Effects of Alcohol, Smoking, and Everyday Drugs While Breastfeeding

After successfully making it through a tightly controlled pregnancy it can be a relief to get back to life as normal with your diet. But if you choose to breastfeed your baby then it may not yet be time to completely throw off the shackles and return to your former lifestyle. 

Breast milk is a byproduct of what goes into our bodies, so we have to continue to be conscious of what we consume.

There a range of substances that may have been a part of that regular former lifestyle that may be ready to make a comeback if it is managed the right way. 

In this article we break down a number of the most common substances that are often part of everyday life, and can have an impact on the quality and volume of your breast milk. 

As always, it is best to consult with a medical professional on your specific circumstances to ensure the health of yourself and your baby.

alcohol smoking caffeine and drugs while breastfeeding infographic

Alcohol

While most professionals say that moderate alcohol consumption is safe when breastfeeding, your best option is just to avoid it altogether in order to avoid any potential issues. 

This is mainly because alcoholic drinks vary so much and it is easy to overdo it with the heavier stuff, which will eventually make its way into your breast milk.

How much can I safely drink while breastfeeding?

Women often receive conflicting information regarding the effects of alcohol on mother and baby while breastfeeding. There is definitive evidence that it has a negative effect on baby development during pregnancy, but breastfeeding is more of a gray area.

It really all comes down to how much a breastfeeding mother consumes on a regular basis.

The Dietary Guide for Americans defines an alcoholic drink as a total of 0.6 ounces of pure alcohol. 

This could mean 12 ounces of 5% beer, 1.5 ounces of 40% liquor or distilled spirits, and everything in between.

It is advised that if you do want to continue drinking alcohol while breastfeeding, you should stick to only one standard drink per day according to the guidelines previously mentioned.

However, if there is any question in your mind regarding your alcohol consumption and breastfeeding baby, it is best just to avoid alcohol altogether.

What types of alcohol can I drink?

The type of alcohol is not as significant as the volume. It is important that you are aware of the alcohol content and what constitutes a standard drink.

This could be as low as 30-40ml for a spirit, to 500+ml for light beer. 

Be sure to check the label before you consume and have a way to measure your portions… But a close guess would be good enough.

Aside from this, you will need to consider how you are typically affected by each type of alcohol. Anything that will easily get you drunk or even slightly tipsy should be avoided.

alcohol while breastfeeding

Effects of too much alcohol on my breast milk

Because alcohol finds its way into your bloodstream, it also finds its way to your breast milk. 

This means that a certain percentage may end up being consumed by your baby.

The side effects it can have on your baby aren’t usually very severe as long as you aren’t drinking heavily. 

It mostly affects their sleeping patterns, making them drowsy. 

Excessive alcohol consumption can also lead to slow weight gain in babies as they do not feed as efficiently. 

It has also been seen to cause more serious neurological issues, such as tonic-clonic seizures, and pseudo-Cushing syndrome.

The biggest thing to remember is that you should never attempt to breastfeed if you are intoxicated. 

You may physically harm your baby in addition to potentially exposing them to excessive alcohol levels in your breast milk.

Will the pump and dump remove alcohol from my milk?

Oftentimes, mothers will ask if “pumping and dumping” their milk after consuming alcohol will make their breast milk safe again for their baby.

This “pump and dump” method is just a myth. Pumping does not remove alcohol from your breast milk. In fact, as long as you have alcohol in your bloodstream, you also have it in your breast milk.

Alcohol levels in breast milk are highest about 30-60 minutes after consumption, and the amount of time it remains present is dependent on how much you have had to drink. 

The alcohol content from one drink alone can last up to 2-3 hours, longer if you have consumed more.

The only thing you can do is simply wait it out, allowing the alcohol to leave your bloodstream at its normal rate prior to expressing or pumping your milk.

Will alcohol affect my milk supply?

Believe it or not, many believe that drinking alcohol (beer in particular) while breastfeeding helps to increase breast milk supply. However, this is just another myth. 

