Drinking while breastfeeding

Introduction

If you make the decision to breastfeed your baby, what steps should you take to ensure your baby receives the best nourishment? While many mothers are aware that avoiding alcohol whilst pregnant is advisable, it seems that the guidelines for post pregnancy are somewhat unclear. After consulting with the experts we have complied some essential facts about drinking alcohol whilst breastfeeding.

The effect of alcohol

• The level of alcohol in a mother’s bloodstream is very similar to the levels in the breast milk

• Levels peak between 30 and 60 minutes of drinking alcohol, or 90 minutes if you drank with a meal.

• It takes between two and 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 breast milk. The effect on your baby

• Breast milk containing alcohol is likely to disrupt your babies sleep patterns and cause the baby to become agitated

• Larger amounts of alcohol may cause a sedative effect

• Research shows that babies may take around 20% less milk if alcohol is present in breast milk. This is because alcohol inhibits the mother’s ‘let-down’ which releases milk to the nipple.

Consequently, babies are likely to need feeding more often and may even go on ‘nursing-strike’ due to the altered taste of the milk. In moderation 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.”

However if you do drink over the recommendations at a social occasion, you may want to avoid breastfeeding. Wendy advises, “If you feel drunk and particularly if you have drunk enough to vomit, it is better not to breastfeed for 12 hours”. Alcohol contained in breast milk will not remain there once the alcohol has passed from the mothers system. Therefore ‘pumping and dumping’ to expel the milk containing alcohol is not necessary. Know your limits According to breastfeeding consultant and former maternity nurse, Geraldine Miskin, first-time mums often choose to avoid alcohol altogether, however those with children tend to be more comfortable including alcohol in their diet. “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 follow these guidelines;

• Have alcohol with a meal and shortly after a feed, so there is time to process the alcohol before baby needs to feed again.

However, 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”. Is abstinence best? Many take a very different view on alcohol and breastfeeding. Janet Fyle, professional policy advisor at the Royal College of Midwives (RCM), argues that drinking in moderation sends out the wrong signal to mothers. “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.” Janet argues that advising women it is OK to drink in moderation is very dangerous, as many ask the question, “What is moderation? If someone is consuming alcohol regularly, it’s very easy for them to cross the line.” Mothers raising children alone without support and those with post-natal depression could be particularly at risk. Mothers nursing their babies in bed should be particularly 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.” While abstinence is the College’s official recommendation, midwives are encouraged to consider the individuals circumstances when advising on drinking alcohol. Janet stresses, “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.”

Conclusion – What is best for baby?

The evidence suggests that for mothers who want to enjoy the odd drink, switching to bottle-feeding is not necessary and may deny your baby the benefits of breast milk. “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.”