Risks Associated with Alcohol and Breastfeeding
While the harmful fetal effects of alcohol use during pregnancy are well-known, the potential immediate and long-term effects of using alcohol and breastfeeding or concentration of alcohol in breast milk aren’t entirely understood. The World Health Organization recommends avoiding alcohol completely while breastfeeding, but even so, 12%-83% of breastfeeding women report consuming alcohol, according to an article published in the journal Pediatrics.1
Further, misconceptions and conflicting information have made it challenging to really know for sure what is a safe level (if any) of drinking while breastfeeding. Fortunately, more research has been conducted in recent years to better understand how alcohol consumption plays a role in a child’s development when breastfeeding.
Though there isn’t a clear consensus amongst medical professionals, the safest option is always to refrain from drinking until you’ve transitioned away from breastfeeding.2
Is There a Moderate Amount That is Safe to Drink Prior to Breastfeeding?
Many mothers who abstain from alcohol use during pregnancy choose to resume drinking after the baby is born. According to the Academy of Breastfeeding Medicine (ABM), at least half of Western mothers who breastfeed consume alcohol occasionally after giving birth.3
According to the Centers for Disease Control and Prevention, moderate alcohol consumption (i.e., no more than 1 standard drink a day) is not known to be harmful to the baby if the mother waits at least 2 hours after drinking before she breastfeeds.2 ABM clinical guidelines suggest breastfeeding mothers can have up to 2 beers or 8 ounces of wine daily but should again wait 2 hours after consuming to breastfeed.3
The definition of a standard drink, according to the Dietary Guidelines for Americans, is 12 ounces of a 5% beer, 5 ounces of 12% wine, 8 ounces of 7% malt liquor, or 1.5 ounces of 80 proof liquor.2,4
What Effect Does Drinking While Breastfeeding Have on an Infant?
The amount of alcohol in breast milk is typically about the same as the amount in the mother’s bloodstream.1, 5 Studies evaluating the effects of infant alcohol exposure through breast milk have shown mixed results. Some have found insignificant behavioral changes, while others observed mild effects on infant sleep patterns, milk volumes consumed during breastfeeding, and early psychomotor development.3, 5
Few studies have been done on long-term effects. A 2018 study examining the effect of maternal alcohol use during lactation on children’s cognition scores later in life suggests that alcohol exposure through breast milk may be associated with dose-dependent reductions in cognitive abilities in 6- to 7-year-old children who were breastfed as babies.1
Does Pumping Remove Alcohol From Breast Milk?
Contrary to popular belief, pumping does not speed the removal of alcohol from breast milk. Expressing milk and discarding it (i.e., “pumping and dumping”) does not change the rate with which alcohol levels normalize in the mother’s milk. Only time can lower the mother’s blood alcohol level which in turns lowers the amount found in breast milk.2 However, some mothers may choose to pump to relieve any discomfort from engorgement or to adhere to a pumping schedule and may decide to toss the expressed bag of milk rather than giving it to the baby.
How Long Should You Wait Before Breastfeeding After Drinking?
The Centers for Disease Control and Prevention and the ABM recommends that mothers wait at least 2 hours after drinking before nursing an infant. Alcohol levels are usually higher in human breast milk the first 30-60 minutes after the mother has consumed alcohol.2
Generally, alcohol can be detected for about 2-3 hours after a mother has drank, but this duration may be longer depending on the amount of alcohol consumption. For example, 2 drinks can be detected 4-5 hours afterwards, and 3 drinks can be detected for up to 6-8 hours.2 This amount of time will vary from mother to mother depending on a number of factors including weight, whether food was also consumed at the same time, and how fast her body typically breaks down alcohol.2
. Gibson, L. & Porter, M. (2018). Drinking or Smoking While Breastfeeding and Later Cognition in Children. Pediatrics, 142(2).
. Centers for Disease Control and Prevention. (2018). Alcohol.
. Reece-Stremtan, S., Marinelli, K., & The Academy of Breastfeeding Medicine. (2015). ABM Clinical Protocol #21: Guidelines for Breastfeeding and Substance Use or Substance Use Disorder, Revised 2015. Breastfeeding Medicine, 10(3).
. National Institute on Alcohol Abuse and Alcoholism. (n.d.). What is a Standard Drink?
. Haastrup, M., Pottegard, A., & Damkier, P. (2013). Alcohol and Breastfeeding. Basic and Clinical Pharmacology and Toxicology, 114(2), 168-173.