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Maternal alcohol use is a complex topic. While some professionals dismiss acute exposure as harmless, total abstinence while nursing is your safest option.
Some studies show moderate alcohol consumption (up to one standard drink per day) has not been linked to adverse outcomes in infants. This is especially true for nursing mothers who wait at least two hours after consuming a single drink to breastfeed.
However, if a breastfeeding mother ingests more than moderate alcohol, it could harm the infant. Newborns are exposed to alcohol when it is passed in breast milk.
Alcohol is especially harmful to them because their metabolisms work at about half the rate of adults. Breastfeeding mothers should never consume alcohol within their baby’s first month, as it can be challenging to predict when the infant will need their next feed.
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Side effects of babies ingesting alcohol from breast milk include:
Alcohol can also impair mothers’ judgment, impacting their ability to care for their children safely.
Mothers should never co-sleep with their infant after alcohol intake (especially after excessive drinking). Doing so increases the risk of sudden infant death syndrome (SIDS).
Excessive alcohol consumption (especially binge drinking) could ultimately cause a mother’s milk supply to decrease. Decreased milk production can deprive the baby of necessary nutrients.
Contrary to popular belief, alcohol does not increase milk production in breastfeeding mothers. Drinking alcohol decreases milk production by disrupting the hormones that influence lactation.9
Alcohol can inhibit the release of oxytocin and prolactin, key hormones for milk production, potentially reducing lactation capacity. Less oxytocin impacts the milk ejection reflex. Alcohol doses of 0.5 g/kg can reduce the oxytocin response to suckling by up to 18%.9
Moreover, while barley is a component of beer, it does not increase prolactin production.
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Alcohol transfers to human milk readily, but how much is transferred depends on:
Breast milk alcohol levels parallel blood alcohol concentration (BAC) levels. The highest amount of alcohol in the mother’s milk occurs 30 to 60 minutes after alcohol exposure.
While acute alcohol consumption disrupts milk production only as long as the alcohol remains in your system, chronic or heavy consumers may experience decreased production overall.
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How long alcohol stays in breast milk depends on how much alcohol is consumed.
The more alcohol the mother consumes, the higher the alcohol levels will be in her bloodstream. Therefore, it will be passed into breast milk. The same rules apply to drinking while pregnant, although current guidelines recommend not drinking.
The level of alcohol in breast milk peaks about 30 to 60 minutes after consumption. However, it can still be detected in breast milk for 2 to 3 hours after a drink.
Here’s a quick rundown of how long alcohol remains in human milk:
These periods rely on what type of drink you consume. Here are a few examples of single standard drinks:
Maternal alcohol consumption of one standard drink daily won’t typically affect an infant, especially if the mother waits at least 2 hours before breastfeeding.
However, maternal blood alcohol levels of 300 mg/100 ml can result in significant side effects. Extreme alcohol consumption can cause decreased milk ejection reflex (let-down), creating breast pain and discomfort.
Slow let-downs can impact an infant’s milk intake, especially if the baby starts fussing or coming on and off the breast.
Signs your child may be affected by acute alcohol consumption include:
Nursing infants who consume milk with alcohol may experience sleep disturbances and issues in early development.
A baby's liver is not fully developed, making it less effective at metabolizing alcohol, which can lead to higher alcohol concentrations in the baby's bloodstream. Because infants process alcohol poorly, they receive a higher dosage of alcohol than nursing mothers.
If you suspect your child is affected by maternal alcohol consumption, here’s what you can do:
Without standard testing, you can estimate alcohol clearance by waiting approximately 2 to 3 hours per standard drink before resuming breastfeeding. Doing so reduces the likelihood of alcohol presence in breast milk.
If you become intoxicated, avoiding breastfeeding until you are completely sober is best.
Research about drinking while breastfeeding is not as conclusive as the research surrounding the risks of drinking while pregnant.
The risks of consuming alcoholic drinks while pregnant include:
Prenatal alcohol exposure is one of the leading preventable reasons behind neurodevelopmental abnormalities and congenital disabilities in the United States. An estimated 0.2 to 1.5 infants out of every 1,000 live births suffer from fetal alcohol syndrome disorder.8
Furthermore, alcohol use disorder (AUD) has been commonly considered genetic. Exposing your newborn to alcohol has significant health effects.
Even one regular glass of wine can threaten a baby’s development because the alcohol in the mother’s blood passes to the baby via the umbilical cord.
Drinking alcohol while breastfeeding can also negatively impact the mother in the following ways:
While it isn’t recommended, it is possible to nurse a baby while enjoying the occasional drink. If you intend to drink alcohol socially, remember these tips:
Suppose you engage in a single social drink. Here are a few other things to avoid when breastfeeding:
If you drink no more than three cups of coffee daily, your breast milk shouldn’t contain more than 1% of the caffeine you ingest. However, it’s critical to stop drinking coffee if your child becomes fussy or irritable when breastfeeding.
While some mercury is innocuous to most adults, it can damage an infant’s nervous system. As such, you should restrict your diet to two to three servings of fish a week and no more than one serving of species like white tuna.
Nicotine (including e-cigarettes) quickly passes into breast milk, decreasing milk supply by lowering prolactin and affecting an infant’s sleep patterns.
Expressing or pumping milk after consuming alcohol does not reduce BAC levels in the body. The best option is to allow blood alcohol levels to drop for at least 2 hours.
Lactating women should also practice healthy drinking habits, such as:
Plenty of options are available if you’re struggling with substance use disorder and want to keep your child safe.
Many local treatment centers offer special accommodations and support for breastfeeding mothers. Here, mothers can get individualized and family therapy.
Overall, breastfeeding mothers should avoid consuming alcohol, as infants may experience weakened immune systems, stunted growth, delayed motor skill development, and an increased risk of cognitive impairment, among other things.
In addition, alcohol consumption can decrease milk production, as the substance disrupts the hormones involved in lactation. If you suspect your child may be affected by alcohol in your breastmilk, immediately stop nursing and consult your primary healthcare provider.
Nursing mothers can reduce blood alcohol levels in their breast milk by staying hydrated, getting ample rest, and eating nutritious meals.
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