Steve Mason
Dr. Sharon Unger is a staff neonatologist at Mount Sinai Hospital in Toronto.
Question
Is it safe for breast-feeding mothers to drink alcohol? Or can the alcohol enter her breast milk and potentially harm the nursing infant?
Answer
It is indisputable that drinking alcohol during pregnancy poses severe risks to unborn babies - every expectant mom is ingrained with the "no alcohol" rule. The risks associated with drinking while breastfeeding, however, are not as clear. The best advice when it comes to alcohol and breastfeeding: Plan in advance and understand the potential risks to your baby.
Research shows that alcohol easily enters breast milk and passes to the nursing infant. Unfortunately, no safe limit has been established, making it important to protect babies from exposure to alcohol.
When first born, infants are particularly vulnerable to the risks associated with alcohol because they metabolize, or break down, alcohol at a much slower rate than adults, potentially making their blood alcohol level climb higher than expected.
Newborns are also particularly vulnerable to the effects of alcohol because their brains are still rapidly growing and developing. Alcohol has been proven to have a negative impact on a child's neurodevelopment, alter their sleep patterns, impair motor development and decrease their milk consumption.
This doesn't mean that a mom must completely give up drinking while she is breastfeeding (the Canadian Paediatric Society recommends exclusive breastfeeding for the first six months and to continue breastfeeding up to two years or more of a child's life). For many women, it would be an unrealistic expectation after nine months of steadfast sobriety during pregnancy to completely abstain from alcohol in the postnatal time period.
Instead, most physicians advise nursing mothers to plan ahead: If you expect to drink on occasion, pump once or twice a week and store the milk in the freezer. This way breast milk that is free of alcohol is available when needed, and moms won't worry if they go out and have an unexpected drink.
Complete abstinence is only recommended while new moms are establishing a breastfeeding routine with their newborn. During this time, which differs for each mother and baby, moms must breastfeed often and on demand, making it difficult to plan ahead.
Some women still rely on "pumping and dumping" (pumping and discarding their milk after drinking) to rid their breast milk of alcohol. Other than for a woman's comfort and to maintain milk supply, this technique is really not necessary because alcohol continuously diffuses in and out of the milk as a mother's blood alcohol level changes. As her body metabolizes it, the alcohol is removed from a woman's breast milk over time.
Instead, after drinking, a mother must ensure that enough time has passed for the alcohol to have completely left her system before nursing. Refer to the Hospital for Sick Children's Motherisk website (motherisk.org/women/updatesDetail.jsp?content_id=347) for a table that provides the length of time it will take for alcohol to disappear by taking into account a woman's weight and the number of drinks consumed. For example, a woman who weighs 140 pounds should wait two hours and 19 minutes after a single alcoholic drink (12 ounces of beer or five ounces of wine) before breastfeeding her baby.
The health benefits of breastfeeding cannot be overstated so it's worth the effort to plan in advance in order to always provide your baby with the optimal nutrition free of potential hazards.