Alcohol and Breastfeeding Tips to Survive the Holidays

confused mom

Whether it’s a glass of Cab with Thanksgiving dinner, a spiked hot apple cider for Christmas, or a glass of Champagne on New Year’s Eve, chances are high you will be offered a spirited beverage at some point this holiday season.

The safest choice is to not drink but if you want to have a drink with your holiday meal, you won’t sabotage your breastfeeding journey if timed properly.

Can I drink alcohol while breastfeeding?

YES, in moderation. There are many myths out there when it comes to alcohol and breastfeeding but the truth is that drinking, in moderation, is compatible with breastfeeding.

What things should I consider before drinking?

    • Age of your baby - newborn - 3 month olds have an immature liver so they will be more affected by any present alcohol than an older baby. After 3 months of age, their systems can process or metabolize alcohol more quickly so some parents may choose to wait to drink until baby is at least 3 months of age or older.
    • Baby’s weight gain and your milk supply - alcohol can lower the amount baby feeds due to the inhibition of oxytocin and therefore the milk release. If your baby is struggling to gain weight or you already have a low milk supply, you may want to avoid a drink at this time.
    • Your own weight impacts how quickly alcohol metabolizes and leaves your system.
    • Amount of alcohol you plan to consume (more info below) - volume can impact your BAC and how long it will take the alcohol to clear your system.
    • Food consumption -  if you drink on an empty stomach you may find your impairment lasting longer than if you are drinking with food.

    Do I have to pump and dump when drinking alcohol?

    NO! In fact, pumping and dumping will not clear the alcohol in your system and doesn’t remove the alcohol present at a faster rate. Milk is made from our blood, so as long as there is alcohol in our blood/system, it will also be in our milk. You also cannot speed the rate of alcohol elimination from the body by drinking water or coffee.

    If you are away from your baby for an extended period of time, you may choose to pump to help protect your milk supply but that expressed milk can be saved and fed to your baby at a later time. Some are still unsure about feeding this milk so you can dump if that is what makes you most comfortable, but you can also mix this with “sober milk” to further dilute any traces of alcohol that may be present.

    How long do I need to wait after drinking before I feed my baby?

    A general rule of thumb is 2 hours per drink to clear or leave the system. The CDC shares that one standard drink is defined as:

  • 12 oz of beer, 5% alcohol content by volume (ABV)
  • 8 oz of 7% ABV malt liquor
  • 5 oz of 12% ABV wine 
  • 1.5oz of 40% ABV (80 proof) distilled spirits such as gin, rum, vodka, whiskey, etc. (1)
  • Studies have shown that the amount of alcohol in the system peaks about 30-90 minutes after ingestion (a bit longer at 60-90 minutes if having a drink with food) so actually feeding WHILE drinking would give you the longest stretch of time until your baby’s next feed. (2) Keep in mind that there is not a direct line from your mouth to your breast and the alcohol is filtered and metabolized by the body once consumed.

    How much alcohol gets into my milk?

    Various studies have shown that the amount of alcohol via breast milk the child is exposed to is minimal. 

    One such study found that maternal alcohol intake led to a milk concentration of alcohol that would expose the nursing child to approximately 5-6% of the weight-adjusted maternal dose. What does this actually mean?!

    Per the study, an example given is that if a mother of approximately 70 kg (154 lbs) were to drink four standard drinks of 12g pure alcohol at one time and then feed her child at the time of highest maternal alcohol concentration in the blood, the child would be exposed to 1.37 g/L (or 0.182931266 oz/gal) in the milk. If this child then drank 150 mL (5 oz) the blood alcohol level of the child would be 0.005% (2).

    The Blood Alcohol Content (BAC) thresholds give standards for impairment with 0.00% meaning nothing at all, 0.02% altering mood with slight loss of judgement, 0.05% lower inhibitions and lowered alertness with impaired judgement and 0.08% being the limit where you are deemed unsafe to operate a motor vehicle due to reduced muscle coordination and impaired judgement and reasoning. A BAC of 0.40% is a potentially fatal blood alcohol level (3).

    Comparing the results of the study above to the legally recognized limits we can see that the amount that passed from parent to baby is indeed very low.

    As your own weight can play a part in how much alcohol you would have to consume to get to these unsafe levels, check out some charts to know what your safe and unsafe amounts are so you can make the best decisions for yourself and your child.  (4-5)

      

    How does alcohol impact my milk supply?

    Some studies have shown that drinking alcohol can impact the levels of oxytocin that are produced which can interfere with the release of milk. This can lead to your baby taking less milk per feed than typical and may cause them to nurse more frequently as a result.  (6)

    There are studies that have shown that minimal amounts of alcohol are detectable in milk and there are agencies that caution against any alcohol consumption at all.

    Even Dr. Thomas Hale,  associate dean of research at Texas Tech University Health Sciences Center and the executive director of the InfantRisk Center, and the go-to person for info on how things interact with breastfeeding shares “mothers who ingest alcohol in moderate amounts can generally return to breastfeeding as soon as they feel neurologically normal.” (7) In his book Medications & Mother’s Milk, it states “Alcohol transfers into human milk readily, with an average milk/plasma ratio of about 1. This does not necessarily mean that the dose of alcohol in milk is high, only that the levels in plasma correspond closely with those in milk. The absolute amount (dose) of alcohol transferred into milk is generally lower and is a function of the maternal level.” (8) 

    Dr Jack Newman, a Canadian pediatrician specializing in breastfeeding medicine and an IBCLC says “reasonable alcohol intake should not be discouraged at all. As with most drugs, very little alcohol comes out in the milk. Therefore, 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.” (9)

    Ultimately the decision will rest with you, the parent. Whichever route you go, be safe and Happy Holidays!



    References

    Alcohol - Drugs and Lactation Database (LactMed) - NCBI Bookshelf (nih.gov)

    Alcohol and breastfeeding - PubMed (nih.gov)

     

    1.  Alcohol | Breastfeeding | CDC
    2. Alcohol and Breastfeeding - Haastrup - 2014 - Basic & Clinical Pharmacology & Toxicology - Wiley Online Library
    3. Blood Alcohol Content (BAC): What It Is & Levels (clevelandclinic.org)
    4. BAC Chart.pdf (wv.gov)
    5. BloodAlcoholChart-FLYER.indd (notredamecollege.edu)
    6. Infants' suckling responses to the flavor of alcohol in mothers' milk - PubMed (nih.gov)
    7. InfantRisk Center
    8. Medications & Mother’s Milk (19th Edition) Thomas W. Hale
    9. 0405-more-bf-myths.pdf (shopify.com)

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