The question of alcohol and breastfeeding is currently very topical. Almost 90% of the population consumes alcoholic beverages anyway, including breastfeeding women.
Compatibility of alcohol and breastfeeding with lactation isn’t studied enough. Most nursing mothers hear controversial advice about the impact of alcohol on the baby. In this article we will examine some of the aspects of alcohol consumption during breastfeeding.
What is alcohol?
Ethyl alcohol (ethanol) is the main component of the alcohol, and alcoholic beverages also contain various impurities that influence negatively on organisms of mother and fetus, especially at its high concentration and/if used in large quantities. Ethanol molecule differs by its low charge, so it easily gets from the blood through various biological membranes into the body tissue. The ethanol concentration increases rapidly in the tissue until it reaches the level of its concentration in the circulating blood.
Entering into the body, the alcohol gets absorbed from the mucosa of the mouth and esophagus, just a little bit more – from the gastric mucosa and the large intestine, and the main part of it is absorbed from the initial part of small intestine.
Alcohol in breast milk
Alcohol penetrates easily into breast milk. But, according to research, relatively small amount of alcohol that was ingested by mother, reaches her blood and breast milk. The peak of alcohol concentration in mother’s blood and mother’s milk comes approximately in 30-90 minutes after taking alcohol, but this figure varies from person to person, depending on how much food was eaten in that time interval, on mother’s weight, and on the percentage of fat in her body, etc.
Alcohol is excreted from the mother’s milk and mother’s organism rapidly enough. The metabolism of alcohol in adults is about 30 milliliters in three hours. Accordingly, the “mothers, who drink alcohol in moderate amounts, can breastfeed as soon as feel neurologically normal”.
How long does alcohol stay in breast milk?
Contrary to ordinary opinion, alcohol isn’t accumulated in breast milk but derived from milk simultaneously with its removal from the circulatory system. Thus, when the level of alcohol decreases in blood, it also decreases in milk and expression of breast milk doesn’t contribute to the removal of alcohol from the body. Expression of breast milk, plentiful drink, rest – don’t affect the rate of alcohol elimination from the body. However, the amount of consumed alcohol affects it – the more the mother drank, the longer the alcohol eliminates from the body.
What do experts say about alcohol and breastfeeding?
The majority of experts believe that the periodic consumption of alcohol by a nursing mother is not harmful to a breastfed baby in the amount of one or two drinks.
For example, Dr. Cheston Berlin, a member of the Committee on drugs and chemicals in human milk of American Academy of Pediatrics, recommends for nursing mothers to take no more than one or two drinks a week. He also recommends interrupting to breastfeed for 6-8 hours, if the mother drank several drinks in a row.
Dr. Jack Newman, a member of the Professional Advisory Council of La Leche League, writes:
“That mixture, that child will receive, while mom will pour out her milk because it contains a small amount of alcohol, will put the child a greater risk of problems than if the child receives milk containing alcohol “.
The Committee on Medicines of American Academy of Pediatrics also classifies alcohol (ethanol) as a medicine “usually compatible with breastfeeding in low doses.”
The sure side-effects of combining alcohol and breastfeeding
However, if a nursing mother drinks alcohol regularly, the side effects of the excessive consumption can be drowsiness, weakness, delay in child’s motor development, low weight gain, as well as problems with the outflow of mother’s milk. It is thought that two or more drinks could suppress the mother’s oxytocin reflex.
Also, speaking about the impact of alcohol on the baby, you should always pay attention to the baby’s age and weight. The younger and lighter in weight the child is, the more destructive will be the effect of even the small amount of alcohol.
Myths about alcohol and breastfeeding
There are many myths concerning drinking alcohol during breastfeeding, that are not based on facts.
For example, previously, mothers were recommended sometimes to drink alcoholic beer to stimulate lactation. However, two studies found that after consuming alcoholic and non-alcoholic beer by mothers, children, whose mothers received alcoholic beer, sucked more frequently, but received less milk than children, whose mothers drank non-alcoholic beer.
In two other similar studies, children, whose mothers received the orange juice with the addition of alcohol, sucked more frequently in the beginning but received an average for 20-27% less milk than children, whose mothers drank only orange juice. One of these studies also found changes in the smell of milk in proportion to the concentration of alcohol in breast milk.
Another study examined the rhythms of sucking during several hours after the mother took alcohol. Despite the fact that children were given less milk for 4 hours after the mother drank an alcoholic beverage, they compensated it with the more frequent application and getting more milk during the next 8-16 hours after drinking, when the level of alcohol in the mother’s blood returned to normal. In an attempt to determine what caused a decrease baby’s consumption of the milk, if was it connected with a change of milk taste or with a decrease of mother’s oxytocin reflex, in one study, children were given bottles of pumped breast milk. There was a small amount of alcohol added in a half of bottles, and there wasn’t – in the second half. Researcher measured the force of baby’s sucking using a nipple shield with the sensor that was attached to the nipple. They found that children sucked more milk and sucked more often from those bottles that had the taste of alcohol, than from the bottles without alcohol flavor. The researcher concluded that the decrease in consumption of breast milk after the mother’s alcohol consumption is not connected with the fact that the child doesn’t like the smell of alcohol.
Thus, we can conclude that alcohol did not increase the production of milk, actually, children suck more frequently but obtain less milk during 3-4 hours after a mother has drunk an alcoholic beverage. In addition, one study showed a decrease in milk production by 23% after one drink that was drunk by the mother.
There is a common myth that breastfed children sleep better if the mother takes alcohol. However, during the study, a change of the baby’s sleep and wake regime was revealed after a small amount of alcohol drunk by the mother. Perhaps it’s due to the fact that a single drink produces a state of euphoria in a healthy person, which is then followed by the oppression of the central nervous system. It’s manifested with lethargy and sleepiness. The period of falling asleep reduces, but sleeping is characterized by a rapid succession of stages, there is a deficiency of deep sleep during which a person is fully relaxed. This also applies to a child whose mother has drunk alcohol: the child falls asleep really fast, but it’s likely that it will wake up more often. Despite the fact that children fell asleep faster, they were sleeping much less during 3.5 hours after they drank milk with alcohol, compared with the duration of sleep when they drank only milk. The researchers concluded that alcohol affects the rhythms of sleep and wakefulness of the child and lead to a decrease in sleep duration.
Also, you shouldn’t forget about another aspect of alcohol consumption related indirectly to breastfeeding. Mother’s response time to certain stimulus increases after taking a few drinks. It’s especially important because breastfed baby demands the constant control. Mother of the child should always respond quick to its actions, but the increase of reaction time and poor coordination of movements can lead to mother’s inability to react to her baby, which may cause baby’s injuries.
Summing up, I want to say that, according to current research, the consumption of alcohol by a nursing mother doesn’t harm the child if the mother drinks light alcohol rarely and in small quantities. But regular or immoderate alcohol consumption, of course, has a negative effect on a breastfed baby.
So if you go to an event where you plan to drink more than 1-2 drinks, try to make “bank” of expressed milk in advance, which can be given to your child at a time, until the concentration of alcohol in breast milk doesn’t become extremely low and remember, that expressed milk is desirable to give to the baby with a spoon or cup, not from a bottle.
Try to keep your whole diet as safe for the baby as possible: Breastfeeding Diet: What to Eat?
A table on doses you may consult
Table of dependence of alcohol elimination from the milk on the mother’s body mass
The metabolism of alcohol is accepted as a constant 15 mg/dL with a women’s height of 1.62 m.