Are you breastfeeding? Wondering if you can have that drink at your friend's birthday? Expecting to have a big blow out at a mate's wedding? We are here to give you the latest evidence to help you to make an informed decision.
Although we wish the answer was as easy as a yes or no, it's a little bit more complicated...
Does alcohol transfer to breastmilk?
Yes, alcohol does pass into breastmilk and will have the same concentrations as your blood alcohol levels. This means that if there is a little bit of alcohol in your blood, there will be a little bit of alcohol in your breastmilk. If there is a lot of alcohol in your blood, there will be a lot of alcohol in your breastmilk. Typically, the highest amount of alcohol will be seen in your blood (and breastmilk) 30-90 minutes after having a drink of alcohol.
Okay, so if there is alcohol in breastmilk, will my baby get same amount of alcohol as me? Studies show that the alcohol that ends up in the baby's blood stream is only a small amount compared to the amount in the mother's blood stream. Good news, right? Well, it's not just about how much alcohol is in your baby's blood stream, but also how well your baby's body metabolises (processes) the alcohol. The younger your baby, if your baby is preterm, or is unwell, they may find it more difficult to metabolise.
How does alcohol affect breastfeeding?
Alcohol reduces the mother's hormones oxytocin and prolactin which are both very important for breastfeeding. Let's have a look at how alcohol can affect breastfeeding by interfering with these hormones:
Oxytocin is what controls your milk ejection reflex or you 'let-down.' The research shows that when alcohol is involved, your oxytocin levels reduce which can inhibit your 'let-down.' This means that your baby may need to suck for longer in order to get your milk to flow.
Prolactin is involved in telling your breasts to stop or start making milk. If prolactin is low, your breasts will make less milk. So, if alcohol reduces prolactin, you will make less milk after drinking alcohol. Luckily this is only temporary, and your prolactin levels (and your milk production) will increase again when there is no more alcohol in your system!
The use of alcohol soon after birth may delay how soon your milk 'comes in' due to the interference with these two hormones.
Does this mean my baby won't be able to remove milk if I drink alcohol? The first thing to say is that the amount of alcohol you drink will affect how much your oxytocin and prolactin are impaired by. If you only have a drink or two, your breasts won't suddenly dry up! Typically, the research has shown that babies will feed more often to compensate or may become fussy because the flow isn't their 'usual.'
What are the short-term risks?
There are some studies that have reported slight changes to babies sleep patterns and increased agitation. These views have been widely criticised as babies' sleep can be influenced by many things and well, babies get cranky. In summary, if you are going to drink alcohol while breastfeeding, keep an eye out for these.
Other studies looking at heavy alcohol use show that it may cause fluid retention and hormonal imbalances in your baby.
What are the long-term risks?
Unfortunately, the research on the long-term risks of drinking and breastfeeding is pretty minimal or so poor that we cannot draw any major conclusions from them.
There are some studies that show frequent and excessing drinking while breastfeeding may influence baby's growth, motor development, later academic performance, personal social development, cognition, and language development. However, other studies show that development and growth is no different between mothers who drink alcohol during breastfeeding and those who do not. Many studies also include smoking and prenatal exposure to alcohol which could impact the results. One study did separate these out and found growth delays as well as impaired cognitive and behavioural development. However, they did not take into account the impact of families' low socioeconomic status.
One mice study looked at alcohol exposure during lactation from day 6 to day 20 postpartum in which the mother mice had water replaced with 25% ethanol solution. The results found behavioural changes such as higher risk-taking behaviours, increased hyperactivity and atypical stress regulation and adverse effects to the brain in the mice pups. This study of course cannot be directly translated into human terms but hey, it's good to know what research is out there!
How can I reduce the risk?
Okay so let's say that after reading this through, you have decided that you are going to have that glass of champagne. What can you do to make it as safe as possible?
Avoid alcohol just before breastfeeding your baby.
Drink alcohol immediately after breastfeeding and wait 2-3 hours before nursing your baby.
Having one drink every so often is less likely to involve risk, but frequent use and larger amounts may have short-term and long-term impacts.
If you aim to have a big one, consider pumping and dump. This means that you feed your baby pre-expressed breastmilk while you pump to maintain your supply throughout the binge. This breastmilk then gets dumped (or thrown away).
Consider if your baby is preterm or unwell. If the answer is yes, it might be worth avoiding alcohol or pumping and dumping. I would also recommend chatting to your baby's medical professionals for advice.
Every mother and baby are different, and every situation is unique. Ultimately, arm yourself with knowledge and do what feels right and best for you!
What are your thoughts on drinking and breastfeeding?
If you would like support with your baby's feeding, contact us to book an appointment. |
References:
Anderson, P. O. (2018). Alcohol use during breastfeeding. Breastfeeding Medicine, 13(5), 315-317.
Gibson, L., & Porter, M. (2020). Drinking or smoking while breastfeeding and later academic outcomes in children. Nutrients, 12(3), 829.
Haastrup, M. B., Pottegård, A., & Damkier, P. (2014). Alcohol and breastfeeding. Basic & clinical pharmacology & toxicology, 114(2), 168-173.
Harris, M., Schiff, D. M., Saia, K., Muftu, S., Standish, K. R., & Wachman, E. M. (2023). Academy of Breastfeeding Medicine Clinical Protocol# 21: Breastfeeding in the Setting of Substance Use and Substance Use Disorder (Revised 2023). Breastfeeding Medicine, 18(10), 715-733.
May, P. A., Hasken, J. M., Blankenship, J., Marais, A. S., Joubert, B., Cloete, M., ... & Seedat, S. (2016). Breastfeeding and maternal alcohol use: Prevalence and effects on child outcomes and fetal alcohol spectrum disorders. Reproductive Toxicology, 63, 13-21.
Perez Jr, R. F., Conner, K. E., Erickson, M. A., Nabatanzi, M., & Huffman, K. J. (2023). Alcohol and lactation: Developmental deficits in a mouse model. Frontiers in Neuroscience, 17, 1147274.
Vaughn, C. J. (2012). Drugs and lactation database: LactMed. Journal of electronic resources in medical libraries, 9(4), 272-277.
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