Alcohol and Breastfeeding: Is it Safe to Drink While I’m Breastfeeding?

But now that you are breastfeeding is it actually safe to enjoy that alcoholic beverage or will the effects of the alcohol be harmful to your baby?

Most health care professionals agree that drinking small amounts of alcohol while breastfeeding won’t hurt your baby. However, opinions vary over the amount of alcohol that is safe for a breastfeeding mother to drink.

Roughly 34-million women of childbearing age drink alcoholic beverages (approximately half of all lactating women in Western countries consume alcohol while breastfeeding), so, it is understandable that it has been the subject of a lot of research.

Still, we do not know the exact way that alcohol consumption can affect babies’ and what the safe consumption amounts are.

Does Alcohol Get Into My Breast Milk?

The short answer is yes. Alcohol is one of the most readily absorbed drugs known and alcohol does pass from your bloodstream into your milk.

Alcohol levels reach their highest in breast milk about 30-60 minutes after drinking or after 30-90 minutes if you have had something to eat while you are drinking. If you don’t have another drink, the concentration gradually falls and a couple of hours after having a single drink the alcohol will have mostly left your breast milk.

Alcohol is not stored in the breast so as your liver metabolises the alcohol causing your blood alcohol level to drop, so does the alcohol level in your breastmilk.

Should I Pump and Dump?

There is no benefit in “pumping and dumping” your breastmilk unless you are uncomfortable and need to express to relieve the discomfort. As your blood alcohol drops so will the level of alcohol in your breast milk and pumping and dumping will not speed up this process.

Any breast milk that you express during the time that it takes for your blood alcohol to drop will still contain alcohol. The alcohol will not work its way out of the milk, once outside your body, and any milk pumped while you are affected by alcohol will need to be discarded.

How Long Should I Wait After Drinking Alcohol to Feed My Baby?

The more drinks that you have, the longer it takes for your body to clear the alcohol from your system. Some studies suggest that the amounts of alcohol moving into breast milk are very low compared to the alcohol consumed so that the amount of alcohol that your baby actually gets is minimal and the amount of alcohol ingested by a breastfed infant is only a small fraction of that consumed by its mother.

Other studies say that for every unit of alcohol (one unit of alcohol is approximately a single (25ml) measure of spirits, half a pint of beer or half a standard (175ml) glass of wine) then there is a period that you should wait before feeding your baby. The time that is suggested to wait before feeding you baby varies on

• What and how much you’ve eaten
• How much you weigh
• How quickly you are drinking. The time that it takes for your liver to detoxify the alcohol in your system will not be sped up by coffee, cold showers, fresh air or exercise.

Mothers who ingest alcohol in moderate amounts can generally return to breastfeeding as soon as they feel neurologically normal. As a general rule, if you are sober enough to drive you should be sober enough to breastfeed.

Everybody metabolises alcohol differently and your metabolism of alcohol can vary from day-to-day. The Australian Breastfeeding Association has a handy App to help you work out how much time you may like to wait.

Download the free Feed Safe app for Apple and Android devices.

One study suggests that the amount of alcohol that a baby will get through breast milk is approximately 5-6% of the weight-adjusted maternal dose and, even in a theoretical case of binge drinking, your baby would not be subjected to clinically relevant amounts of alcohol.

Many breastfeeding mums choose to stop drinking alcohol, however, occasional light drinking while breastfeeding has not been shown to have any adverse effects on babies. Alcohol is best avoided until your baby is over three months old and then enjoyed as an occasional treat.

Planning Ahead is Key

If you do have an alcoholic drink, make sure you allow at least a couple of hours for the alcohol to go through your system before your next breastfeed. Alternatively, you could have a small drink while you’re actually breastfeeding your baby. By the time the alcohol is in your system, your baby will have finished feeding.

Or for total peace of mind, if you’re planning to have an alcoholic drink, you could express and store milk beforehand and give that to your baby for their next feed. If, on a single occasion, you have a little more alcohol than you had planned to or if your baby needs to feed sooner than you had anticipated it is OK to breastfeed your baby.

A critical issue to consider is around the care of your baby if you are drinking alcohol. If you are under the influence of alcohol you may make fewer safe decisions around the attention and care of your baby. Drinking alcohol reduces the ability of the mother to be aware of her baby’s needs, whether she is breastfeeding or not.

It is crucial to plan ahead to arrange that safe sleeping arrangement have been made and never to sleep with your baby if you have been consuming alcohol. Mothers who have been drinking alcohol should never let themselves be in a situation where they might fall asleep with the baby; on a bed, chair or settee (this would also apply to other carers who have been drinking alcohol). Doing this has a strong association with Sudden Infant Death Syndrome (SIDS).

Will Drinking Alcohol Alter My Milk Supply?

Studies have shown that alcohol can affect the balance of hormones that control breast milk production (prolactin and oxytocin) and can reduce your supply. Moderate consumption can reduce oxytocin levels affecting milk supply and let down.

