Everything You Need to Know About Caffeine, Pregnancy & Breastfeeding

This image has an empty alt attribute; its file name is cafe-coffee-caffeine-pregnancy-and-breastfeeding2-1.jpg
Photo by Nick Hillier on Unsplash

One morning, I was grabbing a coffee at a coffee shop just around the corner from my workplace. I go there sometimes, when I leave my house and arrive early to work. I would spend the extra 15 minutes to drink my coffee and study a bit of my nursing material. At the time, I was preparing for my NCLEX-RN (National Council Licensure Examination).

Everyone could see that I was visibly pregnant. Of course, at 32 weeks, I was definitely showing, and you can also tell by all the stares that came my way when I stepped foot into the shop.

No, I didn’t order decaffeinated coffee. I ordered a regular one. And I just have one cup per day, but not every day.

This image has an empty alt attribute; its file name is coffee-caffeine-cafe-pregnancy-and-breastfeeding-1.jpg

When the barista took my order, he was hesitant. He looked at my swelling belly, then at my face, and then at his coworker. I was waiting for him to say something, and he did. He simply said,

oh, you know we also have decaffeinated coffee and espresso too.”

I was empathetic and tried to understand that this man’s concern came from a good place. So I kindly declined his offer and asked for a regular coffee. Then I proceeded to say that one cup a day is fine.

And although it looked like he didn’t believe me, he went ahead and poured me a cup of caffeinated coffee anyway.

I will say that this did bother me. I’m sure he thought very little of me to be drinking caffeine while carrying a child. But seriously? Did he think I was drinking alcohol everyday too?

I respect his concern but he didn’t respect the fact, that I did my research and that if he wanted to correct me about something, maybe he should have done his research too.

Obviously, I am not the first pregnant woman to experience this. In fact, my experience was pretty mild compared to others.

Have you heard about the one where a grandmother literally snatched and threw away a pregnant woman’s cold brew coffee?! Mamma-mia…

This image has an empty alt attribute; its file name is coffee-caffeine-pregnancy-and-breastfeeding-5.jpg
Photo by Jarek Ceborski on Unsplash

Is it safe to drink caffeinated coffee during pregnancy?

After the first trimester, it is safe to drink ONE CUP of caffeinated coffee per day and by one cup, I mean 200 mg of caffeine or a 10-12 ounce cup depending on where you go.

I know, research can make this all very confusing. New studies continue to combat each other. Some say it’s not okay to have a cup a day, and then other studies refute these results and claim that these conventional pregnancy theories are a thing of the past.

This image has an empty alt attribute; its file name is coffee-caffeine-pregnancy-and-breastfeeding-6.jpg
Photo by Alicia Petresc on Unsplash

But one fact is true – there is some sort of link between caffeine and miscarriages, stillbirths, and low weight births, especially when consumed in the first trimester.

The problem with this fact is that we cannot apply a quantity of how much caffeine to these risks or determine the true cause and effect relationship between the two.

However, studies do show that consumption of caffeine over the recommended 200 mg per day results in double the risk of miscarriages and low birth weights.

This image has an empty alt attribute; its file name is coffee-caffeine-while-pregnant-and-breastfeeding.jpg
Photo by Mike Kenneally on Unsplash

How does caffeine affect the human body?

Caffeine is a central nervous system stimulant. In the brain, caffeine causes alertness which is why many of us consume caffeine.

Basically, the stimulant blocks adenosine from connecting to adenosine receptors in the brain. (Adenosine is an inhibitory neurotransmitter in the brain that causes relaxation and sleepiness.) The chemical structure of caffeine is very similar to the structure of adenosine. Caffeine therefore, binds to the adenosine receptors and blocks adenosine from binding to it. This blocks feelings of sleepiness formerly brought on by adenosine, and the release of other natural stimulants such as dopamine. (Dopamine is also a neurotransmitter released by nerve cells and contributes to feelings of pleasure and satisfaction.)

We use caffeine to:

  • manage drowsiness
  • manage headaches
  • increase metabolism
  • enhance exercise performance
  • boost your mood
  • increase concentration
  • increases motivation to work

The peak effect of this stimulant occurs after approximately 30 minutes after consumption.

