Some women think that it is okay to drink alcohol as long as they drink during their breastfeeding, so that the alcohol does not have a chance to get into the milk. Others think that they can have a drink and then pump and chuck the milk that follows. Others have heard that if they have a drink and then wait an hour before feeding, everything will be fine. Still others, especially in cultures where alcohol is thought to increase milk production, believe that alcohol is not a problem for a breastfeeding baby or that it does not even get into the breast milk.
Drinking alcohol is relatively common among breastfeeding women; in a survey of 772 breastfeeding women and 776 non-breastfeeding women, 36 per cent of the breastfeeding women consumed alcohol as early as three months after giving birth. Although they were less likely than non-breastfeeding women to have two or more drinks per week, they were just as likely as those women not breastfeeding to have one drink per week.
Let’s set one thing straight – alcohol does enter breast milk. Alcohol actually concentrates in breast milk and can pass directly to the baby, and this has been shown by numerous studies testing breast milk for alcohol content. The amount of alcohol that reaches the baby is small, but it is there nonetheless – and in larger amounts (more than the equivalent of a small glass of wine), alcohol has been shown to inhibit a mother’s milk production.
The timing of drinking and breastfeeding is a little more tricky than you might think. When the alcohol is in your bloodstream, it is also in the milk that you produce. Drinking just before you nurse, or during nursing, may not help matters at all. In order for the alcohol to completely leave your bloodstream, you should probably wait to breastfeed for at least an hour after your last drink.
In the short term, alcohol in the breast milk changes the behaviour of the baby as he or she feeds, and babies actually take in significantly less milk if it contains alcohol. This has been shown in a small study in which babies were videotaped as they nursed, both after their mother drank plain orange juice and after she drank orange juice with a small amount of alcohol in it. A panel of adults judged the smell of the breast milk both with and without alcohol (they thought the alcohol-laden milk smelled different), and the samples were analysed to see how much alcohol they contained. And while you might think that having an alcoholic drink before you nurse will help the baby to sleep better (perhaps because a glass of wine makes you more sleepy), the reverse is actually true. In a different study, babies slept significantly less and for shorter periods of time after their mothers drank alcohol.
Aside from taking in less milk and becoming a bit restless, you may wonder if there are any more serious side effects for a baby from having milk that contains a little bit of alcohol. The effects of alcohol from breast milk on a child’s development are not completely clear. Some studies have shown that alcohol in breast milk is tied to decreased motor development in babies. In a study of 400 infants, those who ingested breast milk that contained alcohol had lower scores on a test of motor development (measuring things like crawling and walking) when they were one year old, but they did not score significantly lower on tests of mental development. Thirty of the 400 infants were considered to have had a high infant alcohol score. In a subsequent study of 915 eighteen-month-old toddlers, researchers did not find a link between exposure to alcohol and delayed motor development. However, they cautioned that we don’t know whether there are any effects later in life.