Studies have found that babies consume about 20% less than the average amount of milk in the 3 to 4 hour-period after their mothers’ consumption of an alcoholic beverage.

After conducting excessive research on rats, it is believed that the cause of alcohol-induced drops in breast milk supply are due to changes in hormone levels that are responsible for the milk letdown process.

Baseline prolactin levels don’t necessarily change, but the release of prolactin and oxytocin levels that result from a baby’s suckling is significantly lower. 

This results in shorter feedings and less milk consumed by your baby.

Of course, if your baby is not taking in enough milk at each feeding, their growth will start to be affected. You may find that they stop gaining weight as well as other negative side effects if this pattern continues long-term.

For more information check out the video below:

Cigarettes

Women who smoke are advised to quit the moment they know they are pregnant as it can interfere with the baby’s development in utero. 

However, once the baby it outside the womb many of these women pick the cigarettes back up again without knowing the effect it can have on her child and her breast milk.

Is it safe to smoke cigarettes while breastfeeding?

The quick answer to this question is both yes and no. It depends on whether you take the proper precautions to protect your baby and keep them healthy.

The nicotine itself is not usually an issue – unless you are smoking upwards of 20-plus cigarettes per day. The problem primarily lies with secondhand smoke, which we will talk about shortly.

E-cigarettes may also pose a problem, though there is little solid evidence at this time to either back or deny this claim. 

Regardless, e-cigarette aerosol contains potentially harmful chemicals that may find their way into your milk and affect your baby’s respiratory system.

How can I minimize risk?

Obviously, the best thing you can do to minimize risk is quit smoking altogether. Even with proper precautions, there is still the potential for long-term harm to your baby.

If you simply cannot quit, there are a few things you can do to protect your little one.

First – and most important – is to continue breastfeeding. 

This may be easier said than done as smokers tend to wean earlier due to their affected milk supply (we will touch on this more shortly).

Though the amount of nicotine found in breast milk is double what is transferred to maternal serum (placenta) during pregnancy, breast milk can offer protection against the negative effects smoking may have on your baby. 

To put it simply, the benefits of breastfeeding outweigh these negative effects.

It is also best to take your smoke breaks as far away from your baby as possibly, ideally outside, in an open-air environment. This will drastically reduce your baby’s exposure to secondhand smoke. 

This includes your partner or any other person who may be around your baby on a regular basis.

Finally, in order to avoid any potential issues within your breast milk itself, wait to smoke after a breastfeeding session rather than before.

smoking while breastfeeding

Effects of smoking on my breast milk

The American Academy of Pediatrics (AAP) may have removed nicotine from its “contraindicated” substance list in recent years, but that doesn’t mean that cigarette use is safe to continue around your baby.

It’s the secondhand smoke that poses the biggest risk to your baby’s health.

Infants of smokers are put at a high risk for colic, respiratory infections, and even SIDS (Sudden Infant Death Syndrome). 

They are also more likely to have high blood pressure, asthma, and ear infections in the future.

Exposure to secondhand smoke also puts babies at a higher risk for behavioral and learning problems like ADHD and slower learning in school. 

Will smoking affect my supply?

It is a bit difficult to say whether or not smoking decreases milk supply. However, it is a known fact that a high percentage of breastfeeding babies whose mothers are smoking tend to wean earlier than average.

This could be due to a number of facts other than just a decrease in milk supply.

Studies show that smoking may reduce levels of basal prolactin, one of the hormones responsible for milk letdown. 

It can also change milk composition as well as flavor, which may result in babies wanting to wean on their own.

As previously mentioned, it is important that you continue to breastfeed even if you are smoking. Components found in breast milk will help protect your baby from most negative effects of smoking. 

Your milk is also produced on a supply and demand basis, so continuing to breastfeed as much as possible will maintain your supply if not increase it.

