Ebola cases in DR Congo rise to 78, 44 dead

Seventy-eight cases of Ebola have been recorded in an outbreak in northeast Democratic Republic of Congo, claiming 44 lives, DRC officials and the World Health Organization (WHO) said Friday.

The latest outbreak of the viral disease, which is highly contagious and frequently fatal if untreated, has prompted a visit by the head of the US Centers for Disease Control and Prevention (CDC), the health ministry said in a statement.

“In all, 78 cases of haemorrhagic fever have been reported in the region, of which 51 are confirmed and 27 probable” while “24 suspect cases are under investigation”, according to reports from Congolese authorities and the WHO.

Confirmed cases are verified by way of laboratory tests on samples taken from patients. The cases treated as “probable” often concern diseased people who had a close epidemiological link with confirmed cases, but have not been tested.

Congolese authorities reported “two deaths of confirmed cases at Beni”—a trading town with a population approaching a quarter of a million people in North Kivu province.

There were also “five new confirmed cases at Mabalako, including a health worker at the Health Reference Centre in Mangina,” the epicentre of the outbreak in the Beni region.

“We are expecting to see more cases,” WHO spokesman Tarik Jasarevic told reporters in Geneva.

The outbreak is the tenth to strike the DRC since 1976, when Ebola was first identified and named after a river in the north of the country.

It affects a part of the country wracked by violence for more than 20 years, from all-out war to insurgency and sustained ethnic clashes.

Forty-one deaths were reported in North Kivu and three in neighbouring Ituri region to the north, according to the health ministry.

Congolese Health Minister Oly Ilunga Kalenga had talks with the director of the CDC, Robert Redfield, regarding CDC training programmes for epidemiologists in the field, an official statement said.

The ministry’s directorate for disease control announced on Tuesday that doctors in Beni had started to use a novel treatment called mAb114 to treat patients with Ebola.

The treatment is “the first therapeutic drug against the virus to be used in an active Ebola epidemic in the DRC,” it said.

mAb114 is an antibody initially isolated from a survivor of an Ebola outbreak in the western DRC city of Kikwit in 1995, it added.

Ebola has long been considered incurable, though swift isolation and the rapid treatment of symptoms such as vomiting, diarrhoea and dehydration has helped some of the patients to survive.

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The Chipotle Outbreak That Sickened Nearly 650 People Was Caused by This Bacteria

The source of the outbreak that sickened nearly 650 people at a Chipotle in Ohio last month has been identified.

Stool samples taken from sick customers tested positive for Clostridium perfringens, a bacterium that can cause food poisoning when food is stored at unsafe temperatures, according to the Delaware General Health District, the public health department in Delaware, Ohio.

Although cooking kills C. perfringens cells, it doesn't necessarily kill bacterial spores that can grow into new cells, according to the U.S. Department of Health & Human Services (HHS). That means that if food is left sitting out for too long, or it's not refrigerated, the spores can grow and produce new cells, which may lead to illness when the food is eaten. Indeed, C. perfringens bacteria thrive in temperatures between 40 to 140 degrees Fahrenheit (4 to 60 degrees Celsius), a range that's often called the "danger zone," because it's not too hot, or too cold, for bacteria to grow. [Top 7 Germs in Food that Make You Sick]

C. perfringens illnesses often occur when foods are prepared in large amounts, and are then kept warm for a long time before serving, HHS said.

In Ohio, health officials identified 647 people who got sick after eating at a Chipotle in the city of Powell between July 26 and July 30. Customers reported symptoms such as vomiting, diarrhea and stomach pains, according to Business Insider.

An inspection of the restaurant found that some foods were not being kept at proper temperatures. For example, beans were not held at a warm enough temperature, and lettuce was not properly cooled, Business Insider reported.

In response to the outbreak, Chipotle leadership "will be retraining all restaurant employees nationwide beginning next week on food safety and wellness protocols," Brian Niccol, CEO of Chipotle, said in a statement. "To ensure consistent food safety execution, we will be adding to our daily food safety routines a recurring 'employee knowledge assessment' of our rigorous food safety standards."

Original article on Live Science.

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Can you get pregnant while on the pill: 5 ways it can happen

In this article, we look at how effective the birth control pill is, and five reasons why the pill might fail. We also give tips on how to prevent pill failure and describe some early signs of pregnancy.

How effective is the pill?

The combined pill contains hormones that prevent ovulation, which is when the ovaries release an egg for fertilization. Another type of pill, known as the minipill, causes a person’s cervical mucus to thicken and the uterine lining to thin, which reduces the likelihood of sperm reaching an egg.

The birth control pill is very effective if a person takes it correctly and does not miss any pill days. According to the Centers for Disease Control and Prevention (CDC), the pill is 99.7 percent effective with perfect use. This means that less than 1 out of 100 women who take the pill would become pregnant in 1 year.

However, with typical use, the effectiveness of the pill is 91 percent. This means that around 9 out of 100 women would become pregnant in a year of taking the pill.

It is essential to start a new pack of pills the day after finishing the previous one. However, sometimes a person may not have their new package yet. Missing a few days between packs can make the pill less effective at preventing pregnancy.