Consuming too much caffeine can cause:

  • insomnia
  • nervousness
  • restlessness
  • irritability
  • upset stomach
  • increased heart rate
  • increased blood pressure
  • muscle tremors

It is also a diuretic, meaning it increases urination. This causes the body to release more fluids through urine possibly resulting in dehydration.

How is caffeine addictive?

Caffeine can be physically addictive and behaviourally addictive, especially in those who consume caffeine on a regular and sustained basis.

Physical addiction to caffeine occurs when the body produces more adenosine receptors to make up for the ones that are blocked by caffeine. This means that there are now more receptors that caffeine can bind to, requiring you to drink more coffee to “fill” those additional receptors. This also explains how coffee drinkers build up a tolerance and require more coffee over time.

Behavioural addiction occurs through the repetition of drinking the coffee in a social environment and the positive feelings involved in that environment, rather than the caffeine itself.

Withdrawal from caffeine can cause:

  • headaches
  • lack of concentration
  • drowsiness
  • irritability

How does caffeine affect the growing fetus?

Caffeine can directly and easily pass through the placenta to the fetus. Adults can metabolize caffeine but the fetus cannot, especially in the early phases of development.

As mentioned above, caffeine binds to our receptors altering the chemistry of our brains and effecting our cells, membranes and tissue. This change in chemistry may interfere with proper development of the fetus.

Another theory proposes that the vaso-constricting (constriction of blood vessels) properties of caffeine may cause increased blood pressure in the mother, leading to decreased blood flow to the fetus. The lack of blood flow to the placenta deprives the fetus of the oxygen and nutrients it needs to grow.

Caffeine not only increases blood pressure but also blood glucose levels as well. And it increases the workload of the liver that is already dealing with the increased hormonal demands of pregnancy.

Is it safe to consume caffeine while breastfeeding?

It is safe to drink caffeinated coffee while breastfeeding. Keep in mind that caffeine does pass through to your baby through breast milk, but only in trace amounts (approximately 1% of what you take in).

When breastfeeding, it is recommended that you should consume no more than 3 to 5 cups of coffee per day or no more than 300 mg daily.

If you drink about 3-5 cups of coffee, make sure to spread the consumption throughout the day to prevent high concentrations of caffeine in your breast milk.

If you find that your baby is becoming more restless and cranky after you’ve have coffee and breastfed, it may be time to reassess your intake amount.

How do you cut back on caffeine?

For chronic coffee drinkers who are or will be pregnant, it is important to wean yourself off of caffeine rather than stop cold turkey.

Start by mixing half caffeinated coffee with half decaffeinated coffee at first. Then eventually work towards drinking decaffeinated coffee entirely.

What other foods and drinks contain caffeine?

Besides coffee, caffeine can also be found in the following and should be consumed in moderation:

  • espresso beans
  • tea leaves
  • sodas
  • chocolate (cocoa beans)
  • energy drinks
  • some over the counter medication

As I’ve always mentioned, it is very important that you talk to your doctor about your caffeine consumption during pregnancy or breastfeeding.

We all know that mothers and mothers-to-be must make a lot of sacrifices for their growing babies but luckily, a cup of Joe doesn’t have to be one of them!

Thanks for reading.

This image has an empty alt attribute; its file name is signature.png

Life Saving Skills Every Parent Should Know: CPR & AED for Infants

Becoming a mother or father encompasses a tremendous responsibility, and that involves keeping your children safe from harm. This is why I decided to write a post about CPR and the use of the AED for infants (newborn to one year old) in hopes of raising awareness of this important life saving skill (that hopefully, you never have to use).

This is a in-depth step by step guide on how to perform CPR and use the AED on your infant if a situation ever arises.

It is important to note that this post does not replace courses with licensed first aid & CPR instructors. Instead, this post is meant to encourage you to enroll in a licensed class and supplement your learning. I have taken classes with the Red Cross and St. John Ambulance and their instructors are passionate and informative. I highly recommend them.

What is CPR?

CPR stands for cardiopulmonary resuscitation. CPR is needed when the heart, circulation, and respiration cease. The goal of CPR is to provide adequate blood perfusion to the brain, the heart, and vital organs by manually compressing the heart to pump blood. In doing so, you will decrease the likelihood of organ damage due to lack of oxygen.