For more information check out the video below:

Marijuana

With recreational and medical marijuana use becoming more and more prevalent in our society, it has become a very popular substance amongst pregnant and breastfeeding women. 

Most mothers who are smoking marijuana during pregnancy claim that it is to help ease symptoms of nausea and vomiting. 

However, marijuana use during pregnancy can have adverse effects on placental function, resulting in developmental issues in unborn children.

These women – those who use marijuana during pregnancy – are highly like to continue postpartum, so it is important to touch on the effects marijuana use can have on a breastfed baby.

Is it safe to smoke marijuana while breastfeeding?

There is data to supporting both claims – that marijuana use while breastfeeding is and is not safe.

The main psychoactive component in marijuana – tetrahydrocannabinol (THC) – can be found in the breast milk of a mother who uses the drug.

Albeit, it is found in only small quantities, but that can easily increase based on the amount a breastfeeding mother uses per day.

These traces of THC have also been found to remain in breast milk anywhere from 6 days to 6 weeks later.

There is insufficient long-term data to determine whether the use of cannabis negatively affects breastfed babies, so professional opinions vary. 

Overall, it is recommended that breastfeeding mothers avoid marijuana use just to be safe.

How can I minimize risk?

If you do choose to use marijuana while breastfeeding, you should follow similar guidelines as those outlined in the cigarette use section.

Wait until after you have breastfed your baby to use or smoke marijuana – though this may or may not help as THC can remain in the breast milk for several days.

You should also smoke as far from your baby as possible so they are not exposed to secondhand smoke, which is just as much of a concern with marijuana as with cigarettes.

marijuana while breastfeeding

Effects of smoking marijuana on my breast milk

Because traces of THC can be found in the breast milk of a woman who uses marijuana, you need to consider that these babies may be susceptible to symptoms associated with THC in present in their bloodstream.

Potential risks for your baby include developmental problems like movement, coordination, and strength. It may also affect intellectual development. 

Because babies of mothers who use marijuana also tend to wean earlier or feed insufficiently, it can also negatively affect their weight gain.

Anything that impairs your personal mental and physical states can also put your baby at risk. 

You may injure your baby or may be unable to care for them properly under the influence of marijuana.

Will smoking marijuana affect my supply?

Similar to the effects smoking cigarettes can have on breast milk, babies of mothers who use marijuana tend to wean earlier. 

This could simply be due to changes in taste or it could be the result of lower milk supply – though there is little evidence to support the latter.

For those mothers who use marijuana and smoke cigarettes need to account for both substances influencing their breast milk production. 

The tobacco may lower prolactin levels, physically decreasing milk supply, and marijuana could possibly affect your baby’s ability to feed appropriately.

Caffeine

Caffeine is often the drug of choice for most breastfeeding mothers. After all, with a demanding schedule and a loss of sleep, a cup of coffee may just be the pick-me-up you need to get through your day.

But what about the effects caffeine can have on your breastfed baby?

How much caffeine can I safely consume while breastfeeding?

About 1% of the amount of caffeine you consume finds its way into your breastmilk

It may not seem like much, but babies process caffeine differently than adults. It is a much slower process, which means the effects are greater and last much longer.

That being said, it is best to limit your caffeine intake for both your baby’s health as well as your own.

Even if you are not breastfeeding, it is recommended to limit your caffeine intake to 300 mg per day, which is also a relatively safe amount when breastfeeding.

caffeine while breastfeeding

How can I minimize risk?

Quitting caffeine is easier said than done when you’re a new mom, so it is best to limit yourself and time your caffeine intake around your baby’s feedings.

Don’t overdo it with the coffee. Stick to the recommended limit of 300 mg per day, which could be 2-3 cups of brewed coffee per day depending on the type of coffee you use. 

Unless you drink one cup after another 24/7, this limit is very easy to stick to.

Timing your caffeine intake with your baby’s feedings can also help. Breastfeed your baby before drinking your morning cup of coffee to minimize the caffeine’s effect.

