Drinking when breastfeeding

After nine months of having to halt drinking due to pregnancy, after popping all you want to do is pop a bottle of wine or champagne. While some mothers may not really miss having a drink, for others this becomes another restriction that breastfeeding places on their lives.  For many women a glass of wine at the end of a long day is truly a treat and a coping skill.

How much can you have?

The American Academy of Paediatrics maintains that an occasional intake of no more than 0.5g alcohol per kg of body weight is safe. This means that for a mother weighing 60kg, they may consume 60ml liquor, 240ml wine or 2 beers. The general rule of thumb is that maternal blood alcohol levels must be higher than 300mg/dl before it significantly affects baby. It doesn’t state exactly how often ‘occasional’ is, but most professionals define as 1-2 times a week.Dr Thomas Hale, author of the book , Medication and Mothers Milk, fairly small amounts of alcohol actually reach breast milk. The alcohol levels in the milk will be similar to the levels in mom’s blood. And as mom’s body metabolises the alcohol and her blood levels fall, so the alcohol will move from the breast milk back into to her blood stream again. This means alcohol is not stored in your breast milk for baby to consume later. Once the effects of alcohol on your body have worn off, there will be nothing left in the breast milk either.Looking at the above levels and at how it actually works it is generally thought that if a mother’s blood alcohol level is low enough to drive, it will also be low enough for her to safely breastfeed.

Factors influencing how alcohol affects baby

There are some things that will influence how much you can drink and how it may affect your baby:

• Baby’s age: The older baby is, the better his body can metabolise alcohol. A baby is most vulnerable in the first 3 months of life as the liver is still so immature.
• Mom’s weight: A bigger, heavier person can handle more alcohol than someone who is small and lightweight.
• Taking food with alcohol: Generally, alcohol is absorbed less well if taken with food.
• The amount: The more you drink, the bigger the effect on baby.

The negative effects?

• Consuming large amounts of alcohol can lead to drowsiness and weakness in baby.
• Regular heavy drinking can cause abnormal weight gain and delayed motor development.
• Alcohol can reduce your let-down reflex, which may lead to baby taking longer to feed after you’ve had a drink.
• More concerning is that alcohol can affect mom’s natural reflexes and ability to care for baby. This perhaps explains moderate drinking best; drinking an amount of alcohol that impairs your coordination and discretion is dangerous for baby for obvious reasons, and is therefore no longer categorised as moderate.
• You should never co-sleep with baby if you were drinking. Many of the studies linking sudden infant death syndrome (SIDS) to bed-sharing were done on mothers who were intoxicated at the time.

 To use alcohol safely you should

• Be more cautious if your baby is still very small.
• Eat before or with taking alcohol.
• Spread out your drinks over the evening, rather than drinking it all at once.
• Consider feeding baby before you have a drink. That way your alcohol levels will be down again by the time baby wants to feed again.
• Plan ahead. If you know that you really will be drinking too much you can express breast milk for baby ahead of time.
• Pump and dump – as explained above, alcohol is not stored in breast milk but as long as there is alcohol in your blood stream it will be in your milk as well.