Alcohol itself hinders both the milk ejection reflex (responsible for your milk letdown) and milk production, especially when taken in large amounts. But even a small amount, such as a single beer or glass of wine, can disrupt the balance of milk-producing hormones in breastfeeding women.

While the immediate effects of alcohol on milk production and delivery last only as long as the alcohol is in your system, chronic alcohol use has the potential to lower your milk supply overall.

But I’ve Been Told That Having Alcohol Can Increase My Breastmilk Supply?

You may have heard the old wives’ tale that drinking alcohol can help to boost your supply. This may have been true in the past because of the way that alcohol was traditionally made and the ingredients used. The brewing process in past times differs greatly to the way that is made in modern times.

In the past, not only was the alcohol content lower, the brew was also jam-packed full of grains and herbs. This made the nutritional content higher and possibly helped to give supply a little boost. Consequently, there was probably some truth in the idea that these traditional beers could help with milk supply.

Nowadays, due to the lack of nutritional grains and herbs and a higher alcohol concentration, rather than increasing your supply, your breastmilk volumes are more likely to be lowered by the alcohol content.

One study showed that breastfeeding women express nearly 10% less milk in the first two hours after moderate drinking (a little over one glass of wine or beer) and several other studies have shown that babies tend to get about 20 percent less breast milk if they nurse in the first four hours after the mother drinks alcohol.

How Does Drinking Alcohol Affect My Breastfed Baby?

Drinking occasional small amounts of alcohol has been shown to have minor short-term effects on your baby’s behaviour. Some babies experience increased awake times and are more irritable.

A small study explains that babies slept for 25% less time after exposure to small amounts of alcohol in breast milk. And while breastfed babies may become drowsy and fall asleep more quickly after their mother drinks alcohol, they also sleep for a shorter amount of time.

Alcohol in your breast milk can also change the way that your breast milk tastes and smells and therefore may change the way that your baby feeds. Your baby may be reluctant to or refuse to, feed while the smell and taste of your breast milk remain altered by the alcohol.

Bear in mind that alcohol can temporarily reduce your milk supply. So, if you do have a drink, your baby may seem hungrier and want to feed more. Studies have found that babies breastfeed more frequently, but consume less milk in the 3-4 hours after an alcoholic beverage is consumed.

The long-term effects of drinking alcohol while breastfeeding are less clear and further research needs to be done. Regardless of this, drinking regularly or heavily while breastfeeding is not advised.

Moderate, heavy or continued drinking and may lead to drowsiness, deep sleep, weakness and decreased growth for your baby. Alcohol abuse (excessive drinking) by the mother can result in slow weight gain or failure to thrive in her baby.

The let-down of a mother who abuses alcohol may be affected by her alcohol consumption, and she may not breastfeed enough. The baby may sleep excessively, or may not suck effectively leading to decreased milk intake. The baby may even suffer from delayed motor development.

Everything in Moderation

So, it is possible to have a drink while you are breastfeeding – just in moderation! Remember that small amounts of alcohol move into breast milk when you drink an alcoholic beverage and as your body metabolises the alcohol the amount in your breast milk will also decrease.

Drinking small amounts of alcohol occasionally won’t affect your baby, however drinking regularly or heavily may affect your milk supply, make your baby sleepy or affect their growth and development.

A little planning ahead can help you to minimise the amount of alcohol that reaches your baby and help you enjoy the occasional drink.

What have you heard about drinking alcohol while breastfeeding? What questions do you have about drinking alcohol while breastfeeding? Let’s have a chat here or on the Medela Australia Facebook page!

References

• Anderson, P. O. (1995). Alcohol and Breastfeeding. Journal of Human Lactation, 11(4), 321–323.
• Haastrup MB et al. Alcohol and breastfeeding. Basic Clin Pharmacol Toxicol. 2014;114(2):168-173.
• https://www.breastfeeding.asn.au/system/files/ABA_Alchohol_BF%2520for%2520website.pdf
• Mennella JA. Regulation of milk intake after exposure to alcohol in mothers’ milk. Alcohol Clin Exp Res. 2001;25(4):590-593
• Mennella JA. Short-term effects of maternal alcohol consumption on lactational performance. Alcohol Clin Exp Res. 1998(7);22:1389-1392.
• Mennella, J. A. & Gerrish, C. J. (1998). Effects of exposure to alcohol in mother's milk on infant sleep. Pediatrics, 101
• Newman, J. (1996). Is Alcohol So Bad for Breastfeeding Mothers? Journal of Human Lactation, 12(2), 93–93.
• Schulte, P. (1995). Minimising Alcohol Exposure of the Breastfeeding Infant. Journal of Human Lactation, 11(4), 317–319.
• Hale, Thomas. Medications and Mothers’ Milk, 2017 edition. Springer Publishing, 2017: 348-350.

DISCLAIMER: This information provides general information only. For specific advice about your baby or your healthcare needs, you should seek advice from your health professional. Medela does not accept any responsibility for loss or damage arising from your reliance on this information instead of seeing a health professional. If you or your baby require urgent medical attention, please contact your nearest emergency department.