Effects of excess caffeine on my breast milk

Caffeine appears very quickly in breast milk – usually within 15 minutes after consumption – and reaches its maximum concentration at about an hour. 

While it may take some mothers several cups of coffee to keep them going through the day, babies metabolize caffeine much slower, which means it stays in their system for much longer.

Exposure to excessive amounts of caffeine can cause several issues for babies. Some of these symptoms can look very similar to the effects caffeine has on adults – feeling unsettled, sleeping difficulties, agitation, and being jittery. 

It can also cause colic and constipation as well as iron deficiency.

Of course, the range of effects caffeine can have on your baby varies greatly; it’s going to depend on a few factors:

  • Strength and amount of caffeine consumed by the mother
  • Age of the baby
  • Whether the mother also smokes (which can increase the effect of caffeine in a breastfed baby).

Sticking to the recommended amount of caffeine intake per day does not cause any harm to your baby.

Will too much caffeine affect my supply?

It is believed that caffeine intake will decrease breast milk supply, but this is just a myth.

While breast milk supply does not necessarily change as a result of caffeine itself, certain factors that result from excessive caffeine intake can cause your milk supply to drop. 

Most of these are due to caffeine’s effect on your baby and their ability to feed appropriately.

If you are taking in too much caffeine, your baby may be too fussy to eat, causing you pain with potentially blocked milk ducts and causing your milk supply to drop as you are not being drained efficiently.

For more information check out the video below:

Pain Medications

Early motherhood can come with many aches and pains, from breastfeeding soreness to recovery from childbirth itself. 

This can leave many mothers asking which pain medications – OTC or prescription – are safe to take while breastfeeding.

What types of pain medications are safe while breastfeeding?

Generally, if the medication is something that is available OTC or can be prescribed to a baby, it is safe for the mother to use while breastfeeding.

Most OTC pain medications, particularly ibuprofen (Advil and Motrin) and acetaminophen (Tylenol) are safe for use while breastfeeding. 

Very low levels make it into the breast milk, and it has a short half-life so those levels don’t even last long.

On the other hand, aspirin should be avoided due to its blood-thinning properties, which can also affect your baby through breastfeeding.

Of course, anything that contains codeine and/or tramadol – drowsiness as well as mental or physical impairment – should be avoided while breastfeeding. 

This includes prescription pain medication like oxycodone and Percocet.

Can I safely consume while breastfeeding?

Even with the medications that you can take, you should only take the minimum amount, just what is needed to relieve your symptoms. 

There is no need to introduce unnecessary foreign substances into your child’s body that could potentially harm them.

How can I minimize risk?

Don’t make medication your go-to when you have some minor aches and pains. Instead, try other natural remedies. 

The fewer foreign substances you introduce into your system, the less risk they will affect your baby.

Of course, if you are experiencing pain that interferes with your ability to properly care for your baby, you should do what you need in order to ensure that you and your baby are safe.

Just be sure that you always avoid aspirin and only take the minimum amount required to eliminate your pain. You should also only take the medication that is for your specific symptoms.

To be safe, never take any medications while breastfeeding without first speaking with your doctor.

pain medication while breastfeeding

Effects of excess pain medications on my breast milk

As previously mentioned, aspirin should be avoided as consumption through your breast milk may cause Reye’s syndrome in your baby. 

This is a rare condition, but it could end up being fatal as it can cause severe liver and brain damage.

With regards to ibuprofen and acetaminophen use, there really aren’t any negative side effects for your baby as very little trace of these medications find their way into your breast milk and they do not last very long.

Will pain medications affect my supply?

As long as you stick to the medications that are safe for breastfeeding as well as the recommended dosage, your milk supply should not be affected.

In fact, not taking them may do more harm than good when it comes to milk supply. Relaxation is essential when it comes to helping your body create breast milk. 

Chronic or severe pain can interfere with proper milk production.

