Breastfeeding and Alcohol Use
The harmful effects of alcohol during pregnancy have been proven to lead to very restrictive recommendations for pregnant women concerning alcohol intake. Previously, it was a common belief that alcohol was beneficial during breastfeeding, and many women were encouraged to drink alcohol while lactating to relax, promote lactation and the milk ejection reflex, and enhance infant sleep. This notion has somewhat subsided in recent years in favor of a more cautious approach, but versions of it still surface from time to time, which can cause confusion and concern in new mothers.
Current recommendations by regulatory authorities and the American Academy of Pediatrics seem to be based on a ‘better safe than sorry approach and advise that women abstain entirely from alcohol intake until they no longer breastfeed or at least avoid breastfeeding in the hours immediately after alcohol intake. Various online resources that new mothers may consult similarly advocate abstention or delay before breastfeeding.
It has also been demonstrated that alcohol dose-dependently inhibits oxytocin and thereby the milk ejection reflex, which could probably explain this reduction in milk yield. However, the inhibitory effect of alcohol on oxytocin is subject to a sizeable interindividual variation. Several studies have examined the inhibitory effects of alcohol on oxytocin levels. One such study found a 78% decrease in oxytocin after breast stimulation in women who had ingested 0.4 g alcohol per kg (or about 2.3 units of alcohol) and a corresponding increase in latency time to milk ejection.
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What Are The Effects of Drinking Alcohol and Breastfeeding
Eleven studies on the effects of alcohol on the nursing infant were identified. Of these, three studies of a total of 36 participants have shown that children breastfed by women who had consumed alcohol prior to feeding ingested approximately 20% less milk in the first four hr after maternal alcohol consumption than otherwise. However, the children were breastfed more frequently and thus ingested larger amounts of milk 8–12 hr after maternal alcohol consumption
if the women did not consume any more alcohol. This reduction in the children’s milk consumption is not caused by a dislike for the taste of the milk but should probably be attributed to the reduced milk yield after alcohol intake. In addition, children ingest larger amounts of alcohol-enriched milk than plain milk when offered to them in a bottle.
What are the Risks To the Baby?
Small changes in the children’s sleep patterns have been reported. Two studies have shown that the total amount of sleep was unchanged after intake of alcohol-containing milk. but that the sleep was divided into more but shorter intervals. The amount of active (REM) sleep was reduced for the first 3.5 hr in one study and then increased for the next 20.5 hr. In contrast to this, another study from the same group showed that the children’s sleep on average was 25% shorter after ingesting alcohol-containing milk and that the number of times the children slept was unchanged.
The possible long-term effects of alcohol in mother’s milk are unknown. A single, frequently cited case from 1978 of an infant adversely affected by alcohol in the breast milk has been reported. The child was diagnosed with pseudo-Cushing syndrome at four months of age, and upon examination, the mother reported a weekly intake of more than 17 liters of beer in addition to other alcoholic beverages. The mother was encouraged to discontinue her alcohol intake, and afterward, the child gradually reverted to normal development.
Can alcohol be found in breast milk?
Yes. Alcohol levels are usually highest in breast milk 30-60 minutes after an alcoholic beverage is consumed, and can be generally detected in breast milk for about 2-3 hours per drink after it is consumed. However, the length of time alcohol can be detected in breast milk will increase the more alcohol a mother consumes. For example, alcohol from 1 drink can be detected in breast milk for about 2-3 hours, alcohol from 2 drinks can be detected for about 4-5 hours, and alcohol from 3 drinks can be detected for about 6-8 hours, and so on.
However, blood alcohol levels and the length of time alcohol can be detected in breast milk after drinking will depend on a number of factors, including the amount of alcohol consumed, how fast the alcohol is consumed, whether it is consumed with food, how much a mother weighs, and how fast alcohol is broken down in a mother’s body.
What is a “drink”?
