Is Alcohol safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Alcohol. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
A nursing mother was drinking large amounts of quinine wine, wine, champagne, beer and liquors. Her infant had been gaining 30 g of weight daily until he weighed almost 6 kg at 5 weeks of age. The infant had been restless and sleepless for several days when he suffered from violent fits and tonic-clonic seizures that required medical treatment. After he was taken off the mother's breast and began to be nursed by a wet nurse, his weight quickly dropped by 200 g in 3 days and fell into a pattern of calm sleep.[ 21 ] A similar case of chronic heavy alcohol use by a nursing mother resulted in pseudo-Cushing syndrome in her 4-month-old breastfed infant. The infant had a bloated appearance, excessive wight gain and diminished length for age. The mother reported drinking 50 cans of beer weekly and "generous" amounts of other alcoholic beverages to increase her milk supply. The infant's symptoms resolved and growth pattern returned to normal after her mother stopped consuming alcohol.[ 22 ] A series of 23 cases of severe thrombocytopenia and bleeding were reported among 21- to 60-day-old breastfed infants of Chinese women in Singapore over a 5-year period. None of the infants had received prophylactic vitamin K at birth and all of their mothers had been taking alcohol tonics after each meal beginning at 7 to 10 days after delivery which was a common practice among only the Chinese in the mixed ethnic population delivering at the hospital. Most of the infants also received 5 to 15 mL daily of "gripe water", which had an alcohol content of about 5%. The authors attributed these cases to the lack of prophylactic vitamin K (which was common practice at the time) and increased clotting factor degradation caused by alcohol.[ 23 ] A woman who drank 750 mL of port wine in 24 hours noticed that her breastfed 8-day-old had a deep unarousable sleep, snoring, pain insensitivity, inability to suck, excessive perspiration and a feeble pulse. These symptoms were attributed to the very you
Effects on milk supply
An expert panel stated that no conclusion could be drawn regarding any associations between maternal alcohol consumption during lactation and milk composition or milk production.[ 4 ] Studies in mothers who were 2 to 8 days postpartum found that acute doses of alcohol infused intravenously reduced the oxytocin-mediated milk ejection reflex following infant sucking. The effect could be overridden by administration of exogenous oxytocin, indicating that alcohol inhibits oxytocin release, not its effect on the breast.[ 49 ] Alcohol doses of 0.5 to 0.99 grams/kg reduced oxytocin response to infants sucking by 18%; doses of 1 to 1.49 grams/kg reduced the response by 62%; and doses from 1.5 to 1.99 grams/kg reduced the response by 80%. Alcohol also increased the time for letdown to occur after nipple stimulation, from 29 seconds to 64 seconds with doses of 1 to 1.49 grams/kg and from 38 seconds to 331 seconds with doses of 1.5 to 1.99 grams/kg.[ 50 ] Other investigators found that drinking 100 mL of whiskey containing a total of 50 mL of absolute alcohol (about 4 drinks in a 60 kg woman) abolished the rise in serum oxytocin in response to breast stimulation with a breast pump in 16 nonpregnant, nonlactating women. Pretreatment with naloxone blunted alcohol's inhibitory effect on oxytocin release.[ 51 ] Acute alcohol ingestion can either increase, decrease or have no effect on serum prolactin in nonpregnant, nonlactating women.[ 52 - 54 ] Drinking 100 mL of whiskey containing a total of 50 mL of absolute alcohol lessened the increase in serum prolactin in response to breast stimulation with a breast pump in 11 nonpregnant, nonlactating women. Serum prolactin rose by 71% over baseline 20 minutes after stimulation without alcohol and only by 25% after alcohol consumption. Pretreatment with naloxone blunted alcohol's inhibitory effect, with the combination resulting in a 46% rise in serum prolactin over baseline.[ 55 ] It is not clear how these finding apply to lactating wome
Levels in milk
The alcohol (absolute ethanol) content of various drinks are as follows: 12 fluid ounces of beer (4.5%) = 12.6 g; 4 fluid ounces of table wine (12%) = 11.2 g; 1 fluid ounce of whiskey (100 proof) = 11.7 g. Blood alcohol is often reported as a percent; a concentration of 1 gram/L of alcohol is equivalent to 0.1%. Maternal Levels. Five nursing mothers drank 0.4 grams/kg of alcohol as vodka (about 2 drinks for a 60 kg woman) over 1 minute after a standard breakfast and followed the drink with 80 mL of water. Blood and milk samples were collected over the next 3 hours. Eight additional women who were not breastfeeding followed the same protocol. Blood and milk alcohol levels had a later peak in lactating women (48 minutes) than in the nonlactating women (31 minutes). The bioavailability of alcohol in the lactating women was 74% of bioavailability in the nonlactating women; peak blood alcohol concentrations were numerically lower, but not statistically different from the nonlactating women. Milk alcohol levels closely paralleled blood alcohol levels with an average peak level of 0.44 grams/L, falling to about 0.35 grams/L at 90 minutes and about 0.09 grams/L at 3 hours after the dose.[ 7 ] Twelve women between 4 and 41 weeks postpartum drank a 0.6 grams/kg of alcohol (about 3 drinks for a 60 kg woman) as a 15% solution over 5 minutes on an empty stomach. Blood and milk samples were obtained every 30 minutes for 2 hours. Alcohol concentrations in milk closely paralleled blood concentrations with the highest concentration averaging 1.05 grams/L at 1 hour after the dose. By 2 hours, the alcohol concentration in milk was 0.7 grams/L. Acetaldehyde, the major metabolite of alcohol, was undetectable in milk (assay limit not stated), but was detectable in maternal blood.[ 8 ] Eight nursing mothers with infants ranging in age from 6 weeks to 2 years 9 months rapidly drank from 0.46 to 1.5 grams/kg of alcohol after a small meal. The time of peak alcohol concentrations varied from
Source: NIH LactMed (National Library of Medicine).
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.