Alcohol and Breastfeeding

By Krista Gray, IBCLC. Last updated September 21, 2013.

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Is it safe to breastfeed while drinking alcohol?

Many moms want to know if it is safe to breastfeed while consuming alcohol. While the dangers of drinking while pregnant are well documented, risks of drinking while breastfeeding are less clear.  A “safe” level of alcohol in breast milk has not been established.  In general, the maternal blood plasma level of alcohol is the same as the alcohol content in breast milk.  As levels rise in maternal plasma, they rise in breast milk as well.  It is not possible to “pump and dump” or drink extra water to make the alcohol go away.  Rather, as blood alcohol levels decrease, so do the levels in breast milk.  Knowing how alcohol moves into and out of breast milk can help a mother time an occasional drink around when she breastfeeds so she can enjoy both alcohol and breastfeeding.

The American Academy of Pediatrics’ Policy Statement says, “Ingestion of alcoholic beverages should be minimized and limited to an occasional intake but no more than 0.5g alcohol per kg body weight, which for a 60 kg mother is approximately 2 oz liquor, 8 oz wine, or 2 beers. Nursing should take place 2 hours or longer after the alcohol intake to minimize its concentration in the ingested milk.” 1

What influences the level of alcohol in breast milk?

Breast milk levels of alcohol are similar to maternal blood plasma levels.  As plasma levels increase, so do breast milk levels.  As plasma levels decrease, so do breast milk levels.  However, just as there are a number of factors that determine how much alcohol a person can tolerate, these same factors can affect breast milk levels:  how fast and how much is consumed; mother’s weight and adipose body tissue; as well as stomach contents.   Of the concentration of alcohol in breast milk, a nursing baby is only exposed to a fraction of the amount.  However, a baby’s body metabolizes alcohol at a much slower pace than an adult, so the potential for build-up of alcohol toxicity is always a possibility.

Click here, to explore more about the compatibility of breast milk and drugs as well as how drugs affect breast milk.

When does breast milk contain the highest levels of alcohol?

When a mother consumes a drink on an empty stomach, peak levels usually occur 30-60 minutes later.  When consumed with food, peak levels occur slightly later: 60-90 minutes. 2  Alcohol passes freely into and out of breast milk based on alcohol levels in maternal plasma.  In adults, it takes roughly 1 ½ – 2 hours to metabolize one alcoholic beverage. 3  As with most medications’ impact on children, alcohol takes longer to metabolize in a baby than an adult.  Newborns in the first four weeks can process alcohol at half the rate of an adult; preterm babies are at even higher risk for alcohol toxicity. 4

What is the safest way to breastfeed when drinking alcohol?

For a mother who wants to enjoy an occasional drink or two, this can usually be done safely while breastfeeding.  Especially after the very early days when most newborns seem to nurse all the time, there are some great strategies that can eliminate your baby’s exposure to alcohol.  If, for example, you want to consume one drink, it is best to nurse your baby immediately beforehand.  Then, if your baby were to go several hours before his next feed, the alcohol should be gone from your blood stream and therefore eliminated from breast milk as well.  But what should you do if your baby wants to nurse unexpectedly and you have just had a drink?  If your baby is under six months, it may be wise to have some expressed breast milk ready in case of this scenario.  If your baby is over six months and has already started solids, she could have a snack until you are prepared to breastfeed.  If your baby is a newborn or still nurses very frequently where there is not window of a few hours in the evening for you to enjoy a drink, it is best to prepare beforehand by expressing enough breast milk for her to have during the time your milk will have alcohol in it.

What impact does alcohol have on a baby?

Excessive alcohol consumption can have many negative impacts on a baby’s health including neurodevelopmental delays, growth retardation, and changes in sleep patterns.  Maternal blood plasma levels typically need to reach 300 mg/dL for significant side effects to be noted in baby. 5  However, drinking alcohol can also impair a mother’s ability to take care of her baby, regardless of breastfeeding or not.  Consuming alcohol is contraindicated to bed sharing as well.

How does alcohol impact milk supply?

Despite rumors that alcohol is a galactagogue and increases a mother’s milk supply, research shows the opposite to be true. Julie Mennella’s research (2001) has shown that oxytocin levels are lower after ingesting alcohol with a slowed milk ejection and frequent drinking can cause lowered milk production. 6 7  Overall, the presence of alcohol in breast milk decreases the amount of milk a baby consumes.

Show 7 footnotes

  1. American Academy of Pediatrics (2012) Breastfeeding and the Use of Human Milk. Pediatrics 27 Feb 2012. http://pediatrics.aappublications.org/content/early/2012/02/22/peds.2011-3552
  2. Mannel, R. et al. (2013) Core Curriculum for Lactation Consultant Practice, 3rd ed. Burlington, MA: Jones & Bartlett Learning, p.332.
  3. Mannel, R. et al. (2013) Core Curriculum for Lactation Consultant Practice, 3rd ed. Burlington, MA: Jones & Bartlett Learning, p.332.
  4. Mannel, R. et al. (2013) Core Curriculum for Lactation Consultant Practice, 3rd ed. Burlington, MA: Jones & Bartlett Learning, p.332.
  5. Mannel, R. et al. (2013) Core Curriculum for Lactation Consultant Practice, 3rd ed. Burlington, MA: Jones & Bartlett Learning, p.465.
  6. Mennella, J.A. (2001) Alcohol’s effect on lactation. Alcohol Research and Health, 25, 230-234.
  7. Mennella, J.A. (2001) Regulation of milk intake after exposure to alcohol in mother’s milk. Alcoholism: Clinical and Experimental Research, 25, 590-593.
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