According to the CDC, anyone who misses two or more pills in a row should use a backup contraceptive method or avoid sexual intercourse until they have taken the birth control pill for 7 consecutive days.

Medications that interfere with the pill

Some medications can make the pill less effective. Medications include certain antibiotics, such as rifampicin, and anti-fungal drugs, such as griseofulvin.

A person should use backup contraception while taking these medications and for 48 hours after finishing the course.

Other more long-term medications and supplements may also affect how well birth control pills work. These can include:

  • epilepsy drugs, such as phenobarbital, phenytoin, and carbamazepine
  • anti-viral medications used to treat HIV
  • St. John’s Wort, which is a herbal remedy

If a person is concerned about contraceptive failure and the possibility of being pregnant, they should speak to their doctor. However, there are also some early signs that can indicate pregnancy:

  • Bloating. While bloating is often a symptom of premenstrual syndrome, it can sometimes also be a sign of early pregnancy.
  • Breast tenderness. Raised levels of the hormones estrogen and progesterone can cause breast tenderness early in pregnancy. Some women may also experience symptoms, such as tingling, heaviness, or feelings of breast fullness.
  • Light spotting. A small amount of bleeding or spotting can occur when an egg attaches to the uterine lining. If spotting occurs outside of an expected menstrual cycle, it may be an early symptom of pregnancy.
  • Unexplained fatigue. Hormonal changes that occur in the body during pregnancy can make a person feel tired, even during the early stages.
  • Urinating more often. Hormonal changes can increase a woman’s need to urinate during early pregnancy.

Anyone who thinks they could be pregnant may wish to take an at-home pregnancy test. These tests have become more sensitive to a person’s hormone levels and better at detecting pregnancy in its earliest stages.

However, at-home pregnancy tests still may not reliable if an individual takes it too early or does not follow the instructions correctly. According to the United States Food and Drugs Administration (FDA), for most reliable results, a person should take the test 1–2 weeks after their first missed period.


While birth control pills are generally very effective, they can sometimes fail to prevent pregnancies if a person does not use them correctly and consistently.

Anyone who is concerned about the effectiveness or convenience of their method of contraception should speak to a doctor.

If a person misses taking more than one pill, they should use a backup contraceptive method for at least 7 consecutive days of retaking the pill.

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Coffee while breastfeeding: Safety and risks

A morning cup of coffee might help a person manage sleep deprivation, but many people worry about the effects of caffeine on their babies. However, caffeine is safe in moderation for people who are breastfeeding.

In this article, learn about drinking coffee while breastfeeding, including the risks, benefits, and other sources of caffeine.

Coffee and breastfeeding

Many people are told to limit or even eliminate caffeine during pregnancy due to the risk of caffeine crossing the placenta and affecting the developing fetus. However, caffeine is much less likely to affect a breastfeeding infant.

The body metabolizes most of the caffeine in coffee is before it reaches breast milk or has a chance to affect the baby.

According to Dr. Thomas Hale in Medications and Mothers Milk, caffeine is a low-risk drug in moderation. Only about 1 percent of the caffeine a woman consumes gets into her breast milk, and this minuscule amount is not enough to harm most babies.

Breastfeeding parents who want to take the safest approach should consider limiting caffeine intake to about 300 milligrams (mg) a day, according to the Centers for Disease Control and Prevention (CDC). This amount of caffeine is equivalent to 2–3 cups of coffee.

Even caffeine consumption of more than 300 mg is unlikely to harm a baby. However, the CDC note that extreme caffeine consumption of more than 10 cups a day may cause symptoms in the baby, such as fussiness and jitteriness.

Caffeine levels in breast milk peak 1–2 hours after drinking coffee. A person who has recently breastfed may choose to watch their baby during this time to see whether they experience any effects from the caffeine.

Coffee is not the only source of caffeine. People concerned about their caffeine consumption or those who notice that caffeine seems to adversely affect the baby should be mindful of other caffeine-rich foods.

Some common sources of caffeine include:

  • energy drinks
  • black, green, and white tea
  • cola drinks
  • chocolate and cocoa products


No scientific evidence says that someone should give up caffeine while breastfeeding, though it is wise to enjoy it in moderation.

Some ways to manage caffeine intake include:

  • Monitoring the baby. Some babies are sensitive to caffeine and may become fussy or restless when the breast milk contains too much caffeine.
  • Considering how other dietary choices, not just caffeine, affect the baby. For instance, a high-sugar drink might affect the baby just as much as caffeine.
  • Knowing that the adult’s well-being matters, too. People who need caffeine to help them maintain energy and deal with frequent nighttime wake-ups and early mornings should not feel guilty about moderate consumption.
  • Drinking caffeine right after a nursing or pumping session. Depending on how frequently a baby nurses, this may allow enough time for the caffeine content in milk to drop before the next nursing session.
  • Making exceptions for a premature baby. If the baby was premature or has a particular medical condition, such as a history of food intolerances, it is best to talk to a doctor or lactation consultant about caffeine.
  • Cutting back. People who consume more than 2–3 cups of coffee a day, could try reducing the amount of caffeine slowly by making “half-caf” cups, which are a mix of regular and decaf coffee.

For more advice about balancing the risks and benefits of caffeine, people who are breastfeeding can talk to a doctor or lactation consultant.

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