Children’s Health: Know the effects caffeine can have on your children

A cup of coffee or tea in the morning or an afternoon caffeine pick-me-up is usually fine for most adults. But parents might want to take a closer look at caffeine and other ingredients in the drinks their kids love.

Many popular beverages that kids go to for quick energy have a surprising amount of caffeine. Some drinks have other stimulants, too. These energy-boosting ingredients quickly add up in a smaller body.

Caffeine-related visits to U.S. emergency departments nearly doubled among middle and high school students between 2017 and 2023. In 2023, poison control centers recorded a 24% rise in calls about young people with reactions to energy drinks.

Here's what parents and caregivers need to know about caffeine — and how to guide children and teens toward healthy drinks.

There is no biological need for caffeine. Caffeine is a stimulant that boosts alertness, energy and brain activity. Coffee and cacao beans, tea leaves, guarana berries and kola nuts are all natural sources of this drug, but it can also be made in the lab and added to foods, drinks and medicines.

A child's growing body and brain are more sensitive to their stimulation by caffeine. Caffeine side effects can include fast or irregular heartbeat, elevated blood pressure, rapid breathing, anxiety, nausea, restlessness, diarrhea, and sleep loss. Caffeine can stay in the body for more than 8 hours, depending on a person's metabolism. When the caffeine wears off, children may have a headache and feel irritable or tired.

Caffeine can get in the way of other nutrients that help kids grow. They may eat less fruit, vegetables, lean protein and healthy grains after filling up on soda, energy drinks, protein bars and other ultra-processed foods with caffeine.

Caffeine affects kids' sleep. Not getting enough sleep, or not sleeping well or long enough, can affect thinking, mood, digestion, and ability to avoid getting sick. Sleep loss leads to school struggles and robs kids of the energy they need for activities they enjoy.

Studies suggest that some kids are more sensitive to caffeine than others, but we need more research to fully answer this question. Research has found that males were more likely to visit the emergency department for caffeine-related symptoms than females. Kids with heart or lung conditions may also be extra-sensitive to the stimulation of caffeine, since it speeds up breathing and heart rate.

Kids who take stimulant medications for attention deficit/hyperactivity disorder (ADHD) or to treat other conditions may have sleep problems, irritability and mood shifts when they consume caffeine.

The American Academy of Pediatrics says avoiding caffeine is the best choice for all kids. Families should keep food, drinks and medicines with caffeine out of reach. For most adults, having under 400 mg of caffeine per day is generally not associated with side effects. Talk to your doctor if you are pregnant or breastfeeding. People with some health conditions or who take certain medications may be more sensitive to caffeine.

Classic coffee mugs hold about 10 ounces. Super-sized coffee drinks are often 16 to 20 ounces and can have up to 490 mg of caffeine (already over the 400 mg level for adults).

Iced, chilled and frozen coffee drinks also contain caffeine. For example, a 13.7-ounce bottled Starbucks Frappuccino has 110 mg of caffeine and a Dunkin' Iced Coffee has 197 mg of caffeine.

Energy drinks can pack a dangerous punch in the caffeine department. This might be why so many labels carry warnings that the drink is meant for adults only. They come in fruity, candy-like flavors that appeal to kids. Some drinks are sugar-free, but others have a high amount of sugar that can amplify the effects of the drink. Energy drinks with caffeine may also have other ingredients like taurine, guarana, ginseng and L-carnitine.

Some sodas are a source of caffeine as well. For example (12-oz serving): Pepsi Zero Sugar (38 mg), Diet Coke (46 mg), Mountain Dew (54 mg) and Mountain Zevia (55 mg).

Caffeine can hide out in foods, too. A 3.5-ounce dark chocolate bar might have anywhere from 50 to 150 mg of caffeine. Ice cream, protein bars, chocolate chips, energy bars and even chewing gum can have hidden caffeine. Nutrition labels do not have to list caffeine content.

Prescription and over-the-counter drugs such as medicines for migraine headaches, menstrual (period) discomfort, nasal congestion or muscle pain may have caffeine

A newer method of ingesting caffeine are pouches, small packets that are placed in the mouth between the gums and cheek or between the lips. They come in a variety of flavors that appeal to teens. The contents dissolve and the caffeine is quickly absorbed into the bloodstream.

The effects are felt in minutes, making it easy to get a sudden, large, and potentially dangerous dose of caffeine. Pouches may contain as much as 200 mg of caffeine. They look like nicotine pouches, which are restricted for sale to people 21 and older. However, there are no age restrictions on the sale of caffeine pouches.

The best way to steer kids away from caffeine is to talk with them about making healthy choices. You can encourage them to drink water instead and make sure they are getting enough sleep. The stimulation of caffeine is not a substitute for sleep. It is important to teach kids to trust the signals their bodies are sending them, especially when it comes to caffeine consumption.

A caffeine overdose can be dangerous. Get medical help right away if your child had a large amount of caffeine and symptoms such as racing or irregular heartbeat, fast breathing, body shakes your child can't control (tremors), anxious feelings, or the inability to sit still (hyperactivity).

• Children's health is a continuing series. This column was provided by the American Academy of Pediatrics. See more at www.healthychildren.org. Dr. Mark Corkins, MD, FAAP, serves as chair of the American Academy of Pediatrics Committee on Nutrition. He is Division Chief of Pediatric Gastroenterology and Professor of Pediatrics at the University of Tennessee Health Science Center and Le Bonheur Children's, Memphis and the St. Jude Endowed Chair of Excellence in Pediatric Gastroenterology. Dr. Corkins is a Fellow of the American Gastroenterological Association, North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, and the American Society for Parenteral and Enteral Nutrition and honorary member of the Academy of Nutrition and Dietetics. Dr. Corkins has served on the American Society of Parenteral and Enteral Nutrition (ASPEN) Board of Directors.