The alcohol we consume is ethanol, a toxin, and in the brain creates a feeling of euphoria. We use alcohol in this way, as a drug but alcohol is also a pervasive daily habit in our culture – drinking is a social event, a way to relax or connect. The flip side is the real issue of alcoholism and binge drinking in our country. It makes perfect sense that it’s a common question asked of lactation consultants.
The health agencies do agree – if you choose to drink alcohol, drink in moderation while breastfeeding.
The Centers for Disease Control (CDC)
Not drinking alcohol is the safest option for breastfeeding mothers. However, moderate alcohol consumption (up to 1 drink/day) is not known to be harmful to the infant.
American Academy of Pediatrics: Policy Statement – Breastfeeding and the Use of Human Milk, March, 2012, p. 7.
...ingestion of alcoholic beverages should be minimized and limited to an occasional intake but no more than 0.5 g alcohol per kg body weight, which for a 60kg mother is approximately 2 oz liquor, 8 oz wine, or 2 beers. Nursing should take place 2 hours or longer after the alcohol intake to minimize its concentration in the ingested milk.
Most sources advise limiting alcohol intake to the equivalent of 8 ounces of wine or two beers, and waiting two hours after drinking to resume breastfeeding.
How does alcohol affect breastfeeding?
As a breastfeeding mother drinks alcohol, her blood alcohol level increases as well as the level of alcohol in her breastmilk. Luckily, the amount of alcohol available to the child through the breastmilk is much lower; approximately 5-6% of the mother’s maternal dose according to one study (1). The amount of alcohol in breastmilk peaks at around 30 – 60 minutes after consumption and then drops quickly. This time frame extends with each additional drink. The breasts and the milk do not store the alcohol; as alcohol blood level decreases so does the alcohol content of the milk. There is no need to pump and dump as this will not move the alcohol out any faster.
Does alcohol increase milk supply?
Many cultural beliefs exist around alcohol and breastfeeding success. Hilary Jacobson, interestingly writes about The History of Beer as a Galactagogue (a food or drug that increases milk flow and/or supply). Many of the nutritional components of ancient beers have galactogenic ingredients which our modern beers often lack; but beer today is commonly suggested. In some Asian cultures, variations of a rice wine chicken soup may be recommended during breastfeeding and in parts of Mexico, pulque, a beverage of fermented agave, is suggested daily to increase milk supply.
Alcohol (in large doses) does affect a mother’s milk supply but in a negative way. Elevated ethanol levels suppress oxytocin release and delays the milk ejection reflex (also known as the “let-down) (2). As a response babies may drink more frequently trying to help mom’s body trigger the milk ejection reflex. The result, babies drink less milk but mothers do not notice this subtle change (3).
Possible scenario:
Frequent alcohol consumption + less milk removal = less milk production
Other considerations
Your weight, the type of alcohol & amount consumed/over the length of time (lower alcohol content & higher weight will metabolize faster)
Baby’s age and weight (an older, heavier baby can also metabolize faster)
Drugs/medications or food consumed by mom or baby (be aware of drug interactions)
Are other safe, non-drinking caregivers available to assist with baby?
What are the sleeping arrangements for baby? If parents and baby are bed-sharing, it is advised that parents that have consumed alcohol do not sleep in the same bed with their baby (American Academy of Breastfeeding Medicine, Protocol #6).
While drinking in moderation is most ideal, binge drinking and alcohol addiction are a reality. Beyond 1-2 glasses of wine, wait the appropriate amount of time (2 hours per drink) before resuming breastfeeding or caring for baby; pumping to maintain supply, if necessary. Milk pumped while intoxicated should not be fed to baby.
Many moms discontinue breastfeeding due to their wish to drink alcohol but the tremendous benefits of breastfeeding and the risks to both mother and baby with not breastfeeding show it is more beneficial to drink alcohol with safeguards in place than to completely end your breastfeeding relationship.
Questions? Email me here: cheryl@charlottelactation.com
References:
3. Mennella JA. Regulation of milk intake after exposure to alcohol in mothers' milk. Alcohol Clin Exp Res. 2001;25(4):590‐593.