According to the study, approximately 15 percent of 2-year-olds consume as much as 4 ounces of coffee daily. It’s a practice, health experts say, that comes with a dangerous dose of health risks.

The study followed 315 pairs of mothers and infants who were participating in an analysis of weight change during a child’s first week and its impact on body mass index at age 2. While examining diets, researchers found that 48 of the participating mothers were feeding their 2-year-olds coffee as part of their daily fluid intake.

Infants and toddlers of Hispanic mothers were more likely to drink coffee than those of non-Hispanic mothers, according to the study, but researchers did not examine further to determine why. Female infants were also found to be more likely to drink coffee than male infants.

Cultural practice may be one of the reasons some children drink coffee at younger ages, according to the study. In some countries, including Cambodia, Australia, and Ethiopia, children under 5 are given coffee.

“I think too much caffeine in childhood is a bad thing and worse in the case of a younger child,” said Joel Steelman, M.D., endocrinologist at Cook Children’s. “Coffee consumption by younger children is a big deal. I wouldn’t recommend parents start this practice. There are much healthier options. Caffeine could interfere with sleep – naps and bedtime. Overconsumption of caffeinated drinks could lead to symptoms of dizziness, headaches, mood changes and seizures.”

The U.S. Federal Drug Administration (FDA) has not provided guidelines on coffee consumption for children, but previous studies suggest there are potential negative health impacts, including Type 2 diabetes, depression, obesity and sleep disturbances. The American Academy of Pediatrics (AAP) recommends against the inclusion of caffeine in a growing child's diet.

Deborah Schutte, M.D., cardiologist and medical director of Cardiology at Cook Children’s, said her chief concern regarding toddler coffee consumption is the cardiovascular effect, particularly increased heart rate and high blood pressure.

“It boggles my mind why any parent would give a toddler caffeine. Toddlers are wired enough, why would anyone want to add to that?” Schutte asked. “My concern with caffeine and toddlers is more about tachycardia and arrhythmias. Caffeine can cause the heart to pump at an unnatural pace, resulting in palpitations.”

Schutte also points out that giving toddlers coffee could lead to dehydration, particularly since caffeine is a diuretic.

A 2013 study found that 2-year-olds who drank coffee or tea between meals or before bedtime were three times more likely to be obese in kindergarten.

“Just because there are no guidelines, doesn’t make it OK,” Schutte added. “What people don’t consider is that there is caffeine in drinks and food that we don’t always realize, such as chocolate and coffee- flavored ice cream, so caffeine levels can sneak up on you.”

According to the FDA, the average American adult consumes approximately 300 mg of caffeine each day - the equivalent to between two and four cups of coffee.

Canadian guidelines recommend no more than 45 mg of caffeine for children ages 4-6. This is equivalent to one 16 ounce can of soda.

If parents are already giving their toddler coffee, it’s possible to wean their child off the caffeinated beverage, Steelman said. He recommends parents talk to their pediatrician about a weaning off caffeine schedule.

I can’t tell you how many times I’ve heard this from anxious parents as their child is having his echocardiogram done. In reality, a murmur is something that is heard, not seen.

In a normal heart, the valves make noises as they close, the classic “lub-dub” attributed to normal heart sounds. A murmur is an extra sound, “lub-shhh-dub.” Most of the time the murmur is innocent or functional, some may call it benign.

Innocent murmurs are simply sounds we hear as blood flows through a normal heart. More than two-thirds of children with normal hearts will have a murmur at some point in their life. There are classic innocent murmurs that occur at various times throughout a child’s life, and usually they go away on their own over time.

Aside from these are the pathologic murmurs, or sounds that occur because there is a problem with the heart, maybe a valve that isn’t working properly, a hole in the heart, or a vessel that is narrowed.

Typically there are characteristics that help distinguish innocent murmurs from pathologic murmurs. Louder, more harsh murmurs are more characteristic of pathologic murmurs. The timing that the murmur is heard is also important. Innocent murmurs are typically heard when the heart is squeezing (this is a systolic murmur). In the case of innocent murmurs, there is usually no need for further evaluation. Innocent murmurs don’t “progress” to pathologic murmurs. There is no need for activity restrictions and no need for antibiotics when the child goes to the dentist. In the case of pathologic murmurs, follow up, activity restrictions, and whether the patient needs antibiotics when he or she goes to the dentist all depend on what is causing the murmur.

Having said this, not all systolic murmurs are innocent. Murmurs heard when the heart is relaxing (diastolic murmur) are usually pathologic.

An echocardiogram is a test that helps us evaluate the heart in the event that the murmur sounds concerning. The probe, or camera, sends ultrasound waves toward the heart . This time it is about what we see. The waves bounce off solid structures and the machine organizes the returning signals into a 2D picture, which is displayed on the screen. The study also uses color signals to help determine the direction of flow, and Doppler signals to determine how fast the blood is traveling across different areas of the heart.

The cardiologist uses all of this information to determine if there is a problem and a treatment plan for the child begins. And to think it all begins with those first anxious moments of listening to a child’s heart.

About the author

Deborah Schutte, M.D., is the medical director of Cardiology at the Cook Children's Heart Center. The cardiology team at Cook Children's has extensive experience in the diagnosis and treatment of pediatric heart care. They know the unique requirements of treating the growing hearts of children, including those with extremely rare and difficult conditions. Our areas of expertise include cardiac surgery,interventional cardiology, adult congenital cardiology, electrophysiology, cardiac testing and imaging,echocardiography, fetal echocardiography and cardiac anesthesiology.