Boozy breastfeeding: is it safe to drink and nurse?

Everyone knows that there is no such thing as safe alcohol consumption when you’re pregnant. But when it comes to alcohol and breastfeeding, what are the rules? Maybe you’ve heard that it’s ok as long as you pump and dump? Or that as long as you stick to beer it’s actually beneficial to the breastfeeding process? There’s a ton of conflicting and downright bad advice out there. So sit tight, and let us break down the facts.

Can I drink alcohol if I’m breastfeeding?

The Centers for Disease Control and Prevention (CDC) maintains that while breastfeeding parents shouldn’t drink, one drink a day isn’t known to be harmful. The Australian Breastfeeding Association, in contrast, says that three or more drinks is harmful. So if major organizations can’t give a clear answer, what’s the average mom supposed to do? The short answer is to err on the side of caution, because the effects of alcohol are hard to measure. So yes, you can have an alcoholic drink if you are breastfeeding, but under specific circumstances.

Measuring alcohol intake

“If you’re sober enough to drive, you’re sober enough to breastfeed,” might sound like good advice but objectively measuring your own sobriety can be difficult. Numerous factors affect your body’s ability to process alcohol, from your weight to what you’ve eaten to your sex. Women, for example, are typically more affected by alcohol than men. This occurs because they have a higher proportion of fatty tissue in their bodies, as well as fewer alcohol-metabolizing enzymes than men do. So even if a man and a woman weigh the same, she will likely become intoxicated more quickly from the same amount of alcohol than he will. As well, the effects of alcohol are influenced by tolerance. While you may have been a three-glasses-of-wine-a-day gal before your little one was born, nine months of sobriety might mean that half a beer leaves your head spinning these days. Your best bet is to drink in moderation.

How long after drinking can I breastfeed again?

While the CDC says that breastfeeding about two hours after having a drink should be fine, you may be better off using a breastfeeding and alcohol chart to figure out how long to wait to breastfeed after drinking alcohol. According to the Motherisk alcohol and breastfeeding chart, one drink every two hours doesn’t apply until you hit 180 pounds. For women who weigh significantly less, 90 pounds for example, they’re looking at closer to three hours a drink to ensure their breast milk contains no alcohol. And keep in mind that alcohol concentration peaks in breast milk 30-60 minutes after you’ve had a drink (longer if you’re eating at the same time). So while you may have sobered up, your milk might not have.

It’s worth mentioning, however, that your baby isn’t getting the same amount of alcohol that you are. If you breastfeed after a glass of wine, which typically contains 12 percent alcohol, your baby isn’t drinking breast milk with 12 percent alcohol. Even if that glass of wine raises your blood alcohol level to 0.08 (which is over the legal limit for driving), your baby is still only consuming breast milk which contains 80 milligrams of alcohol per 100 mL of fluid. Contrast that with the 14 grams of alcohol typically contained in one standard drink, and it’s clear that what you drink is significantly diluted by the time it reaches your baby.

What are the side effects of alcohol in breastmilk?

While the alcohol you’ve drunk is diluted by the time it reaches them, your baby is still significantly smaller than you are. Their liver is also less developed and less able to process alcohol. So significantly less alcohol can affect them. Newborns are at an especially vulnerable and sensitive stage, so it may be best to wait until your little one is a little older (at least over the one month mark) before drinking and breastfeeding.

The exact effects of moderate drinking and breastfeeding on your baby aren’t clear. Studies have shown decreased nonverbal reasoning in six and seven-year-old children of mothers who drank alcohol while breastfeeding. And the more alcohol the mothers reported drinking, the lower their children’s scores. But it’s unclear if these deficits persisted once the children got a little older. Or if they are exactly related.

There is no doubt, however, that heavy use of alcohol while breastfeeding has extremely dangerous effects on babies. These include but aren’t limited to interrupted sleep, seizures, psychomotor delays, inability to rouse from sleep, and a faint pulse.

Effects of alcohol on breastfeeding

While heavy use of alcohol affects your baby, even moderate amounts of it can affect your body’s production of breast milk, even temporarily reducing your supply. Alcohol intake also increases letdown time (the time between when the nipple is stimulated and when the milk flows out). It’s not entirely clear if these factors alone account for why breastfeeding infants drink less milk and nurse for less time after their mother has been drinking. But each of these elements is likely to mean a fussier-than-normal hungry baby.

Plan ahead

So given all the fuzzy guidelines, what’s a mom to do? Well, if you want to have a drink, have a drink! Wine, beer, a martini, it’s up to you. But plan ahead. If you can, breastfeed before you drink. Baby can also drink pumped or hand-expressed breast milk so you don’t have to nurse if you drink too much. Drink your beverage slowly, and have a snack to slow down the intoxicating effects. If you have your baby with you, make sure you have a designated “baby holder” nearby to hand them off to if you feel addled or a little tipsy. Parenting while intoxicated can be extremely dangerous and bumps and falls can be deadly for infants. And under no circumstances should you bed share with your child after you’ve had any amount of alcohol.

Unfortunately, “pumping and dumping” isn’t actually helpful. It doesn’t decrease the amount of alcohol in your milk because it correlates with your blood alcohol level. Much like you, nothing sobers up your breast milk except time. Having said that, if your breasts are uncomfortably full because of missing a feed while drinking, it’s ok to express some milk until you’re comfortable again.

Pregnancy means nine months of sobriety, leaving many new moms looking forward to a glass of wine upon delivery. While not drinking if you’re breastfeeding is your safest option, having the occasional drink is fine. Just make sure to limit yourself to one at a time and don’t drink every day. It might be frustrating, but you only breastfeed for such a short amount of time in your life. It’ll be over before you know it.

And if you are concerned about your drinking, please speak with your doctor.