Alcohol and breastfeeding

Introduction
We ask the experts whether it's safe to drink while breastfeeding.

It takes between two and three hours for a unit of alcohol to leave a nursing mum’s breast milk.
You’ve decided breast is best for baby – but should you stay off the bottle yourself? Many mothers are unsure. While women are cautioned not to drink during pregnancy, advice on what to do after the baby’s been born isn’t so clear.

Effects of alcohol
Levels of alcohol in breast milk remain close to those in the mother’s bloodstream. Levels will be at their highest between 30 and 60 minutes after drinking, or 90 minutes if you’ve been drinking with a meal. It takes two-to-three hours for a unit of alcohol (a small glass of wine, or half a pint of ordinary-strength beer) to leave a nursing mum’s milk.

While large amounts of alcohol in breast milk can have a sedative effect, it’s more likely to make your baby agitated and disrupt sleep patterns. Alcohol inhibits a mother’s let-down (the release of milk to the nipple). Studies have shown that babies take around 20% less milk if there’s alcohol present, so they’ll need to feed more often – although infants have been known to go on ‘nursing strike’, probably because of the altered taste of the milk.

Within reason
Dr Wendy Jones, a pharmacist who is a Registered Breastfeeding Supporter with the UK based Breastfeeding Network says it’s safe for breastfeeding mothers to drink alcohol “within reason” – a position supported by La Leche League and the American Academy of Pediatrics Committee on Drugs.

“An occasional glass of wine is fine but binge or regular drinking above the recommended daily levels of two to three alcohol units is harmful to mum and baby,” says Wendy. “It is better not to drink every day but to keep alcohol for social occasions.”

If you do overdo it at one of these social occasions, breastfeeding probably isn’t wise. “If you feel drunk and particularly if you have drunk enough to vomit, it is better not to breastfeed for 12 hours,” Wendy advises.

Alcohol is not locked into breast milk, so ‘pumping and dumping’ (expressing and discarding milk) is unnecessary. “The mum may need to express milk for comfort if she has been drinking very heavily but as the alcohol level in her own body falls, the level will fall in her milk.”

Know your boundaries
According to breastfeeding consultant and former maternity nurse, Geraldine Miskin, first-time mums often choose to avoid alcohol altogether, but those who already have children tend to be less concerned.

“They have experience looking after small babies and children and know their boundaries,” she says. “Managing family needs with a sore head will definitely not be part of their plan. However, if you have more than one child and a crazy day with no help – a glass of wine at the end of the day keeps you sane!”

Geraldine suggests that mothers who do want a drink should have one with a meal shortly after a feed, so there is time to process the alcohol before baby needs to feed again. Even so, she advises having at least two alcohol-free days each week: “This way you won’t become dependent on ‘that one glass of wine’ at the end of a long day, which can quickly become two or three.”

Abstinence
Not everyone takes such a relaxed attitude, however. Janet Fyle, professional policy advisor at the Royal College of Midwives (RCM), believes that saying it’s fine to drink in moderation sends out the wrong signals.
 
“The RCM advises abstinence in pregnancy and during breastfeeding,” says Janet. “In the light of all the evidence, we believe cumulative alcohol consumption can be harmful to mother and baby.”

Telling women that it’s OK to drink in moderation is dangerous, Janet says. “What is moderation? If someone is consuming alcohol regularly, it’s very easy for them to cross the line.” Mothers with post-natal depression or those who lack support could be particularly at risk.

Women who nurse their infants in bed need to be especially careful. “If you are co-sleeping, you must never consume alcohol because of the danger of suffocation,” says Janet. “The same applies to your partner.”

However, while abstinence is the College’s official policy, Janet stresses that midwives are encouraged to take an individual’s circumstances into account. “We’re not trying to tell people how to live their lives. If someone says ‘I’m going off to a wedding, can I have a glass of champagne?’, that’s different.”

Best for baby
So would a woman who wants to enjoy a drink now and then be better off switching to bottle-feeding? The evidence suggests not.

“Breast milk from a mother, who has the occasional small glass of wine or half a pint of beer (the equivalent of one to two alcohol units) is still superior to formula milk, which does not contain all the immunological and other special properties we know breast milk has,” says Wendy.

“If you know your boundaries with alcohol, there is no need to switch to formula,” agrees Geraldine. “Just think of all the benefits your baby will be missing out on if you give up breastfeeding during the day – just so that you can have a glass of wine at night.”

National Breastfeeding Awareness Week runs from 10-16 May 2009.

Page last updated by
Root User, 04 Sep 2009.
Page checked on
05 May 2009

The above is an archived exact copy from http://www.drinkaware.co.uk/features/family/alcohol-and-breastfeeding