Steps on How to Perform CPR on an Infant

Note: An infant is considered a newborn to one year old.

Scene: You find your baby unconscious in the play room.

Photo by Piotr Janus on Unsplash

Step 1: Assess the scene and make sure it is safe to approach.

As you approach your infant, you need to make sure the scene is safe to enter. Of course, in this situation, you are at home and your infant is in the playroom.

Take note of their environment and the objects around them.

Photo by Shitota Yuri on Unsplash

Assessing the scene and looking for cues will help you figure out what has happened, and guide you in your next steps of action.

Step 2: Try to stimulate the infant to wake up.

Elicit a response by trying the following:

– Flick the bottom of their feet

– Gently stroking the infant

Note: Never shake an infant due to the risk of shaken baby syndrome which can result in severe brain damage.

Step 3: If the infant does not respond, call for help.

If you are alone, call 911 for help and if possible, do not leave the infant’s side.

If someone is with you, get them to call 911 and find an AED (Automated External Defibrillator) while you provide care. In a home setting, finding an AED may be very difficult!

Step 4: Assess for breathing and pulse simultaneously for no more than 10 seconds.

Put your ear to the infants mouth and nose and listen for breathing sounds.

Watch their chest for up and down breathing movement.

At the same time, place your index finger and middle finger together and feel for the brachial or femoral pulse.

The brachial pulse is felt at the inner part of the infant’s arm, just above the elbow.

The femoral pulse can be felt in the inner and upper thigh.

You should be listening for breathing, watching the chest for rise and fall, and feeling for a pulse all at the same time and as quickly as possible.

Step 5: If there is no breathing, give a rescue breath.

Cover the infants mouth and nose entirely with your mouth and deliver one breath to see if the infant’s chest rises.

If it does not rise, the infant may have an obstructed airway (such as chocking). If that is the case, you will give 2 back thrusts with the palm of your hand after delivering compressions using the 2 finger technique (more detail below). Make sure to tilt the infant head downwards to allow gravity to help dislodge the foreign object out of their airway.

If the chest rises, their airway is clear. Deliver a second breath.

Note: Each rescue breath should last 1 second long, and make the chest rise.

Step 6: If the infant remains unresponsive, begin compressions.

Two Types of Compression Techniques for Infants:

1. 2-Finger Compression

Place your index and middle finger of one hand on the lower part of the sternum (in the middle of the chest, just below the nipple line) while your other hand supports the infant’s back. Use this technique when you are delivering back thrusts.

When to use this technique: When you are the only rescuer on site or if your hands are too small to encircle the chest of the infant

2. 2-Thumb Encircling Hands Technique

Preferred compression technique because it results in improved cardiac perfusion

Place both your thumbs on the middle third of the infant’s sternum (just below the nipple line) while encircling and supporting the infant’s back with both hands.

When to use this technique: This is the preferred compression technique. Use this technique if you can encircle the infant’s chest with both your hands. If the infant is very small, or your hands and thumbs are too large, you can put your thumbs on top of each other and compress that way.

Note: Avoid compression of the xyphoid portion of the sternum – compression here can damage the infant’s liver

How to Compress and Ventilate

If you are by yourself, compress 30 times and follow with 2 breaths (compression – ventilation ratio: 30:2)

Compress about 1/3 deep or 1 1/2 inches deep of the infant’s chest at a rate of 100-120 per minute.

If you are with another rescuer, they can help you. Instead of 30 compressions, deliver 15 compressions, and provide 2 breaths. Then you and the other rescuer can take turns compressing and giving rescue breaths at a ratio of 15:2. Also, while one person is performing CPR, the other can find and set up an AED.

Having another rescuer allows you to take turns and rotate. Compressions can get tiring, especially if you are the only rescuer waiting for help. As you get tired, your compressions may become sloppy and ineffective. It is shown that high quality compressions along with the AED are the two most critical interventions in saving a life so make sure you are doing them right. Always use the help whenever it is available.

Step 7: Continue CPR if infant remains unresponsive, and until help or the AED arrives

As you continue compressing and giving 2 breaths, make sure to reassess the infant every 2 minutes (after 5 cycles of CPR) or until help arrives. Which ever comes first.

