Can You Drink Alcohol While Breastfeeding?

After pregnancy and nine months of abstaining from all alcohol, many new moms want to know when they can have a beer or glass of wine.  So, can you drink alcohol while breastfeeding? The simple answer is yes.

There is a lot of conflicting information on the internet related to this. When I had my first baby I felt pretty confused. I wanted to have a drink with family and friends again but I did not want to do anything to put my baby at risk.

There are basic rules related to alcohol use while breastfeeding but one size does not fit all. Most mothers are going to have to take a look at the facts, the recommendations, and think about how their bodies process alcohol and use their own judgement.

After doing some research I feel fine having an occasional drink (or more) and breastfeeding my baby. I just make sure to know how my body responds to alcohol and to prepare the best I can for those occasions. I have summarized some of the facts and opinions related to this subject so you can make your best informed choice as well.

How does alcohol affect our milk?

When we drink alcohol it does transfer in and out of our breast milk the same way it transfers in and out of our bloodstream. Alcohol levels peak about 30-60 minutes after ingestion. The amount of alcohol that makes it into the milk is much less than what is ingested so in most cases it is a miniscule amount.

Different estimates have put it at less than 2-16% of the amount of alcohol ingested by the mother. Alcohol levels are metabolized by adults at about 15-20 mg/dl an hour.

The amount of alcohol in most drinks

In the United States, one "standard" drink contains roughly 14 grams of pure alcohol

• 12 ounces of regular beer, which is usually about 5% alcohol, some light beers are about 4.2% alcohol
• 5 ounces of wine, which is typically about 12% alcohol
• 1.5 ounces of distilled spirits, which is about 40% alcohol

The recommendation found frequently online is to wait 2 hours per drink. There is also a frequent rule touted that if you are sober enough to drive you are sober enough to breastfeed. These are both a safe bet but may be a bit conservative.

While it makes sense to wait to breastfeed your baby until you do not feel the effects of the alcohol, it's really going to correspond to your weight and how quickly your body metabolizes the alcohol. Some adults may metabolize a drink in an hour and some may take two to three hours. How much you have eaten may also alter this stat. It's hard to pinpoint any exact rules about alcohol and breastfeeding since these factors can vary so much.

How does alcohol affect my baby?

In general a drink or two is almost always fine and not harmful to your baby. It gets more questionable for much larger amounts of alcohol and how frequently or often you are drinking. So while a drink or two here or there is fine, a drink or two every day for an extended period may not be. Unfortunately there is not clear information on this since it is hard subject to document and study.

Long term side effects of alcohol use in a breastfeeding mother are not known. Some possible side effects for the infant include lower weight gain and possible motor development delays. Shorter term side effects are less milk supply letdown and your baby consuming less milk while there is alcohol present.

Another thing to keep in mind is that a newborn will have a harder time metabolizing small amounts of alcohol. An infant older than three months will be able to process it more efficiently.

In general, if you use good judgement, having drinks occasionally is fine. If you feel you have a drinking problem or are a heavy alcohol user please talk to your Dr. about other options.

What are some of the official recommendations?

The AAP says that alcohol use while breastfeeding is usually compatible. If consumed in large amounts it lists possible side affects that could occur:

Drowsiness, deep sleep, weakness, and abnormal weight gain in the infant, and the possibility of decreased milk-ejection reflex in the mother.

Dr. Jack Newman in his handout "More Breastfeeding Myths" has said:

Reasonable alcohol intake should not be discouraged at all. As is the case with most drugs, very little alcohol comes out in the milk. The mother can take some alcohol and continue breastfeeding as she normally does. Prohibiting alcohol is another way we make life unnecessarily restrictive for nursing mothers.

The La Leche League's recommendation as taken from their book - The Womanly Art Of Breastfeeding:

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 been proven to be harmful.

Thomas W. Hale, R.Ph. Ph.D. “mothers who ingest alcohol in moderate amounts can generally return to breastfeeding as soon as they feel neurologically normal.” A mother's blood alcohol level must be 300mg/dl before significant side effects are noticed in the infant.

Do I need to pump and dump?

No, and the term pump and dump is pretty awful. Alcohol enters into your milk and leaves your milk in the same way it enters and leaves your bloodstream. Pumping will not do anything to speed this process and there is no need to get rid of the milk while you are drinking alcohol.

The only reason you may want to pump is if you are going to be away from your baby for a long time and for your own comfort. If you are going to miss a feeding you may want to pump during that time.

Pumping can be useful if you would like to have pumped milk available to your baby during the time you are away or having a couple of drinks. You can always prepare by pumping ahead of time but there is no pumping and dumping needed.

Does alcohol help milk production?

No it does not and in fact it can inhibit milk letdown. Alcohol has been shown to block the hormones responsible for the let down of milk and can affect the production of milk. If you are having supply issues you probably do not want to ingest alcohol.

The old rumor that alcohol can help milk production most likely came about due the the barley and hops in beer which are known galactagogues (something that can help you make more milk). You can get the same affect by drinking non alcoholic beer.

Do I need those strips that test alcohol in my milk?

Milkscreen makes a strip that lets you test the level of alcohol in your breast milk. I used to be a fan of these, now I am not so sure. I think it may be unnecessary to test breast milk for alcohol when we already have a pretty good idea that a couple of drinks is fine. I have written a review of these that you can check out here.

Conclusion

Light to moderate alcohol use by a breastfeeding mother is fine. More than that could be a problem but it is not really known how excessive alcohol use impacts breast milk. Obviously a bigger issue may be that if you are drinking more than a moderate amount then you are unable to properly care for your baby.

In general it is a good idea to wait until you feel normal to breastfeed your baby. If you limit your alcohol consumption to an occasional drink or few per week it is not harmful to your baby. If you are worried about it, then it may give you peace of mind to plan ahead or try the milk screen strips.

You can always pump some milk ahead of time to have on hand for your baby. If you would like to have a night out, plan ahead and have a bottle of breast milk available for your baby.

One other thing I would like to add, Dr. Jack Newman has also posted the following information on his facebook page. It is a test done by a mother to measure the amount of alcohol in her breast milk. I discovered the original blog discussing this and you can find it here.

I found this very interesting and it seems to prove that miniscule amounts of alcohol actually make it through to our breast milk.

Please use your own judgement and let me know if you have any questions. Thank you!