Alcohol & Breastfeeding
So the question that many moms have and also one that many have been given incorrect information. How about alcohol and breastfeeding? I hope this helps explain to moms how it all works! I am an IBCLC and mom to 3 (of course!) breastfed boys who are now 16, 13 and 10 and I love helping other moms understand!
Okay here we go!
The American Academy of Pediatrics' statement on breastfeeding and alcohol is that it is compatible. Yes. Compatible. Do they mean safe for chronic abuse, no. But normal alcohol consumption by a responsible adult, yes.
So let's dig a little deeper. "Why?" - many moms ask.
Well, breastmilk is called white blood. This is because breastmilk is a blood line. And when we drink alcohol that alcohol gets into our blood and also our milk. BUT wait... Let me explain. Blood alcohol levels will be equal to levels of (let's call it) milk alcohol levels. They will be the same, meaning whatever your blood alcohol content is, is also what your milk alcohol content will be.
So when one drinks to make their blood alcohol levels unsafe to drive, that is at a minimum of 0.08% blood alcohol in KS and MO. That means that 8/100ths of 1% of your blood is alcohol. That is a very small fraction of your blood - not even 1%. And an unsafe amount to drive, agreed.
So let's make sense of this for our babies and breastmilk.
Babies are drinking our milk. So for all practical purposes they are drinking our (white) blood. So this means that if one is too inebriated to drive, their milk will have the same alcohol levels of their blood. Let's say 0.08% milk alcohol. So when the baby is breastfeeding, the baby is drinking your milk that has 8/100ths of 1% of your milk being alcohol.
Much research tell us that this percentage is what they call, sub clinical, immeasurable and clinical insignificant. Why?
Let me break it down another way. When we adults drink we may drink a beer that is labeled on the outside as 5-8% alcohol or wine that is labeled 13% alcohol content. Drinking too many of these increases our blood alcohol to 0.08% or more. Again, not safe to drive. This is where I want you to remember what the baby is drinking. Their breastmilk is now labeled and says 0.08%. If the baby's blood were taken after nursing, their blood alcohol levels would be so small you can't even measure them. It would be like 0.0000000000000001. Not anything to be remotely remarkable.
Let's look at it another way...
Non alcoholic beer alcohol content is 0.5%. That is about 7X higher than what a mother's milk would have IF she was too inebriated to drive. Adults can drink non alcoholic beer all day long and it is not going to affect them nor raise their blood alcohol levels to anything significant. Not that you should give your baby non alcohol beer. But merely said as an example.
Now I'm not saying that anyone should drink in excess. This isn't healthy for anyone. But we all do have occasional nights or celebrations where we may need a safe ride home. In this case, you should be pumping while separated from your baby so that you may maintain your milk supply, just as your baby normally would. And save that milk when you get home in the freezer or fridge!!!!!
Do not pump and dump!! This is horribly perpetuated myth. Discarding breastmilk is rarely done and rarely necessary.
That milk still has insignificant amounts of alcohol. Some moms may use it as normal. (I would) Other moms may go a step further by diluting the milk, with other milk. One can take expressed milk from another time (without the trace amounts of alcohol) and mix it with the milk from the alcohol occasion, combining them in parts equal to 1/4 to 3/4 or 1/2 to 1/2. That further dilutes the alcohol content from trace levels to now sub trace levels.
Coming home from am occasion like that, in my opinion, it is even just fine to directly nurse your child. Now I wouldn't carry my baby that evening nor sleep with my baby. Someone else could safely carry baby to you while you nurse lying down then take baby to another sleeping space once finished nursing.
Really the biggest concern with drinking and breastfeeding is not the alcohol in the milk. It is: do you have the ability to care for your child? Abusers of alcohol would likely have the biggest concern being neglect of the child, not the alcohol in their breastmilk.
So what does all of this mean? It means you can drink like you normally do and continue to nurse or pump like you normally do. Share a bottle of wine over dinner. Have a beer with girlfriends and chat about all the things parents do - all while caring for and nursing your baby!
If someone is uncomfortable with even trace amounts of alcohol in their breastmilk while they nurse, then they need to wait the time it takes for alcohol to be metabolized out of our blood (and therefore also out of our milk). On average it takes about 2 hours for one alcoholic drink to metabolize out of our blood/milk. So one could nurse, then have a drink, then 2 hours later may nurse again. If it were me, and it has been, I wouldn't go to that trouble. But I respect that there are some women that would.
Some of you may have heard me explain this before, and I hope it can spread to more women. But the take away message from this should be, lead your normal life and be a mom who *happens* to be breastfeeding, not a breastfeeding mom who has to lead a certain particular life.
Summer J Friedmann, IBCLC
9/11/2016