Happy holidays!

The holiday season has officially arrived. Whether you are trimming the tree, spinning the dreidel or celebrating in some other way, you may be wondering, is it okay to raise a glass filled with an adult beverage, while munching some of those butter and sugar-laden cookies that your neighbor dropped off. If you raised one glass too many, the next morning you may be reaching for some Ibuprofen, and washing it down with some Pepto-Bismol because you had a few too many of those cookies.

What exactly is the deal with breastfeeding and drinking alcohol, having a less than perfectly healthy diet, and taking medications, possibly even using some marjuana merijuana maryjwana weed (if you live in one of those states where it is legal, as I do)?

Breastfeeding and Alcohol

Let’s be honest; this section is the main reason you are reading this article. It’s the holidays. Holidays mean parties and celebrations. Parties and celebrations involve alcohol, be it a glass of champagne at New Year’s Eve or an open bar.

You want to be a good breastfeeding mom, but you want to know if you can have some of that champagne, or maybe have a beer when you watch the Superbowl. Maybe you even want to see if you can have a glass of wine every night with dinner.

American Academy of Pediatrics (AAP)

If you’ve done some research on breastfeeding and drinking alcohol, you have seen some conflicting statements.

The AAP states in their “Policy Statement on Breastfeeding and the Use of Human Milk” that “…ingestion of alcoholic beverages should be minimized and limited to an occasional intake but no more than 0.5 g 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.” The AAP is an excellent resource for information on breastfeeding.

Go here if you want to read the complete article: http://pediatrics.aappublications.org/content/pediatrics/129/3/e827.full.pdf . It’s a long document, so if you want to skip ahead to the part about alcohol, it’s on page e833, last paragraph of the first column. It includes the references they used as well. 

Dr. Thomas Hale

The guru of all things chemical while breastfeeding though is Dr. Thomas Hale, Ph.D., R.Ph., at Texas Tech University. Check here for what he has to say: https://www.infantrisk.com/content/alcohol-and-breastfeeding .

Breastfeeding and Alcohol, the Bottom Line

Photo by Brave Heart on Visual Hunt / CC BY-NC-ND

What is the takeaway message?

Having an occasional drink is okay. You might wonder why it’s ok. When you breastfeed and drink alcohol, the alcohol does get into your breastmilk, within about half an hour of ingestion. However, it leaves over the next 1-2 hours. Pumping and dumping does not speed up this process. There is no need to use alcohol test strips. All you need is a watch. Your phone works too since those have clocks and timers and alarms. Oh my!

Buzz, Buzz, Buzz

There will be times for some moms when they drink more than one and may start to get a serious buzz going. If you’re feeling majorly buzzed, it’s best not to drink until that feeling has passed. If your breasts get uncomfortably full while you feel buzzed, I’m going to be conservative and say it probably is best to pump and dump. You can also just pump a little until you are more comfortable and hopefully you’ll be good to breastfeed when your baby is ready to.

You also need to ask yourself the question, who is going to take responsibility for your baby while you are feeling that way. People always ask the question, is it okay to drink. They almost never ask, can I honestly and adequately take care of my baby if I have had too much to drink.

I mention this because I had a couple once who told me that she was going to wean at a certain point because they went on a vacation every year with their extended family and they got “horribly drunk the whole time.” They thought it would be irresponsible for her to breastfeed while in that condition. We all laughed about it until I asked who took care of the kids while they were like that. They looked at each other, then at me. They hadn’t thought about that.

Drinking is okay as long as you follow these simple guidelines:

  • Occasional
  • Moderation
    • 1- 2 drinks
    • 2 drinks should be spaced out between a couple of feedings
  • Breastfeed, drink, wait a couple of hours, breastfeed
  • If the occasion occurs when you don’t want to follow these rules, or think that you might not, line up a babysitter.
  • Alcohol test strips
    • I couldn’t find any scientific studies supporting their use
    • While they say they are “Science Backed” on the website, I couldn’t find any reference to any specific studies,
    • While they say they are Patent Pending, that only means someone else can’t make the same product

Is there anything else to worry about, besides safety?

Why, I’m glad you asked! In fact, yes there is.