You should always seek a more natural approach to pain relief first, but if these methods are ineffective, you can rest assured knowing that ibuprofen and acetaminophen should not affect your milk supply. 

Cold Medicine

When it comes to cold medicines, it can be a bit tricky. It all depends on the ingredients used and the type of cold remedy you are planning to use.

How much can I safely consume while breastfeeding?

In general, cold medications – particularly oral decongestants – should not be taken while breastfeeding

Doing so can affect both your milk supply and your baby’s health.

Cough suppressants like dextromethorpan are safe in general as it is unlikely that they will transfer into breast milk in a large enough quantity to cause harm to your baby, but you should still avoid them if possible.

How can I minimize risk?

Most colds will clear up on their own with a bit of time, rest, and plenty of fluids. It is best just to avoid any sort of medications and allow the cold to run its course.

If you do need to take something to relieve your cold or allergy symptoms, you want to opt for things that do not produce absorption of ingredients. 

These can be things like throat lozenges or nasal sprays. Steam inhalation can also be a great way to relieve congestion.

Effects of cold medicine on my breast milk

Cold medicines come in many different forms and often contain very complicated recipes, often with a long list of ingredients. These can include:

  • Antihistamines
  • Pain relievers
  • Alcohols
  • Caffeine.

All of these things have the potential to negatively affect your baby.

Depending on the type of antihistamine present in the medication, some levels can find their way into your breast milk and cause irritability, drowsiness, and colic symptoms in babies. 

It could also cause issues with their nervous system in rare cases.

Of course, antihistamines are also found in most allergy medications, both prescription and OTC. 

However, the antihistamines present in these medications have not been shown to have adverse reactions on breastfed babies as long as they are taken appropriately.

As we covered in previous sections, alcohol and caffeine can also negatively affect your baby if high levels are present in your breast milk. Your baby may become irritable or very drowsy, affecting their ability to nurse properly.

The younger your child is, the more these things will affect them. 

You should take special precautions with all medications, particularly those with decongestants and antihistamines if your baby is premature or has a history of apnea.

Some cold medications can also cause drowsiness in adults, which can put a baby at risk if the mother is under the influence and unable to care for them properly.

cold medicine while breastfeeding

Will cold medicine affect my supply?

Decongestants can also contain sympathomimeticamines – substances like pseudoepinephrine, phenylephrine, and phenylpropanolamine – which can potentially lower prolactin levels and reduce milk production.

Interference with your baby’s ability to nurse usually has the biggest effect on your milk supply. 

That means if your baby is colicky or drowsy as the result of substances found in your breast milk, that will likely have more of an impact on your supply than the medication itself.

If your baby is unable to nurse efficiently, your body will not produce enough milk, resulting in a drop in milk supply, poor weight gain in your baby, and the potential for early weaning.

Other Prescription Medications

Preexisting medical conditions may require that certain mothers take other prescription medications. Most are safe while breastfeeding; some are not.

Because there can be such a wide variety of medications you may be taking, you will need to talk to your doctor about your specific case. 

They will determine if the drug is necessary, the drug’s effects on milk production, the amount excreted into your milk, the age of your baby, and the potential side effects your baby may be susceptible to.

If the medication is absolutely necessary for your health, your doctor will then determine whether or not it is a medication that will pass into the breast milk. 

If it is and it is something that could potentially be harmful to the baby, breastfeeding may not be possible and you will need to supplement with baby formula

Final Words

No matter what factors may be at play when it comes to how your lifestyle affects your ability (or lack thereof) to breastfeed your baby, you can always reach out to others for help in overcoming these obstacles.

Whether you are dealing with alcohol or drug addiction, the attempt to quit smoking, or simply the interference of an everyday medication, you can always rest assured that you and your child can receive help. 

You should never feel ashamed if you are unable to breastfeed your baby.

Simply keep yourself informed on what is safe and healthy for a breastfeeding baby and reach out if you are in need of any support. 

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