Research about drinking alcohol and breastfeeding
Breastfeeding mothers and lactating parents often receive conflicting advice about whether alcohol consumption can have an effect on their baby. While warnings are often given not to consume alcohol during pregnancy due to evidence that it could cause damage to an unborn child, the risks of consuming alcohol while breastfeeding has not received as much research attention. A number of studies have focused on the effects of alcohol on lactation and the infant, but long-term outcomes are still unknown.
Especially when it is consumed in large amounts, alcohol can cause drowsiness, deep sleep, weakness, and abnormal weight gain in the infant. There is also the possibility of decreased milk-ejection reflex in the mother. No harmful effects to babies have been found when breastfeeding mothers drink no more than one drink a day.
Depending on how much alcohol you consume before you nurse your baby, may experience a number of effects from the alcohol in your milk. Even a small to moderate amount of alcohol may impair milk production and the milk ejection reflex. Some of the negative effects on the baby may be:
- Increased REM sleep in the period from 3.5 hours to 24 hours after exposure to alcohol
- Decreased milk intake by baby
- Decreased weight gain
- Sleep disturbances,
- Increased crying
- Increased startling
- Increased arousal
Potentially, depending on how much you drink and when you nurse your baby after drinking, there may be other, more severe effects on your baby as well. As a result, the guidance on drinking and nursing is changing. According to the CDC, “moderate alcohol consumption is defined as having up to 1 drink per day for women and up to 2 drinks per day for men”.
In brief, LactMed®, a database that contains information on drugs and other chemicals to which those who are breastfeeding may be exposed, offers the following information:
“Breastmilk alcohol levels closely parallel blood alcohol levels. The highest alcohol levels in milk occur 30 to 60 minutes after an alcoholic beverage, but food delays the time of peak milk alcohol levels. Nursing after 1 or 2 drinks (including beer) can decrease the infant’s milk intake by 20 to 23% and cause infant agitation and poor sleep patterns. Nursing or pumping within 1 hour before ingesting alcohol may slightly reduce the subsequent amounts of alcohol in breastmilk.”
Infants exposed to a significant amount of alcohol (0.3 g/kg parent’s body weight) through drinking human milk, spend significantly less time in both active and total sleep. REM sleep is also disrupted. As infants are less able to process alcohol than adults due to their immature systems, some researchers believe that the dosage they receive through their mother’s/lactating parent’s milk may be stronger than it would be in an adult. In research conducted by Mennella and Garcia-Gomez, when an infant’s exposure occurred within 3.5 hours of a mother/lactating parent consuming a significant amount of alcohol, the effects were stronger.
In the following 24-hour period, sleep patterns continued to be disrupted as the infant makes up for the earlier disruption. In addition, the research showed that during times when the infants were awake, they were less active.
Can alcohol and breastfeeding stimulate milk production?
A long-standing “old wives’ tale” regarding consumption of alcohol, particularly beer, while breastfeeding, is that it can help boost milk production. While a barley component in beer–not the alcohol–does boost prolactin production, alcohol alone does so as well. However, in one study, milk production was actually decreased. In addition, in their research on alcohol consumption in lactating women, it was found that alcohol also inhibits the milk ejection reflex and thus reduces the baby’s milk intake.
The research shows that nursing infants actually consumed less milk in the three-to-four-hour period after mothers consumed a small to moderate amount of alcohol. When a mother/lactating parent drinks alcohol and then breastfeeds their baby, their perception is that the baby nurses normally and for a normal time, so they do not realize that their baby is not getting as much milk. According to Menella, who conducted this research on this over a period of years, “infants consumed approximately 20% less breast milk”.
This was the case even though the infants nursed a “similar number of times during the first 4 hr after exposure to alcohol in mothers’ milk” (pp. 591-592) compared with nursing infants not exposed to alcohol in their mother’s milk. Similarly, additional research conducted by Menella and Beauchamp showed that infants consumed about 23% less milk. Menella also found that when pumping milk two hours after drinking alcohol, mothers obtained significantly less milk.