If you are alone and performing CPR, reassess the infant every 2 minutes. If the infant is still not responsive, try to find an AED. Of course, if you are at home, continue CPR until help arrives.

When the AED arrives, apply the pads and wait for the automated instructions while you continue performing CPR.

How to use an AED on an Infant

AED stands for automated external defibrillator and can be found in public spaces for emergency use. It is a user-friendly and smart portable electronic device. It analyzes the person’s heart rhythm and determines if the heart rhythm is irregular (aka dysrhythmia). If the AED senses that the heart rhythm is irregular, it will deliver an electrical shock to restore the heart’s dysrhythmia to its normal rhythm. AEDs will only shock and correct a dysrhythmia. It will not start one that has already stopped such as in asystole.

In cases where the AED does not sense an irregular rhythm that it can shock, you should resume manual compressions and rescue breaths until the AED senses a shockable rhythm. Then reassess the infant every 2 minutes of CPR until the AED delivers a shock or until you see any spontaneous movement from the infant.

It is important to use the AED immediately when it arrives, even in the middle of performing CPR, and even if the AED that you have is not intended for children. Research has shown that survival rates increase when CPR and defibrillation occurs within 3-5 minutes of cardiac arrest.

When the AED is turned on, it will automatically instruct you. Listen to its instructions as it tries to sense a shockable rhythm. If there is a shockable rhythm, it will notify you to stay clear before shocking. “Clear” means do not touch the infant while the AED is delivering a shock.

AED Pad Placement on an Infant (Newborn to 1 Year old)

If there are pediatric AED pads or a pediatric dose attentuator on the AED you have on hand, it can be used for newborn babies and up to 8 years old.

Adults pads can also be used on children if that is all you have. But it is important to ensure that the AED pads do not overlap or touch each other during placement on the infant or child’s chest. This is due to the way the AED delivers the shock. If the pads overlap or touch, the shock delivered will not pass through the heart as it was intended to. Instead, the shock will just transfer from one pad to the other.

Sandwich the Heart

If all you have is an adult AED, place one adult pad in the middle of the infant’s chest and then place the other pad in the middle of their back, as if you are “sandwiching” the heart.

Cardiac Arrest in Children

Children often go into respiratory distress and bradycardia (heart rate drops to 60 or less beats per minute; normal for an infant is 80-160 beats per minute) before going into cardiac arrest. Even with a pulse, health care professionals will initiate compressions right away in preparation for a potential cardiac arrest. They will treat an infant with respiratory distress and a low heart rate as if they were “pulseless“, despite the presence of a pulse.

Signs & Symptoms of Respiratory Distress in Children

If your child is experiencing any or a combination of the following signs and symptoms, they may be experiencing respiratory distress:

  • Nasal Flaring
  • Noisy breathing
  • Rapid and/or shallow breathing
  • Shortness of breath
  • Brief periods of not breathing (also known as apnea)
  • Bluish colour of the skin and mucous membranes (gums and mouth, eyelids, hands and feet, nail beds) (also known as cyanosis)
  • Clammy skin (cool and sweaty skin)
  • Chest wall retractions (when the infant’s chest pulls in with each breath)
  • Mood Changes (difficult to arouse or keep awake, or fussier than usual)
  • Change in body position (positioning themselves in a way that makes it easier for them to breathe)

What to do if you notice the above signs and symptoms in your infant:

Stay calm, stay with your child, and reassure them.

Call for help (911) or take your child to the nearest emergency department if they are in distress.

Be ready to perform CPR if your infant becomes unconscious.

And my best advice to parents is to trust your instincts! If you feel like something just isn’t right, get help.

I hope you never have to use any of these skills in real life on an infant, especially your own, but these things do happen. Babies can choke on their food or toys, accidentally fall into a pool or slip under the water during bath time… And it can all happen so fast and so suddenly. As a new mom who has taken the CPR course many times, I can sincerely say that I have piece of mind knowing that I am definitely prepared when and if the time ever comes. And you should too.

As always, thanks for reading.

The Truth About Eating Raw Fish During Pregnancy

When I was pregnant, all of my friends and family warned me to avoid eating sushi because sushi was one of my favourite foods! Though devastated, I knew I had to make those sacrifices when I got pregnant – raw fish being one of them. And for the sake of my unborn child, I never bothered to question it.

