Breast Milk and Booze

photo by joeshlabotnik via Flickr
photo by joeshlabotnik via Flickr

Boobs and breast milk. Stop pumping and dumping for the love of Gold!

Here’s what you need to know about breastfeeding and drinking to make your own informed decision.

This article is intended for the responsible social drinker. If you think you have a problem with alcohol please contact your physician or local Alcoholics Anonymous group.

1. When drinking (and sobering up), your breast milk alcohol content (BMAC) is pretty much the same as your blood alcohol content (BAC). Blood filters most toxins out of your body and feeds nutrients to your milk ducts. So if your BAC is .08, BMAC is .08.2. Alcohol in breast milk was shown in a 1989 study to decrease psychomotor development for the baby but not affect cognitive development. However, the study did not examine other potential contributing factors, such as cigarette smoking, genealogy and many other potential factors, and is out of date. Another major flaw in the study is that they measured at 1 year, but not again after that, so we don’t know what the long term effects are, if any. The actual test numbers were 98 for the babies exposed to alcohol and 103 for those not exposed. (Little, 1989)

3. Time is the only thing that removes alcohol from the system. The body can process about one drink per hour. Coffee may give you more energy but it will not make you less intoxicated, same with a shower and all the other old wives tales. The only thing that will speed up your metabolism is exercise, but you still need time, the liver can only work so fast, exercise just increases blood flow — it is not a quick fix.

So, let’s look at this information in three case studies, followed by anticipated problems and my recommendations as an exercise physiologist and ex-bartender.

Case Study #1: Mom puts baby to bed after a successful feeding session. Baby usually sleeps for four hours before waking to feed again. Can mom have a glass of wine?

  1. A glass is considered 5 ounces, your average wine glass is 10+ ounces — be careful of how much you are actually consuming. We wine lovers often like to joke about the wine coming in a glass (bottle), or drinking out of giant wine glasses, that is not A glass — more like 4-5 glasses.
  2. As a general rule your body can process one drink an hour, so technically if baby is sleeping for four hours and it takes you an hour to drink both glasses you can probably have two glasses and safely feed in four hours if you have them right after you finish feeding and don’t get caught up in dishes or laundry or whatever else is nagging your list of shit to get done. 🙂
  3. Let go of the guilt! If your BAC is .08, your breast milk contains 7 times less alcohol than a non-alcoholic beer. Your baby is not actually drinking what you are drinking. Does that mean it is completely safe to feed your baby immediately after drinking and that he or she is consuming no alcohol? Absolutely not, but take a breath and learn what is actually happening. Studies have shown decreased motor development in 1-year-olds of mothers who drank and breast fed, but remember your blood clears alcohol from your breast milk just like it clears it from itself, it will be alcohol free in a couple hours. NO need to pump and dump!
  4. Although the exposure is minimal regardless of whether or not you are intoxicated when you feed your baby, the alcohol removal process in an infant is about twice as long as an adult. We don’t want to stress those little organs more than they already are in the stressful growth process.
  5. Gauge the risk-to-benefit ratio. Mom’s sanity is FAR more important than many people consider, including mom. If having a drink or two or a few is going to relax you enough that you aren’t going to shake your baby or jump off a bridge from the stress, it’s probably better for baby to get a little taste of booze, rather than grow up with a crazy or non-existent mom. If you can’t control your drinking, this is in no way advice you should follow. Alcoholism is a serious disease and should not be taken lightly. Long term frequent exposure to alcohol is a serious threat to your baby’s development. There are no studies examining this because what mother in their right mind is going to expose their child to a known threat for the sake of science? So, we are never going to have definitive answers, but we know how alcohol abuse affects adults, so we can deduce what the results could be.

Case study #2: Mom drinks two cocktails at a bar with dinner. Her BAC is approximately .08. She goes home two hours later and feeds her hungry baby.

  1. Her BAC is now about .01 or less. The baby drinks about 3 ounces in a sitting, so of that 3 ounces of breast milk .01% of it was alcohol. Fractions work better for you? 1/100th of what the baby drank was alcohol, the rest was good, nutritious liquid gold.
  2. Again, that does not mean it’s ok for you to go out and get sloshed and feed your baby, but at least be educated about the risk. Non-alcoholic beer contains about .5% alcohol, 50x that of moms breast milk in the above situation (please feel free to correct my math because it is far from my strong suit, but you get the point).

Case Study #3: Mom goes out with the girls for a couple drinks; one thing leads to another and she feels she should take a cab home. She is not sure how many she had but they had at least two shots on top of whatever else she drank. She comes home and the baby is hungry. She feeds the baby pumped milk from her stash. In the morning (six short hours later), the baby is hungry again, but mom feels really hungover.

  1. Realistically, the risk of injuring your baby when feeding your baby while intoxicated (by dropping him/her, for example) is higher than the risk of causing long term psychomotor damage from feeding them a dash of alcohol.
  2. Mom should have pumped and dumped before going to bed. Not because the breast milk was unsafe but because she had been out for hours, and adding six more hours without pumping could lead to engorgement at best, infections such as mastitis at worst.
  3. Because mom is not sure how much she drank, and because alcohol cleansing is not a perfect science (everyone is different), mom has to decide how she feels about feeding the baby in the morning. There is a very good chance that she has naturally cleansed herself of the alcohol or there is a fraction of a percentage left in her breast milk. There are test strips on the market that can indicate if there is booze in your milk, but they are expensive. If she chooses not to feed baby from the breast, she should again pump and dump. If I were her I would pump only enough to relieve the pressure and dump, not a completely empty pump and dump because any remaining alcohol will be naturally filtered out by the next feeding (unless she had over 10 of course, 10 drinks, 10 hours — this is considered binge drinking. If this sounds like something you do, please evaluate your drinking habits for you and your baby’s safety**).

The Bottom Line:

If you practice responsible alcohol consumption you will easily practice responsible drinking and breast feeding. Are you killing your kid if they get a fraction of a percentage of booze in their system? No. Are you permanently damaging your baby if you allow your baby to get any booze in their system? Not likely. Careful planning of alcohol ingestion and baby feeding can result in the baby having no exposure to alcohol, and mom getting the much deserved break she needs.

Pointers:

  • Pump often to get a good stash in the freezer. Consult other moms, and/or La Leche League International for breast feeding and pumping pointers.
  • Know your baby’s sleep schedule and plan accordingly.
  • If you can’t get your baby on a schedule or your baby is too young to sleep for more than a few hours it is probably a bad idea to have many alcoholic drinks.
  • Know YOUR limits and plan accordingly.
  • Stay hydrated so you don’t reduce your production.
  • Booze accordingly and stop pumping and dumping just because you had a drink.

Thank you 🙂

Alexis Barrett, EP-C

**This article is intended for the responsible social drinker. If you think you have a problem with alcohol please contact your physician or local Alcoholics Anonymous group.

Bibliography

http://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/expert-answers/breast-feeding-and-alcohol/faq-20057985

Lawton, M. E. (1985), Alcohol in Breast Milk. Australian and New Zealand Journal of Obstetrics and Gynaecology, 25: 71–73. doi: 10.1111/j.1479-828X.1985.tb00609.x

Ruth E. Little, Sc.D., Kevin W. Anderson, B.Sc., Cynthia H. Ervin, Ph.D., Bonnie Worthington-Roberts, Ph.D., and Sterling K. Clarren, M.D.Maternal Alcohol Use during Breast-Feeding and Infant Mental and Motor Development at One Year.” N Engl J Med 1989; 321:425-430 August 17, 1989 DOI: 10.1056/NEJM198908173210703

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