Basically it's OK, with a few exceptions.
[post_ads]While some women opt for the occasional glass of wine during pregnancy, I knew that I wanted to stick to the official guidelines and abstain completely. I didn't drink any alcohol while I was pregnant—instead, I watched as bottles of wine from the several wine clubs I had joined before getting pregnant
stacked up. After a 10-month hiatus from alcohol, you can bet imbibing
was on my mind. But, as many a new mom knows, the guidelines and myths
of what you can and can't consume don't stop after giving birth. Since
some substances do pass through to breast milk—including alcohol—after
the birth of my son I wondered, now that I was breastfeeding, could I
drink?
In the end, I chose not to, but
not for the reason you might think. Milk production was difficult to
begin with for me and, it turns out, drinking alcohol
while breastfeeding may decrease it even further. (We’ll talk more
about this later.) But in general, it turns out that enjoying an
occasional glass of wine or beer while you’re breastfeeding isn’t a big
deal for most new moms.
Alcohol can make it into breast milk in very small amounts, similar to your blood alcohol concentration when you drink.
But
don't worry, drinking while breastfeeding won't get your baby drunk.
Here's how it works: When you drink alcohol, it goes straight to the stomach
and small intestine, where the blood vessels absorb it into the
bloodstream. Eventually, it travels to the liver, where enzymes break
down the alcohol. Our systems can break down approximately 1 ounce of
alcohol an hour. Any extra accumulates in the blood and body tissues
until the liver can process it.
From
there, the accumulation of alcohol in your bloodstream can pass through
to your breast milk. “Alcohol diffuses freely into milk from the
maternal blood, so it has approximately the same concentration as the
maternal blood alcohol concentration,” Brendan H. Grubbs, M.D.,
assistant professor of clinical obstetrics and gynecology at the Keck
School of Medicine at the University of Southern California, tells SELF.
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Put
another way, “Less than 2 percent of alcohol that a mother drinks
reaches her breast milk,” Amy Schutt, M.D., an assistant professor of
obstetrics and gynecology at Baylor College of Medicine, tells SELF.
Worth noting: Infants metabolize alcohol at about half the rate of
adults (meaning that alcohol stays in their system longer).
All
this means that the amount of alcohol that could pass through to your
breast milk and to your baby is very, very low. A review of 41 studies
published in the journal Basic & Clinical Pharmacology & Toxicology says that even in hypothetical cases of binge drinking,
the effect on the child wouldn’t be significant. "Assuming the worst
possible scenario where a mother engages in binge drinking and ingests
four drinks of 12 grams pure alcohol and then breastfeeds her child at
the time of the maximum blood alcohol concentration, the child would
still not have a blood alcohol level of more than 0.005 percent. It
appears biologically implausible that occasional exposure to such
amounts should be related to clinically meaningful effects to the
nursing children,” the review states. (This isn’t to say that this is
advisable, but is a good way to understand how alcohol in your system
can affect your baby.)
However, even one or
two alcoholic drinks may temporarily decrease milk production. A few
small studies also suggest that drinking while breastfeeding might
impact the baby's sleep.
The real
effect of drinking while breastfeeding may come to how alcohol affects
the breastfeeding process. Despite folklore that linked imbibing to
increased milk production, science has proved otherwise. “Limited data
suggest that drinking even one alcoholic beverage can reduce milk volume
by 23 percent, and drinking two or more alcoholic beverages may inhibit
let-down,” Dr. Schutt says.
[post_ads]Research has shown that drinking alcohol while breastfeeding
inhibits the milk ejection reflex, also known as the let-down—what
happens when your baby suckles your nipple and releases the breast milk
from the glands to the breast. For this reflex to occur, the nerve
connections from the nipple to the hypothalamus area of the brain need
to be intact, because it is the release of the hormone oxytocin
that makes the let-down occur. Considering that alcohol can affect the
hypothalamus, being under the influence can stop the cycle of baby
suckling and milk being released so more milk can be produced. The
result is a temporary decrease in milk production.
If
you’re having trouble with milk production, it might be a good idea to
avoid alcohol while you’re breastfeeding. Talk with your doctor or a
lactation consultant about your concerns.
