To Wine or Not to Wine: That is the Question!

July 05, 2017

To Wine or Not to Wine: That is the Question!

Just in time for Stampede (for all my fellow Calgary mamas)! Happy reading and Happy Breastfeeding!!! 

Well it’s that time of year again – when I get asked about the effects of drinking alcohol while breastfeeding. Most mothers look forward to Stampede, whether it’s that corporate Stampede event, or rockin' concert  when they can indulge ever so briefly in their “before-baby life”.  But like any good mother would do, before taking a sip from that wine glass (or beer mug or boot) … she wonders whether she’s making the right decision? Will that enticing alcoholic drink get into my breastmilk and harm my baby? This blog will answer alcohol and breastfeeding related questions and concerns. Spoiler alert: Breastfeeding and alcohol can mix, within reason.

First, let’s discuss the science. We need to understand how alcohol gets into the breastmilk to be able to determine whether or not it is actually a harmful thing. Alcohol is a drug. It is probably one of the most commonly used drugs worldwide. Any drug a person takes is eventually diluted throughout the entire body. Some drugs cross the blood-brain barrier and some drugs do not. The only way for a drug to get into your breastmilk is for it to find its way into the bloodstream. Alcohol​ does in fact cross the blood-brain barrier and ​does get into your bloodstream. But it doesn’t get trapped in the milk. It is constantly removed from the milk as it diffuses back into the bloodstream during your body’s normal metabolization process. So, when your blood alcohol levels are back down, so are your milk alcohol levels. The concentration of alcohol in blood and breastmilk is about the same. In other words, however long it takes for your body to metabolize your favourite glass of red (or pint of IPA), that’s how long it’s going to be present in your breastmilk.

What does this mean when you are about to accept that glass of sangria from a handsome waiter? Let’s dive into the punch bowl a little deeper! Consuming alcohol while breastfeeding means planning ahead and making smart, informed decisions. Current research says that occasional use of alcohol (1-2 drinks) does not appear to be harmful to the nursing baby. La Leche League’s opinion on this matter states: “The effects of alcohol on the breastfeeding baby are directly related to the amount the mother ingests. When the breastfeeding mother drinks occasionally or limits her consumption to one drink or less per day, the amount of alcohol her baby receives has not proven to be harmful.”

The American Academy of Pediatrics recommends that most breastfeeding mothers should wait 2 hours or longer after alcohol intake before nursing their infants to minimize its concentration in the ingested milk. Others insist even that precaution is not strictly required. Most women can fully metabolize an alcoholic drink in 2-3 hours. This is also why there is no need to pump and dump your milk. If it’s for your comfort, you can go ahead and spill that milk down the drain. However, pumping and dumping your milk after consuming alcohol does not speed the elimination of alcohol from the milk. So, nurse away, and to be on the safe side, the best piece of advice would be to wait at least 2-3 hours after having your drink before breastfeeding your baby.

Another way to think about drinking and nursing is to think about drinking and driving. If you’re sober enough to drive, you’re sober enough to breastfeed! Most jurisdictions consider you too drunk to drive if your blood alcohol level is more than 0.05%-0.1%. On a volume basis, less than 2% of the alcohol consumed by the mother reaches her blood and milk. Alcohol peaks in mom’s blood and milk approximately 30 minutes to 1 hour after drinking. This is not a concentration of alcohol that is going to make baby sick or cause any kind of brain damage if baby ingests it through breastmilk. Generally, if                     you are sober enough to drive, you are sober enough to breastfeed. But remember, your sobriety is individual and depends on how much food you’ve eaten, your body mass index, and percentage body fat.

So while you may not need to “pump and dump” that precious mama milk, you can’t necessarily get away with no pumping. If you have a Stampede event coming up, or any big event for that matter, it’s important to plan ahead so your baby’s needs are covered while you’re away. Start to pump and store your breastmilk a few days before the party (or however long you need to pump enough milk for your absence). Depending on how much and how often the little chief love of your life eats, make sure you have enough milk stored for at least 2 feedings. When enjoying yourself at your festive soiree, make sure to take care of your needs too. Eat a substantial amount of (healthy) food. It’s a good idea to combine a protein with a carb and it’s always a great idea to drink plenty of water throughout the evening. Keep checking in with yourself as well. Ask yourself: How am I feeling? Could I safely get into my car and drive home? This is a good gauge in order to determine if you are sober enough to breastfeed your baby (or carry a squirmy baby up the stairs for that matter). If you are going to be out for a long stretch and want to keep up your supply, you may want to bring your breastpump with you and pump as frequently as baby usually feeds. This is just to help maintain your supply and prevent plugged ducts, not because of the alcohol in your breastmilk. You may also have to re-consider your holiday dress choice if you are going to have to sneak off somewhere and pump. Dresses with zippers in the back are generally a pain in the butt! I say this speaking from experience!

When drinking and nursing, I’s also important to consider the age of the baby and the development of your breastfeeding relationship before consuming alcohol. A newborn or preemie has a very immature liver. Even small amounts of alcohol are going to put a strain on this underdeveloped organ. Until an infant is around 3 months of age, they detoxify alcohol at around half the rate of an adult. An older baby or toddler can metabolize the alcohol more quickly. Alcohol does not increase milk production and has been shown to inhibit let-down and actually decrease milk production. Studies have shown that after a mother has consumed alcohol, babies nurse more frequently but take in less milk in the 3-4 hours after mom has had a drink. One study showed a 23% decrease in milk volume with one drink and another study showed that 2 or more drinks may inhibit let-down. Alcohol is a CNS depressant. Any depressant is going to diminish your reflexive behaviour. Let-down is a reflex. So therefore, it makes sense that this reflex could be ‘slowed’ when alcohol is consumed. One study also 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)

So to sum it all up for you, here are the key points to take away from this festive season blog:

  • Your baby’s age. The younger your baby is the more affected his liver will be by the metabolization of alcohol.
  • Your weight. Your weight and similar factors determine how quickly the alcohol will be metabolized and cleared from your breastmilk/bloodstream
  • Amount of alcohol. The amount of alcohol consumed is directly related to the effects on the infant. The more alcohol consumed, the longer it takes to clear your breastmilk.
  • An alcoholic drink consumed with food decreases absorption. To be entirely on the safe side, it is best to wait 2-3 hours after your last drink before breastfeeding your baby.
  • Baby or no baby (but especially when parenting a baby), alcohol should be enjoyed safely and responsibly.

I hope this post was helpful and informative. Please feel free to leave your comments or contact me with any questions or concerns. Have a great Stampede week everyone!

Have fun and Happy Breastfeeding!!!  

Until next time,

Leanne Rzepa RN BN IBCLC

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