The Dietary Guidelines for Americansexternal defines a standard “drink” as 12 ounces of 5% beer; 8 ounces of 7% malt liquor; 5 ounces of 12% wine; or 1.5 ounces of 40% (80 proof) liquor. All of these drinks contain the same amount (i.e., 14 grams, or 0.6 ounces) of pure alcohol. However, many common drinks contain much more alcohol than this. For example, 12 ounces of 9% beer contains nearly the same amount of alcohol as two (1.8) standard drinks. Consuming one of these drinks would be the equivalent of two standard drinks.
What is “moderate consumption”?
The Dietary Guidelines for Americans defines moderate consumption for women of legal drinking age as up to 1 standard drink per day.
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What You Should Know About Drinking Alcohol and Breastfeeding
- Drinking beer does not increase the lactating mother’s milk supply, as the urban myth suggests.
- Drinking alcohol of any kind may decrease the amount of breast milk the baby drinks.
- Drinking alcohol and breastfeeding can change the taste of breast milk, and some infants may not like it.
- Drinking alcohol and breastfeeding an infant can pose a risk to the baby if he or she consumes breast milk with alcohol.
- Pumping or expressing milk after drinking alcohol and then discarding it (pumping and dumping) does not reduce the amount of alcohol present in the milk quicker. As the alcohol blood level falls over time, the level of alcohol in the breast milk will also decrease. Breast milk continues to contain alcohol if alcohol is still in the bloodstream.
- Current research says that occasional use of alcohol (1-2 drinks) does not appear to be harmful to the nursing baby. Many experts recommend against drinking more than 1-2 drinks per week.
- Excess levels of alcohol in milk may lead to drowsiness, deep sleep, weakness, and decreased growth in the infant. Reduction of let-down is reported when the mother drinks heavily. Drinking alcohol and breastfeeding may reduce the baby’s sucking time at the breast but not the volume of milk consumed.
- Never share a bed or other sleeping surface with your baby if you have been drinking alcohol and breastfeeding. Drinking affects your natural reflexes, and drinking and bed-sharing have an increased association with sudden infant death syndrome (SIDS).
Risk of Drinking Alcohol and Breastfeeding an Infant
- Sleep disturbances
- Increased arousal
- Increased crying
- Increased startling
- Increased rapid eye movement (REM) sleep in the period from 3.5 hours to 24 hours after exposure to alcohol
- Decreased weight gain
- Decreased milk intake by the baby
- Growth retardation
- Impaired immune function
- Delay of motor development
- Potential impairment of cognitive development
- Reduction in the ability for abstract reasoning at school age (6-7 years)
Breastfeeding While Drunk
If you are intoxicated, you should not breastfeed until you are completely sober, at which time most of the alcohol will have left your body. Drinking alcohol and breastfeeding to the point of intoxication, or binge drinking has been shown to impact the way infants sleep. The negative impact on sleep occurs when the infants are exposed to alcohol through milk containing alcohol at the level it would be found in human milk one hour after a mother consumed a significant amount of alcohol (0.3 grams per kilogram of their body weight).
The long-term dangers and effects of alcohol and breastfeeding can affect baby and mother long after the child leaves the infant stage. In addition to developmental delays a child could grow up with due to their mother’s alcohol use, the woman could be grappling with a dependence on alcohol that is also dangerous to her health and well-being. Not everyone who drinks alcohol has a substance use disorder, but if attempts to drink moderately have led to heavy drinking, risky drinking, or other substance-using behaviors, it is possible that it is time for the drinker to get professional help for a substance use disorder.
Alcohol is not an easy substance to quit once a person starts drinking. But it is possible to do with the right help. Alcohol withdrawals are dangerous to manage without professional guidance. Without it, the person can end up relapsing and fall back into the habits they were trying to leave behind. Alcohol is not an easy substance to quit once a person starts drinking. But it is possible to do with the right help. Alcohol withdrawals are dangerous to manage without professional guidance. Without it, the person can end up relapsing and fall back into the habits they were trying to leave behind.
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Remember, breastfeeding is the best way to feed a newborn and is recommended until a baby is at least age one. If you choose to drink, plan carefully to avoid exposing your baby to alcohol. Drinking alcohol and breastfeeding are not mutually exclusive. You can safely nurse your baby after the alcohol has left your breast milk. However, the development of tolerance and withdrawal are indications of alcohol addiction.
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