Chronic alcoholics and occasional heavy drinkers should not breast feed, as their infants may suffer from 'pseudo-Cushing's syndrome'. The characteristic findings of this syndrome in infancy are excessive weight, short stature, and moon-shaped face. Nicotine will pass into the mother's breast milk, but no adverse effects on the infant have been noted. Excessive caffeine in breast milk can cause wakefulness and hyperactivity in the infant. A mother would need to consume 6 to 8 cups of caffeine-containing drinks before these effects are seen.
Caffeine tends to accumulate in the infant.
Caffeine and other xanthines are found in coffee, tea, cola, chocolate cocoa. Periods of drowsiness have been noted in infants who are breast fed while the mother is on anti-convulsant therapy, but severe, acute effects are rare. However, phenytoin administered to breast-feeding mothers can cause methaemogloblinaemia in infants, who should be carefully monitored for any side effects. The penicillins, cephalosporins and aminoglycosides are safe and thus the preferred drugs if indications for their use arise. Metronidazole should be used with caution, as it may produce decreased appetite, vomiting and, rarely, blood dyscrasia.