Alcohol and Breastfeeding
After emerging from a long nine months of pregnancy and having entered the tornado of parenthood, you may once again look forward to that 6’o clock glass of wine after an unrelenting day. But, as a breastfeeding mother, you have probably received a lot of conflicting advice about the safety of drinking alcohol and the effect this may have on your newborn. It has been proven that drinking alcohol during pregnancy can damage an unborn child; however, the risks of drinking alcohol while breastfeeding or pumping are not as clear. While the jury is still out on the matter, evidence points to the fact that the effects of alcohol on the breastfed baby are directly linked to the amount of alcohol consumed. In this context, the effects of occasional and moderate drinking need to be considered.
Summary
Only around 1.5% of the alcohol the mother consumes passes into her breastmilk, but because newborn babies have undeveloped livers, they cannot easily process the alcohol. Furthermore, it takes two to three hours for the alcohol to clear from the mother’s bloodstream and, by extension, her breast milk. Pumping and dumping has been lauded as a popular method for ridding breastmilk of alcohol, but it is not effective because alcohol can only be cleared from the bloodstream naturally. According to research, mothers can safely consume one to two units of alcohol per week and should plan accordingly if they may exceed this limit.
How much alcohol passes into the breast milk?
Peak alcohol levels are reached in the mother's blood approximately 30-90 minutes after consumption. However, there is considerable variation from person to person, depending upon how much food the mom has eaten, the mom’s body weight, percentage of body fat, etc. Recent studies have found that between 0.5% and 3.3% of the alcohol consumed by the mother passes into her breast milk. While this is relatively little, it must be remembered that the infant’s liver is still developing, and as a result, they have limited capacity to process this alcohol. Furthermore, alcohol is only retained in the breast milk while it remains in the blood; it does not accumulate independently in the breast milk. Therefore, nursing should take 2 hours or longer after alcohol has been consumed to reduce its concentration in breast milk.
Does Pumping and Dumping work?
Pumping and dumping is the method of pumping breast milk and throwing it away. Many mothers use this method in an attempt to clear alcohol from breast milk. Unfortunately, this approach is not effective. As intimated, alcohol leaves breast milk only when it has cleared from the bloodstream. Alcohol does not get “trapped” in breast milk! However, pumping and dumping are effective for relieving the engorgement you may be experiencing if you have skipped a breastfeeding session to grab a drink with friends.
How long does it take for alcohol to clear from your breast milk?
As mentioned previously, alcohol levels are highest in the bloodstream and in breast milk 30-90 minutes after consumption. Since pumping and dumping don’t help remove alcohol from breast milk, you will have to wait until your body processes it and naturally removes it from your system. It must also be noted that everybody is slightly different, and as a result, we all process alcohol differently. Smaller people metabolize alcohol slower than bigger people, and depending on your weight, it may take 2 to 3 hours to clear one unit of alcohol from your bloodstream.
Effects of alcohol on your baby
Even though your baby is exposed to a much smaller portion of the amount you drink, alcohol remains in his/her body longer. In fact, up until three months, a baby eliminates alcohol from her body at only half the rate of an adult; however, older babies and toddlers process the alcohol much quicker.
Adverse effects of alcohol on your breastfed baby may include:
Impaired motor development. This usually only occurs with excessive daily alcohol consumption.
Changes in the infant’s sleep-wake patterns. One study showed changes in the infants’ sleep patterns, even those whose mothers were light drinkers.
Poor weight gain. Infants who were regularly exposed to alcohol in the mother’s breast milk gained weight more slowly.
A change in the smell and taste of the breastmilk. Research has found that alcohol changes the smell and taste of the milk directly after alcohol consumption.
Does alcohol stimulate milk production?
It has been a long-held belief that alcohol can increase breastmilk production and that drinking milk stout is beneficial for breastfeeding. Studies have shown the opposite to be true: alcohol actually inhibits lactation to some extent. In fact, babies nurse more frequently but take in less milk in the 3-4 hours after mom has had a drink because of the decrease in milk supply. Furthermore, one study showed a 23% decrease in milk volume with one drink.
Alcohol consumption has also been found to inhibit the let-down reflex in some mothers. This usually occurs when the mother has consumed more than two drinks.
What is the conclusion on drinking alcohol and breastfeeding?
“Reasonable but irregular alcohol intake should not be discouraged. The mother can take some alcohol and continue breastfeeding as she normally does, but prohibiting alcohol altogether is another way we make life unnecessarily restrictive for nursing mothers.”
-Jack Newman & Thomas Hale
As Newman and Hale elucidate above, life is already limiting enough when you are a nursing mother. Sometimes we need to let our hair down and relax, and occasional and moderate drinking is acceptable when breastfeeding or expressing. What we do need to do is plan effectively so that our socializing does not affect our baby:
If you are going to be away from your baby, try and pump as often as you normally breastfeed to maintain your milk supply. This will also help with engorgement and prevent plugged ducts and mastitis.
Do not share a bed with your baby after you have been out drinking. Alcohol inhibits your natural reflexes, and you could harm your baby.
If you have drunk enough alcohol to make you feel disorientated or vomit, do not breastfeed or express milk you intend to feed your baby until you feel sober. Ensure you leave your baby with a responsible caregiver while drinking.
In light of the above evidence, we suggest that you take a common-sense approach: time your glass (or two!) of wine in between feeds (only nurse three hours after consuming alcohol), and be stricter the younger your baby is (less than three months old).
Resources
Coiro, V., Alboni, A., Gramellini, D., Cogarini, C., Bianconi, L., Patti, D., . . . Chiodera, P. (1992). Inhibition by ethanol of the oxytocin response to breast stimulation in normal women and the role of endogenous opioids. Acta Endocrinologica (Copenhagen), 126(3), 231-216.
la leche league international. (n.d.). Drinking Alcohol and Breastfeeding. Retrieved February 2021, from la leche league international: https://www.llli.org/breastfeeding-info/alcohol/
May, P. A. (2016). Breastfeeding and Maternal Alcohol Use: Prevalence and effects on Child Outcomes and Fetal Alcohol Spectrum Disorders. Reproductive Toxicology, 63, 13-21.
Medela. (n.d.). Alcohol and Breastfeeding: Is it Safe to Drink While I'm Breastfeeding? Retrieved February 2021, from Medela: https://www.medela.com.au/breastfeeding/blog/breastfeeding-lifestyle/alcohol-breastfeeding-safe-drink-im-breastfeeding
Mennella, J. A., & Beauchamp, G. K. (1991). The transfer of alcohol to human milk. effects on flavor and the infant's behavior. National English Journal of Medicine, 325(14), 981-985.
Mennella, J. (n.d.). Alcohol's Effect on Lactation. National Institute on Alcohol Abuse and Alcoholism. Retrieved February 2021, from https://pubs.niaaa.nih.gov/publications/arh25-3/230-234.htm