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Boobs and Booze: Is it okay for breastfeeding mothers to drink alcohol?

Since 2004, I have been group leader of the local mothers group as part of my volunteer counsellor position with the Australian Breastfeeding Association (ABA). This requires me to facilitate a topic of interest related to feeding or parenting once a fortnight.
At tomorrow’s meeting, we will be talking about whether it is safe to drink alcohol when you are breastfeeding. The take-home message from this meeting will be that NOT DRINKING is the safest option but if we know the facts about how alcohol affects breastmilk, we can decide how to safely combine drinking and breastfeeding if we have a special occasion coming up or just want to enjoy a glass of wine with dinner.
Some of the facts that will be discussed are:
  • How alcohol gets into breastmilk via your bloodstream and the fact that alcohol will be present in your breastmilk about 30-60 minutes after you start drinking.
  • How much alcohol gets into your breastmilk depends on how much you weigh, how much you have eaten, how quickly you are drinking and the strength and amount of alcohol in your drink.
  • The reason why time is the only way to reduce the amount of alcohol in your breastmilk and the “pumping and dumping” myth.
  • What a standard drink looks like. As a general rule, it takes 2 hours for an average woman to get rid of the alcohol from 1 standard alcoholic drink (ie 4 hours for 2 drinks, 6 hours for 3 drinks and so on). This brochure issued by the ABA has a useful table which shows the approximate time taken for alcohol to be cleared from breastmilk. This table can help mothers to estimate how long it will take for their breastmilk to contain no alcohol.
  • The Australian guidelines recommendation for all women (except when pregnant) is no more than two standards drinks per day. It is generally recommended that breastfeeding mothers can have up to 2 standard drinks (but not every day) once their baby is a month old (which is around the time that breastfeeding is going well and there is some sort of pattern to a baby’s feeding).
  • When feeding an older baby, who tend to have a more regular feeding pattern, it can be easier to time a drink so that the next feed will contain little or no alcohol. However, sometimes babies don’t stick to their routine and may need extra feeds if they are unwell or “out of sorts”.
  • Drinking 3 or more standard drinks per day can be harmful to your health and your baby’s health. Motor development skills have been found to be significantly lower in infants regularly exposed to alcohol through breastmilk (Little, 1989).
  • Some ABA counsellors have reported instances of babies being drowsy and fussy after being breastfed by a mother who has had alcohol. Studies have shown that one standard drink changes the smell of breastmilk and has a mild sedative effective on the baby. A drowsy baby may not suck well which can lead to a reduction in milk supply. Any drug that causes drowsiness in the infant may be implicated in SIDS.
  • Mothers who have been drinking often report a delayed let-down reflex and a perceived reduction in milk supply. They also report having a lower tolerance to alcohol which could be attributed to low oestrogen levels during lactation which can be associated with higher alcohol levels.
  • Too much alcohol can impair the mother’s ability to properly care for her baby, cause the baby to be slower to reach developmental milestones and decrease the flow of milk which can reduce supply.
  • If you are planning a big night out and think you will have more than 2 standard drinks, you may wish to express and store some milk beforehand and arrange for someone who is not affected by alcohol to look after your baby. Do NOT sleep with your baby if you or your partner is affected by alcohol.
  • We will also discuss some strategies to reduce the amount of alcohol in breastmilk such as breastfeeding your baby BEFORE you drink (and you know it will be a couple of hours before you are likely to feed again), eating before and while having a drink, as well as alternating alcoholic and non-alcoholic drinks.
  • And, why it is better to give a breastfeed with a small amount of alcohol than to feed artificial baby milk (in short, the health risks of artificial baby milk outweigh the health risks of a breastfeed that contains a small amount of alcohol).
And what about the old wives’ tale that drinking a dark beer like stout will improve your milk supply? What actually happens is that the alcohol in the beer stops the milk from flowing freely, causing it to stay in the breasts, giving the false impression that you have more milk!