Literally 2 minutes after I had delivered my baby girl, I joked to my doctor and said, “God, I can’t wait to eat sushi again!” My doctor looked at me and said, “…who said you couldn’t before?” I looked back at her puzzled and realized, I never actually asked my doctor if I had to avoid raw fish during pregnancy! I just assumed that it was the obvious thing to do! 

Photo by Valeria Boltneva from Pexels

So if you didn’t know, now you know. To all my sushi loving friends, it’s generally safe to eat sushi and raw fish when you’re pregnant and when you’re breastfeeding! Hooray!

The FDA does state that pregnant women and young children should stay away from raw fish as they have weaker immune systems and are at more risk for food borne illnesses but raw fish served in sushi and sashimi is not included in this recommendation!

In fact, the FDA states that eating a variety of fish when pregnant or breast feeding can provide health benefits for mom and baby! (Keyword: variety! Don’t just eat the same type of fish every time you do!)

Eating fish provides:

  • Protein
  • Omega 3 fats (aka DHA and EPA)
  • Very high in Vitamin B12 and vitamin D
  • Iron
  • Minerals such as selenium, zinc, iodine

And these nutrients contribute to healthy growth and development of your baby. They even provide heart health benefits and lowers the risk of obesity.

Photo by Sebastian Pena Lambarri on Unsplash

2 Things to look out for when eating raw fish

1. Parasitic worms

It’s the parasitic worms found in raw fish that actually make you sick. Ingesting and getting infected with the worms (aka anisakis) results in a painful condition called anisakidosis. These worms invade and penetrate your stomach lining. Some common signs and symptoms include:

  • Severe abdominal pain
  • Nausea and vomiting
  • Diarrhea
  • Allergic reaction
  • Death in very rare cases!

Other parasitic worms present in fish is tapeworm. Fishes potentially infected with tapeworm include:

  • Pike
  • Perch
  • Anadromous fish (fish that migrate up rivers from the sea to spawn such as salmon)

Learn more about parasites from the Seafood Health Facts website!

2. High levels of mercury

Ingesting high levels of mercury can lead to birth defects specifically affecting the brain and nervous system. Mercury is present in streams, lakes and oceans and are either naturally occurring or man made. Mercury turns into methylmercury which is found in nearly all fish but in different amounts. It is this type of mercury that is harmful to us in high amounts.

These fish have the highest mercury level and should be avoided:

  • King mackerel
  • Marlin
  • Orange roughy
  • Shark
  • Swordfish
  • Tilefish
  • Tuna, big eye 

There is no way to prepare or cook fish to lower its mercury level because the mercury is in the tissue of the fish. But that doesn’t mean you should avoid eating fish entirely during pregnancy due to its considerable health benefits. Just consume fish that are low in mercury and avoid fish with high levels.

Photo by Travis Yewell on Unsplash

Fishes low in mercury that you should eat:

  • Anchovy
  • Atlantic croacker
  • Atlantic, and pacific chub mackerel
  • Black sea bass
  • Butterfish
  • Catfish
  • Cod
  • Flounder
  • Haddock
  • Herring
  • Pickerel
  • Pollock
  • Salmon
  • Sardine
  • Sole
  • Tilapia
  • Freshwater trout
  • Canned light tuna
  • White fish
  • Whiting

… and many more! Learn more about which fish is best to eat here on the FDA website.

Remember, a variety of fish in your diet is key!

Photo by chuttersnap on Unsplash

Farmed Fish and Freezing Methods

Some farmed fish used in sushi such as salmon or tuna are very unlikely to be infected with the parasitic worms because of the methods used to farm these fish for mass human consumption.

Also, freezing raw fish kills any worms present which makes it safe to eat. When preparing sushi in your own home, make sure to freeze the raw fish for at least 4-7 days.

Learn more about farmed fish practices here!

Photo by ray rui on Unsplash

What about shellfish?

Shellfish is totally okay to eat when it is cooked. Raw shellfish contains harmful viruses and bacteria that can cause food poisoning so if you’re pregnant, you should probably avoid that scallop ceviche dish!

Shellfish include:

  • Shrimps
  • Prawns
  • Crawfish
  • Crabs
  • Scallops
  • lobster

Keep these tips in mind when you’re at the sushi restaurant and about to enjoy some delicious sushi rolls with you baby bump! But beware of the concerning stares – they don’t know any better…

Thanks for reading everyone!

