Alcohol and Breastfeeding during the Holidays

A common question I get asked during the holidays is “Can I have an alcoholic drink and still breastfeed” or “ I can just ‘pump and dump’ if I drink, right?” During the festivities of the holidays, from Christmas to New Year, the opportunities to indulge with an alcoholic beverage seem to abound. So, what are the current recommendations regarding alcohol consumption while breastfeeding? Let’s take a look.

The CDC’s website states:

Not drinking alcohol is the safest option for breastfeeding mothers. Generally, moderate alcohol consumption by a breastfeeding mother (up to 1 standard drink per day) is not known to be harmful to the infant, especially if the mother waits at least 2 hours after a single drink before nursing. However, exposure to alcohol above moderate levels through breast milk could be damaging to an infant’s development, growth, and sleep patterns. Alcohol consumption above moderate levels may also impair a mother’s judgment and ability to safely care for her child.”

The AAP (American Academy of Pediatrics) policy statement:

Breast milk alcohol concentrations closely parallel blood alcohol concentrations, with highest levels in milk occurring 30 to 60 minutes after consuming alcohol. Moderate alcohol consumption by a breastfeeding mother (up to 1 standard drink per day) is not known to be harmful to the infant, especially if the mother waits at least 2 hours after a single drink before nursing or expressing milk to be fed to the infant. Moderate alcohol intake does not appear to affect breastfeeding duration. Consuming more than 2 standard alcoholic drinks daily is discouraged.”

Basically, no alcohol consumption while breastfeeding is preferred but one website states “up to 1 drink daily” is not a problem for the infant and the other specifically mentions no more than 2 drinks per day. But how much alcohol is actually passing into breastmilk? There has been so much research on breastmilk and infant feeding over the past decade or so. We’ve known alcohol passes into breastmilk and therefore is available to the infant so a lot of older advice or information centered around not breastfeeding at all during alcohol consumption or “pumping and dumping”, the act of expressing our breastmilk and discarding it or using it for some other purpose. What we now know is alcohol passes into breast milk and out of breast milk at the same rate and ratios as it passes into our bloodstream and out of our bloodstream.  We also know the more drinks we have, the higher levels of alcohol are in our blood and therefore, the higher levels of alcohol that are available in breastmilk. According to the CDC, “Alcohol levels are usually highest in breast milk 30-60 minutes after an alcoholic beverage is consumed, and can be generally detected in breast milk for about 2-3 hours per drink after it is consumed.” The idea that you can have a drink or two, then wait 2 hours before feeding comes from this knowledge. Some other outdated advice has been for moms to “pump and dump” but again the CDC states, “The alcohol level in breast milk is essentially the same as the alcohol level in a mother’s bloodstream. Expressing or pumping milk after drinking alcohol, and then discarding it (“pumping and dumping”), does NOT reduce the amount of alcohol present in the mother’s milk more quickly. As the mother’s alcohol blood level falls over time, the level of alcohol in her breast milk will also decrease.”

So, how much is too much? Generally speaking, indulging in 1-2 drinks at a holiday party is not considered to be harmful while breastfeeding. There is no need to wait 2 hours before latching your infant and no need to “pump and dump” and no cause for concern. *However, all sources agree that caring for an infant while intoxicated is never recommended and bedsharing/co-sleeping while or after drinking is strongly discouraged as well. 

 

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stephanie glover, lpn

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Stephanie Glover, LPN, IBCLC (Board Certified Lactation Consultant)

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