  • Alcohol inhibits the release of oxytocin, so your baby may have to wait longer for the milk to let down
  • Studies show babies consume an average of 20% less of your milk when you combine breastfeeding and alcohol.
  • Alcohol may decrease milk supply, so, apparently the whole thing about drinking beer to help increase your milk supply? Not true.
  • Your baby may sleep for a shorter period of time after breastfeeding and drinking alcohol. Bummer! Another reason to not drink too much. Who wants to deal with a hungry, crying baby when they have a hangover?

Diet While Breastfeeding

General guidelines

  • You are supposed to eat 500 calories above your pre-pregnant diet when you are breastfeeding.
  • It should be a well-balanced diet
    • lots of fresh fruits and vegetables
    • a good source of protein
    • healthy fats
    • whole grains.
  • There aren’t a lot of rules, so it’s no different than a regular diet, just a few extra calories.
  • It can be challenging to know what is even “good enough” with your diet, because they keep moving the finish line, aka changing the guidelines.
  • In a perfect world, you would eat the perfect breastfeeding diet. It’s not a perfect world, and you probably won’t eat a perfect diet. If you do, let me know, and I’ll give you a free box of candy as a reward, or a fresh bunch of kale. Your choice.
    • Lots of fruits and vegetables is good
    • Lots of sugar is bad
    • Protein is good
    • Junk food is bad
  • You don’t have to drink milk to make milk.
  • Vegetarians and vegans can make lots of milk without stressing at all over the details (says my vegan best friend).
  • Some foods can help support a good milk supply. That is a blog post in itself. Stay tuned!
  • Foods to avoid are peppermint and sage, which both tend to be very prevalent around the holidays, so if you have a low or borderline milk supply, be on the lookout for these tasty ingredients. They both decrease milk supply.

Drugs

There are two types of drugs.

Photo by jsrcyclist on VisualHunt / CC BY-NC-ND

  • Legal – OTC (Over The Counter) and Rx (Prescription)
    • Any Rx drug you take is only legal if the Rx was written for you
    • Rx drugs can be abused, in which case, you should probably refer to the illegal section of this article
    • Most, but not all, medications are compatible with breastfeeding. 
    • Docs often don’t know which is ok and which is risky, and they may just err on the side of telling you not to breastfeed if they don’t know.
    • Pharmacists at your local grocery store or on the corner, often are not up to speed on the safety of medications and breastfeeding either.
    • Most lactation consultants have a copy of the latest edition of “Medications and Mother’s Milk,” the bible for meds and safety to take while breastfeeding. Call yours and ask.
    • Check the Infant Risk Center (run by the Dr. mentioned above Thomas Hale. The number is (806) 352-2519.
  • Illegal – Just a really bad idea. Cocaine, Meth, Ecstacy…
    • If it’s illegal, it’s just a terrible idea to breastfeed and use illicit drugs.
    • Clearance from your body can be affected by many variables
    • No one can accurately tell you when it’s “ok” to breastfeed again, without doing lab tests
  • Marijuana
    • Can be either legal or not, depending on where you live.
    • That’s kind of beside the point when talking about it concerning breastfeedingPhoto by andronicusmax on Visualhunt / CC BY
    • If you smoke it, eat it or take anything with THC (the stuff that gives you a weed buzz)…
      • It will get in your milk
      • It can stay in your system for a long time
    • How long it remains in your system will be affected by whether you are a
      • new user
      • longtime user
      • occasional user
      • frequent user
    • Consequently, your baby will have THC in his system if you have it in your system
    • There have been few studies because it’s still illegal most places in the US
    • It’s illegal federally, which makes it almost impossible to get federal funding for research
    • If it’s illegal where they live, most women will be unlikely to admit to using it so someone can collect data for a research study
    • Randomized, controlled study? Not gonna happen
    • Not much is known about CBD. 
    • What does Dr. Thomas Hale say?

One Last Thought

Every breastfeeding mom wants to do the best for her baby. Nobody is perfect.

  • Eat a good, balanced diet, and it’s okay to indulge once in a while
  • Alcohol occasionally, and in moderation, especially with the right timing is OK
  • Don’t ever use illegal drugs, abuse legal drugs, or use Cannabis

Next Time

Family Support and Sabotage