5 Reasons Why You Need A Crib Mobile

Are crib mobiles really necessary? Or are they just a decorative piece to add to your nursery?

I always thought that new parents spent way too much money on baby items that they really don’t need, and this included the crib mobile.

But one night as I was putting my baby to bed, I noticed her toy bear sitting on the shelf. I held the toy bear in front of her face and instantly, her eyes lit up, she began to smile, and her arms and legs flailed and kicked like I had never seen before! And I thought, “oh my goodness, maybe crib mobiles really are necessary!…” So I decided to do my research and this is what I found.

Here are the top 5 reasons why you need a crib mobile!

1. Visual Stimulation and Eye/vision Development

Babies start to learn and take in information from their environment right from birth. Therefore visual stimulation is very important in the development of your baby’s eyes and vision. Your baby will track and follow the rotating toys on the mobile improving eye movement, vision, and strengthening eye muscles. From 0-3 months, your baby will see contrasts of black and white at first. As they grow, they will begin to see bold colors such as red, blue, yellow, and green. Colourful toys that rotate and encourage eye movement is definitely something to consider when purchasing or making a crib mobile. Even better, some crib mobiles come with lights that project stars and other images on the walls to help soothe your baby to sleep.

2. Sound Stimulation and Hearing Development

Some baby mobiles play soft lullabies to help soothe baby to sleep. These songs helps keep baby stimulated, contributing to their hearing development, and aids in preparing your baby for bedtime.

Photo by Jelleke Vanooteghem on Unsplash

3. Motor Skills Development

When your baby watches the mobile toys dancing above them, they get excited! They will kick and move, strengthening their neck, arms and leg muscles. Pretty soon, they will start to reach for the toys which contributes to hand-eye coordination and their comprehension of depth, distance, and spatial awareness.

Photo by Minnie Zhou on Unsplash

4. Bedtime Routine

Babies as well as their parents, love routine! And turning on the baby mobile as you settle your little one into their crib or bassinet for the night can help to soothe your little one and let them know that its time to sleep. Adding this step into our bedtime routine really helped. The key is to be consistent (easier said than done!) After a warm bath, I give my baby a calming lotion massage while the mobile plays its lullaby music. Then I put her into her crib, dim the lights, and let the mobile do its magic.

5. …Extra Sleep for Mommy and Daddy!

Last but arguably most important, the baby mobiles lets mom and dad sleep in for that extra half hour when your baby wakes up early. Your baby will keep themselves busy and entertained while you catch those last few precious z’s. Even if it’s 5 more minutes, I’ll take it!

Some things to Consider…

Crib mobiles can be very beneficial in your baby’s development but there are some things to consider when thinking about adding a mobile to your nursery.

It really depends on your baby! Sometimes, crib mobiles can be overstimulating which could hinder your baby’s sleeping habits. Also, some moms believe that toys in the crib will make the crib more of a playground rather than a place to sleep.

There are also hazards to consider as well. Make sure that your mobile is securely attached to the crib and that it is position far enough that baby cannot reach and grab it! Toys that can be detached from the mobile can possibly fall off causing a choking or suffocation hazard. Store bought mobiles are usually up to code but if you’re making your own, make sure the strings aren’t too long for baby to grab and pull.

As well, crib mobiles can be pricey! They can range from $30 to over $100 especially if the mobile has a music box, projects lights or is custom and handmade (like the ones you can find on Etsy). However they can be very inexpensive if you decide to make your own!

Check out my DIY Unicorn and Rainbows Crib Mobile coming soon!

All in all, I believe that the benefits of baby mobiles far outweigh the cons listed above. I believe that making your own gives the nursery a personal touch. It also makes a great keepsake or special gift! Our homemade mobile doesn’t play lullabies or project pretty lights on the walls at night, but our baby still gets excited whenever I put her in her crib for the night.

But my most valuable advice to my readers is to learn and understand your baby’s sleep behaviours and patterns. Understanding what helps your baby (and you!) go to sleep at night will assist in deciding whether a baby mobile is right for you and your family.

I hope this post helps. Thanks for reading everyone!