In
addition, even though the amount of alcohol a baby can ingest through
breast milk is small, some studies show that it may negatively affect
the child's sleep. There are only a few studies
on the matter, however, all small (involving only one or two dozen
infants) and published in the 1990s or early 2000s. Those disclaimers
aside, the studies did show minor sleep disturbances. Some studies found
that although the amount of time spent sleeping was unchanged, infants
woke up more often. Other studies found that infants slept about 25
percent less after drinking milk that contained alcohol. (In all of the
studies, the infants were given only a small amount of alcohol that was
equivalent to the mother having one or two drinks.)
There's also a bigger concern about drinking when you have a newborn: It's not safe to be intoxicated while caring for a baby.
It's
not a secret that people can make some pretty terrible decisions while
drunk. Before kids, this may have amounted to drunk dialing an ex or
picking a fight with your best friend. But when you're caring for a
child, the consequences can be much more severe.
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One
of the most serious concerns involves driving while intoxicated when a
child is in the car, which can result in injuries or death. Statistics
from the National Highway Traffic Safety Administration
show that alcohol is implicated in about one in five motor vehicle
crashes involving a child. Among those deaths, 65 percent of the time
the child was riding in the car with an impaired driver. That's
especially concerning when you consider that motor vehicle collisions
are a leading cause of death among children.
Violence and child maltreatment are also associated with heavy drinking, according to the Centers for Disease Control and Prevention. The National Incidence Study of Child Abuse and Neglect,
which uses nationwide data, found that parental alcohol use was
involved in 13 percent of child maltreatment cases. This is because
alcohol is more likely to be involved in physical or emotional abuse
compared to other drug use, the study authors explain. One limitation is
that the study was published in 2010, the most recent year the data was
available.
Even aside from these
severe cases, being drunk while caring for a baby isn't a great idea.
Alcohol impairs your judgment and reaction time, both of which are
important when taking care of an infant. Being intoxicated can make you
less aware of what your baby needs. If you do decide to get drunk, make
sure a sober adult is in charge of childcare.
In addition, never share a bed or couch with a child if you've been drinking; this has been strongly linked
to a higher risk of sudden infant death syndrome. One reason is that
you might accidentally suffocate the baby while you're sleeping.
Obstructing an infant's airway for even a very short period of time can be dangerous.
Bottom
line: Drinking the occasional glass of wine or beer while breastfeeding
probably won’t harm your baby, but the research is limited.
[post_ads]All
that being said, approximately half of breastfeeding women in Western
countries drink alcohol, according to the aforementioned review in Basic & Clinical Pharmacology & Toxicology.
That’s a lot of lactating mamas enjoying a glass of pinot or a pint of
lager. But the research on the effects of drinking while breastfeeding
on babies is limited, so it's hard to definitively say whether or not
there are any short- or long-term consequences.
“For
obvious reasons, there are no well-designed studies on the effects of
alcohol consumption during lactation on risks to the baby,” Dr. Grubbs
explains. “There are a few case reports of adverse outcomes of babies
exposed to alcohol during lactation, however they have been in extremely
heavy drinkers. These are confounded by associated issues such as
neglect, consumption of tobacco or illicit drugs, and poor nutrition.”
If
you want to drink alcohol while breastfeeding, remember this guideline:
If you’re sober enough to drive, you’re sober enough to breastfeed.
[post_ads]By following the guidelines
set forth by the American Academy of Pediatrics, Dr. Grubbs says
drinking alcohol should not lead to levels of alcohol exposure which
could plausibly result in an adverse outcome in the baby. Overall, the
American Academy of Pediatrics recommends that women minimize alcohol
consumption during lactation, but if you choose to imbibe limit that
occasional intake to no more than 0.5 grams of alcohol per kilogram of
body weight. In real world terms, if you weigh approximately 130 pounds,
this translates to 2 ounces of liquor, 8 ounces of wine, or two
12-ounce beers, according to Dr. Grubbs.
“The
highest concentration occurs approximately 30 to 60 minutes after
consumption, and declines at the same rate as seen in maternal blood,”
he says. So looking to The American Academy of Pediatrics again, waiting
two hours or longer after drinking alcohol before breastfeeding is
recommended to minimize the concentration of alcohol in the ingested
milk.
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