Breastfeeding and Alcohol: facts and fiction
Is it ok to drink if I am breastfeeding? Do I need to pump and dump my milk if I have had an alcoholic beverage? Is stout beer good for breastfeeding? These are the questions that I am frequently asked. There is a huge amount of false information about alcohol and breastfeeding on the internet. Here are some truths.
Disclaimer: the American Academy of Pediatrics (AAP) recommends against any use of alcohol while breastfeeding. That being said, the AAP does give guidelines on the moderate use of alcohol, ie the occasional single drink while breastfeeding. Habitual use and benders are very highly discouraged — habitual use is defined as more than one drink on a daily basis.
It is important to know how alcohol actually gets into your breastmilk. Alcohol diffuses from your bloodstream into your breastmilk. Whatever your blood alcohol level is at any point in time equals what gets passed into your breastmilk. As your blood alcohol level drops, so does the amount of alcohol that is in your breast milk. If you have a single drink, your blood alcohol level and, by default, your breastmilk , will have a negligible amount of alcohol 2 to 2 1/2 hours after consumption. It is considered safe to breastfeed 2+ hours after you have had a single drink.
Because alcohol decreases in breastmilk at the same rate as it leaves your bloodstream, there is no need to pump and dump after drinking alcohol if you wait 2+ hours! Pumping and dumping simply wastes this precious resource unnecessarily. Pumping and dumping also does not speed the time for removal of alcohol from your breast milk.
Stout beer does not help and can harm your milk supply. Dr. Spock — the penultimate authority on childrearing from the 1940s on advised nursing mothers to have a single beer at 4 pm every afternoon as a way of relaxing and boosting their milk supply. There is some truth that barley and hops can help improve your milk supply. However, alcohol can be bad for your milk supply and that outweighs any good effects of the barley and hops.
There are several steps involved in milk production and transfer to you infant, involving multiple hormonal pathways. Prolactin is a hormone that works to actually increase milk supply, especially in the early weeks of nursing. Oxytocin, or the “love hormone” is needed for milk letdown — which allows the milk produced to then be released and transferred to your baby. Oxytocin is an amazing hormone — and I’ll talk more about it in a future blog. Anything that interferes with oxytocin production is harmful to milk letdown.
Alcohol interferes with oxytocin production. It is estimated that two or more alcoholic beverages, consumed at the same time, can decrease your oxytocin production. Breastmilk, left in the breast, can thus lead to decreased milk production. A single alcoholic beverage does not seem to inhibit oxytocin in a significant way.
Anything that slows or decreases the absorption of alcohol into your bloodstream is helpful. If you savor your drink, and make it last over a few hours, your blood alcohol level will have a minimum increase over that time. Eating food while having a drink will also decrease the amount of alcohol absorbed into your system and into your breastmilk.
I make no judgement on the morality of having alcohol when you are breastfeeding — but I do want you to have the best information to make an educated decision. If you are planning on having a drink, breastfeed just prior and then wait 2 - 2 1/2 hours before feeding again. Alternatively, sip your drink slowly and make it last over an extended time period so that there is a minimum rise in your blood alcohol level. Eat food while consuming a drink to further prevent a rise in your blood alcohol level. Do not waste your milk by pumping and dumping. Contact me for more information or go to the primary sites listed below for an extended and more complete analysis of this information.
https://pubs.niaaa.nih.gov/publications/arh25-3/230-234.htm
https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/vaccinations-medications-drugs/alcohol.html
https://pediatrics.aappublications.org/content/129/3/e827.full
