Drinking Alcohol While Breastfeeding
Let’s deal with the science first (see the links at the end of the article for more detailed information):
• There is no doubt that alcohol shows up in breastmilk. However alcohol in breastmilk does not just “sit there” once deposited. Alcohol metabolizes out of breastmilk just as it metabolizes out of all other cells in the body. Most experts agree that the amount of alcohol transferred into the breastmilk from an average glass of wine or beer will not harm a baby.
• How quickly alcohol leaves the breastmilk depends on the strength of the alcohol and bodyweight. Removal of breastmilk does not speed this process (e.g. pumping and dumping). Drinking water, coffee or eating foods does not speed this process. Once the alcohol is absorbed in the system, it will remain in any breastmilk produced until it is removed from the body as a whole.
• The levels of alcohol seems to peak in the body and breastmilk between 45 and 90 minutes. Absorption will occur faster on an empty stomach and slower when consumed with food.
• "Pumping and dumping" serves no purpose other than relieving fullness for the mother. If the baby does not need to feed while alcohol is metabolizing and the mother is not uncomfortable, there is no reason not to leave milk in the breasts for baby’s next feeding, even if it was in the breasts while the mother was drinking. See my related article for more specifics on Pumping and Dumping.
• There is some debate about how alcohol affects breastmilk production. Recent studies seem to indicate that alcohol consumption reduces breastmilk output and can interfere with letdown, and that using alcohol to increase production is an old wives tale. However, anecdotally, I know women who swear that milk production dramatically increased with the consumption of a dark beer such as Guinness.
• Studies indicate that mothers’ alcohol consumption negatively impacts babies’ sleep cycles and quality of sleep.
So… science seems to indicate that, within moderate limits, we can drink. So the question remains of whether or not we should. The issues that many women seem to struggle with surround the desire to return to “normal life,” if only temporarily – kicking back with friends, or over a nice dinner, with a glass of wine. Many women abstain completely during pregnancy, and long for a break from feeling as if our bodies are “on loan” or belong to the baby. No one should need to feel the need to quit breastfeeding or decide not to breastfeed simply to be able to enjoy an occasional drink. This can easily be managed with timing and good judgement.
Here’s my take. Breastfeeding is a big commitment – by nursing, we are doing one of the most important things we can to support our babies’ short and long-term development and health. And while it may seem like it goes on forever and sometimes like it is taking over our lives, it is temporary. While you are waiting, here’s some ideas to stave off the desire to drink. Try to find a way to indulge a feeling of independence that doesn't make it’s way into breastmilk. Sit outside and read (a grown-up book!) during baby’s next nap, or pump some milk for a spouse or caregiver and escape for a spa afternoon or even just a mani/pedi.
If you are longing for a drink to relieve stress, try meditation, exercise or a long walk. If the logistics of managing drinking and nursing are stressing you out – then it isn’t worth it to you. Buy a bottle of wine that you love, and put it away for a night with the girls to celebrate the gift you’ve given your baby after breastfeeding is through.
But if denying yourself a drink has you feeling deprived or resentful towards your baby, that isn’t healthy either. So indulge responsibly. If you are at a wedding and want to participate in a champagne toast – a half glass or even the whole glass of bubbly isn’t likely to hurt your baby (stealing a whole tray from the waiter probably isn’t the best idea, though!). If a glass of wine occasionally when out for a nice dinner, or even a reasonable-strength margarita at a party can ease your sense of “baby claustrophobia” it may be a good trade.
A useful tip in this scenario is to feed the baby immediately prior to (or even during) alcohol consumption, which will maximize the amount of time before the next feeding during which your body can absorb and begin to dispose of the alcohol in your system. Or if you have a baby who has settled into a predictable schedule, choose a time when you know you’ll have 3-4 or more hours until the next feeding and stay with drinks that have moderate alcohol content.
However, becoming significantly intoxicated exceeds the bounds of good judgment. If you crave the taste and social involvement of a beer during the game, or the grown up feel of a glass of wine in your hand instead of a diaper, that’s one thing. But if you crave the pre-child abandon of going out and getting drunk, that impulse is better left for your post-breastfeeding days when your baby can be entrusted to another caregiver.
In addition to the transmission of alcohol to the baby, you risk having your judgment impaired when your baby might need you – suppose the baby begins to run a fever in the night, or an unforeseen emergency happens in the home. And driving while even slightly intoxicated (this goes for others who may drive you, too!) when you’ve got a baby who requires your for both care and sustenance is frankly unforgivable (not to mention the danger to others).
For myself, I have enjoyed a glass of wine when my in-laws open one at our periodic dinners, shared in the wine and cheese hour at the hotel on vacation and enjoyed a (reasonable strength) mai tai when offered at a party. I make sure to eat something containing fat and protein along with it, and consume the drink slowly so that I am staying aware of any effect. The moment I start to “feel” the alcohol, it’s time to put the glass down. I save the indulgence for special occasions, not a nightly accompaniment to my dinner.
We have the rest of our lives to be able to enjoy a drink, but the time when we are nursing our babies is fleeting and to be treasured. It is a chance to give our children the very best start possible and keeping our milk healthy is an important part of the commitment.
Some links for further information on alcohol in breastmilk:
• Alcohol Metabolism – general information on variables affecting alcohol metabolism from the National Institutes of Health
• Effects of Exposure to Alcohol in Mother's Milk on Infant Sleep from Pediatrics, the Journal of the American Academy of Pediatrics
• Alcohol's Effect on Lactation (PDF Format) – discusses alcohol's negative effect on letdown and on baby sleep from the National Institutes of Health
For more information on breastfeeding, here's two of my favorite books:
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