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Alcohol and Breastfeeding

Updated: Jun 19, 2021



You’ve abstained for 9 months. Now, you are breastfeeding and would like to enjoy a glass of wine (or two) as a sweet reward for all your labor. But what are the rules? What is safe? How about pumping and dumping? Let’s take a look at some things to consider when drinking and breastfeeding. And be sure to check out the handy resources at the end of this blog!


First of all, you’re not alone.

The prevalence of alcohol consumption in breastfeeding women has been estimated to be 36-83% in developed countries (the higher end of the range is from older studies)! Obviously, there is a lot of cultural variance, but moms all over the world are trying to navigate this situation!


How much alcohol crosses over to breast milk?

The alcohol level of breast milk is similar to the mother’s blood alcohol level, but the infant receives a small fraction of the mom’s dose. What reaches the baby is calculated using the mom’s bloodstream concentration and how much a baby feeds. Some studies calculate that even after several drinks an infant only has a relatively small amount in their system compared to the mother. We don’t really know exactly how much is safe, but your baby definitely doesn’t get everything you drink!


How long does alcohol stay in breastmilk?

It depends! For one standard drink, there is usually some alcohol in breast milk for 2-3 hours. The alcohol level peaks about 30-60 minutes after the drink. The total duration increases with additional consumption: 4-5 hours for 2 drinks, 6-8 hours for 3 standard drinks.


What effect does drinking have on YOU and breastfeeding?

Studies have shown that drinking alcohol reduces milk supply, despite what those old Guinness ads have claimed! It decreases oxytocin levels and limits milk ejection. Alcohol also affects your ability to be attentive to your baby’s needs. Are you alert enough to not fall asleep in the bed with your baby? To not drop your baby? To respond to your baby’s cues? These are just as important to consider as how much alcohol your baby gets through your milk!


What effect does alcohol have on babies?

Babies who feed within 4 hours of mom consuming alcohol seem to feed less, but feeding picks back up and increases as long as the mother doesn’t continue to drink. There are some studies that suggest alcohol causes a decrease in sleep or fragmented sleep. They might fall asleep faster but don’t sleep as well. Long term? We don’t know! Some studies have shown a delay in psychomotor development in babies with regular or heavy exposure to alcohol, but results haven’t always been reproducible across studies.


What about pumping and dumping?

Pumping and dumping does not decrease the amount of alcohol in your breast milk. It won’t help it clear any faster! Your breast milk will continue to reflect your own blood alcohol content. So don’t waste your milk, just wait to feed until you and your breast milk are free from alcohol! (Obviously, if you need to express some milk and throw it out for your own comfort, do so!)


How do I know when it is safe to breastfeed my baby after consuming alcohol?

Your breast milk should be totally clear of alcohol 2-3 hours after one standard drink (see THIS definition for a standard drink). THIS handy chart or THIS calculator can give you a very conservative estimate of when you (and your breast milk) are completely free of alcohol. Now, do you have to be fully cleared of alcohol to feed? The jury is out on that one! It will depend on your risk tolerance. Some sources say to wait for as little as an hour. Evidence suggests that staying within the recommended limits for women (not more than 1 drink per day and not more than 4 drinks on any given day) is not harmful to an infant, especially if you wait until the alcohol clears to feed.



Conclusion

At the end of the day, NO ONE is going to do the study that proves how much alcohol is too much for an infant (ethics being very important in medicine). While there doesn’t seem to be any evidence that moderate alcohol consumption harms infants, we also aren’t absolutely positive. Overall, it seems that drinking several drinks then breastfeeding is probably not a great idea, but how much is ok really just depends. The safest route is no alcohol, but if you choose to drink, just have a backup plan to be safe (expressed breastmilk or formula supplementation).


Cheers!



Resources

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2799509/


https://www.contemporaryobgyn.net/view/alcohol-and-breastfeeding-what-are-risks


https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/vaccinations-medications-drugs/alcohol.html#:~:text=Can%20alcohol%20be%20found%20in,drink%20after%20it%20is%20consumed.


https://onlinelibrary.wiley.com/doi/epdf/10.1111/bcpt.12149


https://pediatrics.aappublications.org/content/101/5/e2.long


https://www.medsafe.govt.nz/Profs/PUarticles/lactation.htm


http://samples.jblearning.com/9781284111163/9781284111163_CH05.pdf


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