Kids and Caffeine

Do children under your care sometimes seem to be "wired for sound" when they arrive? Do some children have trouble sleeping or resting at nap time? If so, you may want to find out what they are eating or drinking before they arrive at your childcare program. The culprit may be caffeine. A child who has tea, chocolate milk, or a soda with breakfast, or who eats chocolate candy, cookies, or cereal, may be experiencing the side effects of caffeine.

As adults who drink coffee know, caffeine often is consumed for its stimulant effect. This effect can lead to enhanced alertness, energy, and increased ability to concentrate. However, caffeine can decrease a child's ability to perform tasks involving delicate muscular coordination, arithmetic skills, or accurate timing.

Is it healthy for children to consume caffeine? Many health care providers, especially pediatricians, recommend that children avoid or limit caffeine use. Caffeine is absorbed very quickly in the body and then passes into the central nervous system. Caffeine in low doses can affect the body, such as decreased appetite, increased urination, and insomnia (difficulty sleeping). Toxic effects such as nausea, vomiting, diarrhea, cramps, muscle twitching, and agitation can begin with consumption of as little as 4.5 mg of caffeine per pound of body weight (114 mg in a 25 lb. child). Severe caffeine toxicity can lead to seizures, an increased heart rate and an irregular heart beat. "Caffeine sensitivity" refers to the amount of caffeine that will produce negative side effects and this amount varies from person to person. Caffeine does not accumulate in the bloodstream and is excreted in the urine within hours of being consumed.

If a child does consume caffeine, the amount should be limited to 100 mg or less per day. A 12-ounce glass of tea or of most soft drinks would exceed this limit! Whenever possible, offer caffeine-free alternatives, healthy beverages such as water, 100 percent fruit juice, and milk. Read the ingredient labels carefully on all beverages. You may be surprised to find that drinks such as fruit-flavored beverages may contain caffeine. Caffeine can be found in many soft drinks, coffee, tea, chocolate items (including chocolate milk), and some medications, such as pain killers.

A child's caffeine consumption should be monitored as caffeinated beverages may be replacing important foods such as fruit juices and milk. Caffeine also can act as an appetite depressant and children may not be getting enough nutrient-rich foods.

Remember too, that "caffeine-free" means that the food or beverage does not normally contain caffeine and has no caffeine added to it. Some foods and beverages, such as tea or coffee, normally contain caffeine. The term "decaffeinated" only means that some of the caffeine has been removed. It may still contain a significant amount of caffeine, especially for a body as small as a child's.

Many parents are not aware of the effects of caffeine on their children. If caffeine-containing products are to be consumed by children, here are some considerations:

• Caffeine takes three-six hours (longer for some individuals) to begin to leave the body. Avoid consuming caffeine prior to nap time or bed time as it may cause bed wetting and/or difficulty in sleeping.
• Caffeine can cause increased urination, so limit its intake during the summer months to prevent dehydration.
• If a child appears to be anxious or nervous, monitor the amount of caffeine in the diet, including the foods mentioned above and chocolate candy, cookies, brownies, and cake.
• If children drink carbonated sodas, substitute caffeine-free varieties.

Some medications will interact with caffeine. Consult with your health care provider or pharmacist about potential interactions with caffeine whenever you take medications. Additionally, some medications may contain caffeine. Some cold medications, for example, can contain up to 30 mg of caffeine.

By Ann Slattery RN, R.Ph, Supervisor, Regional Poison Control Center of Alabama

Resources

American Dietetic Association, 216 W. Jackson Blvd, Chicago, IL 60606-6995; 312-899-0040; www.eatright.org.