Breastfeeding and Alcohol
We know that there can be many barriers to breastfeeding success, perceived dietary and lifestyle restrictions can be one of these. Dr. Jack Newman, IBCLC, has this to say about alcohol and breastfeeding: “Reasonable alcohol intake should not be discouraged at all. As is the case with most drugs, very little alcohol comes out in the milk. The mother can take some alcohol and continue breastfeeding as she normally does. Prohibiting alcohol is another way we make life unnecessarily restrictive for nursing mothers.”
An Alberta Health Service publication quotes the Canadian Paediatric Society recommendation: “that mothers who drink only occasionally should still breastfeed their children.” It goes on to propose limits on the amount a mother can “safely” drink before she discontinues breastfeeding. “However, breastfeeding is not recommended for women who regularly consume more than a moderate amount of alcohol (more than two drinks per day).”
Dr. Newman and others argue that these statements use inconclusive or limited research, and fail to factor in the risks of discontinuing breastfeeding to the baby and the mother, or even the risks of replacing just a few feeds with artificial infant milk.
What we do know about alcohol and breastfeeding?
ALCOHOL ENTERS THE MILK IN THE SAME AMOUNT AS IS PRESENT IN THE BLOOD STREAM.
What this means is that if a mother has reached 0.05% blood alcohol (the legal limit to drive in Alberta) her milk will have 0.05% alcohol. In other words 100 ml of this mother’s milk would have 0.05 ml of alcohol. Non-Alcoholic beer has 0.5% alcohol. Valencia oranges have about 0.09% alcohol when they are harvested. After 8 weeks of storage they have 0.39% alcohol. There is more alcohol in a Valencia orange than in this mother’s milk.
When a mother’s blood alcohol level reaches 0.2-0.29%, she will be experiencing:
Loss of understanding
Severe motor impairment
Loss of consciousness
And yet, her milk will only have 0.2-0.29ml of alcohol in 100ml, still less than a Valencia orange after 8 weeks of storage and much less than a non-alcoholic beer. By the time she gets to 0.5 blood alcohol she will likely be dead, and yet her milk will only have the alcohol content of a non-alcoholic beer!
Impact of Mother’s blood alcohol level on the Mother
Mother’s Blood Alcohol level
Alcohol Content of Mother’s Milk (what baby is getting)
Compared to Non-Alcoholic beer 0.5%
Compared to Alcohol Content of Valencia Oranges (0.09% at harvest. 0.39% 8 weeks later)
0.05%<0.5% 0.05% < 0.09% Stupor/loss of consciousness 0.2-0.29% 0.2-0.29% 0.2-0.29% < 0.5% 0.2-0.29% < 0.39% Possible death 0.5% 0.5% 0.5% = 0.5% 0.5% > 0.39%
La Leche League International says: “Adult metabolism of alcohol is approximately 1 ounce in 3 hours, so mothers who ingest alcohol in moderate amounts can generally return to breastfeeding as soon as they feel neurologically normal.”
The bottom line is that if you are sober enough to parent, you can and should continue to breastfeed. The most important question is not whether you can drink alcohol and still breastfeed, the most important question is if you are going to drink alcohol to the point of impairment, who is taking care of the baby?
Full References will all be available at www.breastfeedingaction.ca shortly.
Here are the relevant links:
Alberta Health Services: http://www.albertahealthservices.ca/AddictionsSubstanceAbuse/hi-asa-women-effects-alcohol.pdf
Alcohol by volume: http://en.wikipedia.org/wiki/Alcohol_by_volume
Blood alcohol Content: http://en.wikipedia.org/wiki/Blood_alcohol_content
LLLI Alcohol FAQhttp://www.llli.org/faq/alcohol.html
Alcohol in fruit: http://quezi.com/14067
FURTHER STUDIES OF ETHANOL AND ACETALDEHYDE IN JUICE OF CITRUS FRUITS
DURING THE GROWING SEASON AND DURING STORAGE http://www.fshs.org/Proceedings/Password%20Protected/1971%20Vol.%2084/217-222%20%28DAVIS%29.pdf
RELATION OF ETHANOL CONTENT OF CITRUS FRUITS TO MATURITY AND TO STORAGE CONDITIONS