Current evidence shows that, rather than producing more milk for your baby by drinking alcohol, the effects of alcohol on your body actually mean your baby will get less of your valuable milk. Why is this?
Mennella, Pepino, and Teff found that alcohol significantly reduces oxytocin levels while also increasing prolactin levels. Both hormones influence the milk ejection reflex. The lower the level of oxytocin, the longer the delay in the ejection of milk. The higher the level of prolactin, the longer the delay. The combination of alcohol’s effect on the two hormones leads to a significant delay in milk ejection.
Dangers of alcohol and breastfeeding
Depending on the amount of alcohol consumed by the mother/lactating parent, and depending on when the baby is breastfed after alcohol consumption, various researchers have found the most common negative outcomes for the baby to be:
- Sleep disturbances, including shorter sleep periods, more frequent wakefulness, and less total active and REM sleep in the three-hour-period after consuming alcohol
- Increased crying
- Increased startling
- Increased arousal
- Increased REM sleep in the period from 3.5 hours to 24 hours after exposure to alcohol
- Decreased milk intake by the baby
- Growth retardation
- Impaired immune function
- Delay of motor development
- Potential impairment of cognitive development
- Reduction in ability for abstract reasoning at school age (6-7 years)
The Academy of Breastfeeding Medicine state in Clinical Protocol #21 that consuming alcohol during lactation has several negative effects ranging from mild to severe. This is dependent on the amount of alcohol the mother/lactating parent has consumed and other factors related to how quickly their body processes alcohol.
As alcohol is completely water- and fat-soluble, it enters the bloodstream and human milk very easily. The amount of alcohol in human milk after consumption of one standard drink is about 95% that of the amount of alcohol in the mother/lactating parent’s bloodstream.
Another review, conducted by Nonacs, showed that motor development of infants who were exposed to alcohol in human milk regularly was decreased or delayed. The more alcohol the infants consumed through breast milk, the lower the infants scored on indices of motor development. Infants cannot metabolize alcohol as quickly as adults can; newborns can only metabolize alcohol at 25% to 50% of the rate at which adults can.
Concerns about negative effects on the infant’s developing brain are based on animal research. Oei notes that “robust animal data” indicate that “alcohol may be toxic to the developing brain, especially during periods of rapid brain development” such as occur in the first year after birth. Impairments to memory and inhibitory responses may also occur as a result of an infant’s consumption of alcohol.
Though research continues, Haastrup, Pottegård, and Damkier stated that “the possible long-term effects of alcohol in mother’s milk are unknown”.
Warnings about alcohol and breastfeeding
Several sources offer safety suggestions to consider when breastfeeding and drinking alcohol.
- Be aware that newborns cannot metabolize alcohol well; if possible avoid drinking alcohol until your baby is at least 8 weeks old or older
- Breastfeed your baby immediately before drinking any alcoholic beverage, if possible, or pump and save your milk.
- Limit your alcohol intake to one (preferably) or two glasses of wine (8 ounces total) or one or two beers (see “How Is One Drink Defined” for more information on amounts of alcohol)
- Wait at least 2 hours after drinking one standard drink before breastfeeding your baby.
- Be aware that the more you drink, the longer it takes for the alcohol to clear your system.
- If your baby needs to be nursed before two hours or more is up, use your previously expressed milk to feed your baby.
- Drink juice when drinking alcohol
- Eat food when drinking alcohol–it will slow the rate at which alcohol enters your bloodstream.
- “Pump and dump” only if needed for comfort. As long as there is alcohol in your bloodstream, there will be alcohol in your milk.
Reclaim Your Life From Alcohol and Breastfeeding with Alcoholism Treatment
Even a small to moderate amount of alcohol may impair milk production and the milk ejection reflex, besides, drinking alcohol and breastfeeding will produce negative outcomes for the baby. If you suffer from alcoholism, stopping drinking may be a challenge, even if that involves the wellbeing of your baby. We Level Up California can provide you, or someone you love, the tools to recover from alcoholism with professional and safe treatment. Feel free to call us to speak with one of our counselors. We can inform you about this condition by giving you relevant information. Our specialists know what you are going through. Please know that each call is private and confidential.