Alcohol and Breastfeeding

A big question that comes up after 9 long months of pregnancy and not taking so much as a Tylenol or eating a single piece of blue cheese; "Is it safe to drink while breastfeeding?" The easy answer is, yes. It can be safe to drink alcoholic beverages while breastfeeding. However that is not the full answer.

To answer this question we need to know a little more about how alcohol enters your system. Alcohol metabolizes through breast milk the same way it does through blood, at a blood alcohol concentration rate of about 15 to 20mg/dL per hour. This means that the alcohol will leave your breastmilk at the same rate it leaves your blood. Regardless of your size, alcohol metabolizes the same way. If you are a bigger individual, you may not feel it as quickly, but it will still leave your body at the same rate. For a 180lb female it takes about 2 hours per drink to completely metabolize. While yes, your breast milk doesn’t contain the dose of alcohol you ingested (less than 16% of the mothers dose), how much is in your milk will also depend on how much you drink. 

But wait, you said it was safe to drink when you are breastfeeding? 

Yes it is, however it is necessary to make good decisions in how you will plan out your evening if you do not want to waste precious breastmilk. Levels of alcohol peak in the mothers system 30 – 60 minutes after a drink is ingested and then will rapidly fall back to normal (as long as no further drinks are ingested). This means if you nurse and have a glass of wine or beer, chances are by the time your LO is ready to nurse again the alcohol will be mostly out of your system. The bigger concerns come when more than one drink is ingested. Two drinks over the course of 3 – 4 hours is very different than 2 drinks in an hour. If you wish to have more than one drink, plan appropriately. The more you drink, the higher your blood alcohol content, and the longer it will take for that milk to leave your system.  Remember: When we talk about a drink we are talking about a standard size drink. This means 12oz of beer, 5oz of wine, or 1.5oz of hard liquor. Not all wine glasses are the same, and it’s easy to overestimate what 1 drink really is.  What about the milk pumped when you feel you aren’t safe to nurse? Alcohol will only metabolize in breastmilk while in your body. The milk you pump if you are intoxicated will still contain alcohol after it has been pumped. If you do not wish to dump this milk then you should make sure to label it as not safe for drinking. 

But what about alcohol test strips? There is a lot of controversy around the alcohol test strips. They are promoted to moms to let them know that their breastmilk is safe. The idea is simple: you put a drop of your milk on the test strip and it will change colors if there is alcohol present. However, when you read the instructions, it states that the tests are
extremely sensitive. You will get a positive result with a blood alcohol level as low as 13.1mg/dL. This converts to a BAC of .013. For reference in most states the legal limit is .08. As you can see, you will get a positive result from very low levels of alcohol. You could get a positive just from eating a dessert that contains liquor! So while yes, these strips will accurately tell you if your milk as alcohol in it, they cannot tell you how much alcohol there is.

So what if you are planning to go out and drink more than one or two drinks? 

First off, ensure that your child is being left with a sober safe caregiver. If you are going out the choice is easy, but if you are drinking at home discuss with your partner who is going to be in charge of the baby. One of the big concerns with drinking alcohol as a parent is having a sober caregiver for your child. How you feel is no indicator of how intoxicated you really are. Plan on pumping milk before you go out so that you have breastmilk for your child when you are unable to nurse. Know that you will probably need to pump milk as not pumping or nursing can lead to clogged ducts and mastitis. Make sure to dump or label the milk you pump when intoxicated so that you do not offer it to your child later. 

PLEASE NOTE: IT IS NOT ADVISED THAT YOU BEDSHARE IF YOU HAVE HAD ANYTHING TO DRINK. EVEN ONE DRINK. 

Even if you think you are "ok", it is best to have baby sleep in a separate crib or bassinet. Everyone reacts to alcohol differently and even if you feel sober, it is very easy to sleep deeply and become a hazard to bedsharing.

DIRECTLY FROM KELLYMOM.COM
--Alcohol does not increase milk production. In
fact, babies nurse more frequently but take in less milk in the 3-4 hours after
mom has had a drink, and one study showed a 23% decrease in milk volume with
one drink (Mennella & Beauchamp 1991, 1993; Mennella 1997, 1999).
--2+ drinks may inhibit let-down (Coiro et al
1992; Cobo 1974).
One study showed changes in the infant’s
sleep-wake patterning after short-term exposure to small amounts of alcohol in
breastmilk — infants whose mothers were light drinkers slept less (Mennella
& Gerrish 1998).
--Daily consumption of alcohol has been shown in
the research to increase the risk for slow weight gain in the infant.
--Daily consumption of alcohol (1+ drinks daily)
has been associated with a decrease in gross motor development (Little et al
1989).

http://kellymom.com/bf/can-i-breastfeed/lifestyle/alcohol/

From Dr.
Hale: 

Facts:
1. Alcohol enters milk freely. 
2. One drink includes: 12 oz of 5% beer, or 5 oz of 11%
wine, or 1.5 oz of 40% liquor (80 proof). 
3. The peak level in milk is likely to occur about 1 hour
after consumption. 
4. Alcohol leaves the milk compartment as the mother’s blood
alcohol levels drop. 
5. Alcohol present in pumped milk is permanent. Discard the
milk. 
6. Waiting “about” 2 hours per drink is required for
complete metabolism of alcohol in a 180 pound female.
7. Techniques such as drinking more water, taking caffeine,
exercising, pumping and discarding of milk, etc. to enhance
metabolism/clearance of alcohol do not work. Only time will eliminate alcohol. 
8. Elixirs that contain ethanol can lead to blood alcohol
levels similar to those seen by taking one alcoholic drink. 
9. Storing milk before drinking is another way to make sure
your infant is not exposed to alcohol. 
10. Nothing can replace human breast milk as a source of
nourishment for your child; therefore, careful planning before drinking is
advised over formula use.
- See more at:
http://www.infantrisk.com/content/alcohol-and-breastfeeding

So what is the take away here? Moms absolutely can enjoy a glass of wine or a beer when breastfeeding. If you are ever concerned or question the safety of your milk, we would encourage you to always err on the side of caution. Please always drink in a responsible fashion.