Drinking Alcohol and Breastfeeding

by Virginia B. Hargrove

pouring wineYou watched your drinking during pregnancy when solid research supports abstaining from or limiting alcohol. Now that your baby's arrived and you're nursing, you might be wondering if you can have an occasional drink.

According to our contributing expert Dr. Jack Newman, "The mother can take some alcohol and continue breastfeeding as she normally does. Prohibiting alcohol is another way we make life unnecessarily restrictive for nursing mothers."

We've asked nursing moms about their concerns, dug through research and found answers. They wonder:

• How much alcohol gets into breast milk?
• Can I limit my baby's exposure to alcohol by not nursing for several hours after drinking?
• Do I need to pump and dump when I drink?
• What effect does alcohol exposure via breast milk on my baby?
• Should the baby's age factor into my decision?

If your questions don't appear in this list, let us know in the comments.

Breastfeeding and Alcohol Facts

What's the dig on boobs, booze and babies? The official take on alcohol and breastfeeding differs and sometimes conflicts with itself. La Leche League points to research indicating that the amount of alcohol a baby receives when the breastfeeding mother drinks occasionally or limits her consumption to one drink or less per day hasn't been proven to be harmful. The bottom line: alcohol in small amounts, like one to two drinks per week appears harmless. Not willing to take that risk? The solution is to abstain from imbibing, and your breasts will be set to go. As the alcohol leaves your bloodstream, it also leaves your breast milk.

What happens when you drink? Let's follow that alcohol around your body:

  • You sip on a drink
  • Alcohol peaks in your blood and milk 1/2 to 1 hour after drinking. The time varies depending on your body weight and body fat, how much you ate before or while drinking
  • A percentage of the alcohol you drink passes freely into your breast milk
  • Alcohol doesn't remain in your breast milk. It's metabolized by the liver. In two or three hours, your milk will be alcohol-free

Suggestions for the Breastfeeding Momma

For an occasional drink:

  • Feed your baby
  • Enjoy a drink, possibly two
  • Wait approximately two hours per drink before nursing
  • Snuggle in for a guilt-free nursing session

"The general rule of thumb is that you should refrain from nursing for two hours for every drink. For example: If you have a beer and finish it at eight you shouldn't nurse your baby until ten. If you need to pump before two hours then you should dump the milk, but there's no need to pump unless you're uncomfortable." ~Kat, IBCLC Intern

If you plan on several drinks:

  • Pump ahead of time or have formula on hand for your baby during the time your milk alcohol level might be high
  • Invite a designated baby-care person should you need help caring for your little one
  • Pump and dump only if you're uncomfortable or to maintain your milk supply when away from your baby for a long time
  • Once your liver has proccessed the spirits and blood alcohol levels drop, your milk will be safe for your baby. Over-the-counter milk test kits are if you'd like to make sure your baby gets no alcohol.
  • If drinking alcohol while breastfeeding bothers you, consider enjoying a non-alcoholic beverage instead. Any drink is more fun with an umbrella in it!

Alcohol's Affects on Your Baby

Age Matters: A newborn's liver doesn't work efficiently. Alcohol in your breast milk leaves a tiny babe's system slowly. Up until three months, babies are able to eliminate waste products about half as efficiently as an adult.

What do we know about alcohol in breast milk and your baby's development? The limited research that exists suggests that alcohol in breast milk may affect your nursling in several ways:
Short term changes in your baby's behavior such as:

Sleep changes: If mom's been drinking, her baby tended to fall asleep sooner. Sounds great, doesn't it? However, here's the bad news. That same baby slept a significantly shorter amount of time. Active sleep, also called rapid eye movement (REM) sleep, lessen in the four hours after a nursing mom drank alcohol.
Nurses less: Infants drank less milk when their mothers had an alcoholic beverage compared with a nonalcoholic beverage. If you abuse alcohol, your baby might not get enough to eat.

Long term affects such as

Gross motor development: was slightly, but significantly, altered in infants who were exposed regularly (at least daily) to alcohol in their mothers milk.
Light drinking: The motor and mental development of infants whose mothers drank less than one drink per day is similar to the development of their peers whose mothers didn't drink at all or who were formula fed.
Learned preference for alcohol: Study results indicate babies with more exposure to alcohol prefer chewing on an alcohol scented toy.

If you plan on several drinks:

  • Pump ahead of time or have formula on hand for your baby during the time your milk alcohol leve might be high
  • Invite a designated baby-care person should you need help caring for your little one
  • Pump and dump only if you're uncomfortable or to maintain your milk supply when away from your baby for a long time
  • Once your liver has proccessed the spirits and blood alcohol levels drop, your milk will be safe for your baby. Over-the-counter milk test kits are if you'd like to make sure your baby gets no alcohol.

Breastfeeding, Breast Milk and Alcohol

  • Alcohol doesn't enhance let-down. On the contrary, research suggests it inhibits let-down and decreases milk production Based on these scientific studies, it would seem that the recommendation for a nursing mother to drink a glass of beer or wine shortly before nursing may actually be counterproductive, even though the mother may be more relaxed after a drink.
  • You make less milk: Maternal alcohol consumption may slightly reduce milk production. The milk's composition doesn't change, but the amount you produce decreases.
  • Alcohol levels in milk and blood are similar. As your body metabolizes alcoho, the level drops in your milk as well. Unless you're breasts are uncomfortable, wait a couple hours per drink and encourage your baby to nurse instead of pumping and dumping.

Resources for More Information:

• Hale, Thomas. Medications and Mothers' Milk, 13th Edition. Hale Publishing, 2008.
• Newman, Jack, Breastfeeding Myths
• Little RE, Northstone K, Golding J, Alcohol, Breastfeeding, and Development at 18 Months; Pediatrics Vol. 109 No. 5 May 1, 2002.
• AAP Policy Statement, Table Six "Maternal Medication Usually Compatible With Breastfeeding"
• Mennella JA, Alcohol's Effect on Lactation. Alcohol Research & Health 2001; 25(3):230-234.
• Mennella JA, Gerrish CJ., Effects of Exposure to Alcohol in Mother's Milk on Infant Sleep; Pediatrics: May 1998.

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