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Alcohol and Breastfeeding

Dec19

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Dear Amy,

I am currently breastfeeding my 3-month-old, with the occasional bottle of formula here and there if I need to be away from him for more than a few hours.  (Though I am going back to work soon, so he will be getting pumped milk for his daytime feedings in the near future.)

Anyway! My question is this: how do you handle alcohol and breastfeeding?  As someone who (in my former life) really enjoyed winding down with a cocktail or two in the evening, who has spent pretty much the entirety of the past year stone-cold sober, Momma is ready for a margarita or two.  (Just in time for the holidays, ha!)

My first post baby drink ended up being the opposite of relaxing, as I fed my baby a bottle while feeling extremely guilty because my boobs were RIGHT THERE (though he did not seem to mind) and then fretted all night about whether enough time had passed for it to be out of my system. Can I feed him now? What about NOW?  Plus I am lazy, and pulling out a boob is SO much easier. I was so afraid to feed him with any alcohol in my system, especially after googling told me how much more sensitive his liver is in the early months, and every search I did came up with SUCH conflicting info, I just said forget it, not worth it.

But now that he is sleeping for longer stretches (sometimes even all night, but more often from 9ish until a wake-up between 2-4 am) KNOCK WOOD, and he is older, I think I am ready to give it another try. What I would love to know is what guidelines you follow or suggest?

I have read that a glass or two of wine is fine, but, erm…I am not the most refined of drinkers- I kind of prefer a jack and coke to pretty much anything.  Hard to find guidelines for THAT on most mommy-sites!

I am okay with him getting a bottle in the evening before bedtime, but I really would prefer to be ready to nurse by 2am-ish, should he not bless us with a night of sleeping through. I would love to hear how you handle this, if at all?  Should I just hold off a few more months?

Thanks!
Daisy

Here’s what Kellymom.com (my personal breastfeeding information source of choice) has to say about alcohol and breastfeeding. They sum it up thusly: If you’re sober enough to drive, you’re probably sober enough to breastfeed. The alcohol percentage in your breastmilk is not the same as the alcohol in your bloodstream, but it will peak about a half hour to an hour after you drink, so a lot of sources recommend waiting two hours to nurse again.

(While other sources will, of course, say that the nursing/alcohol thing is unnecessarily alarmist, much like our country’s attitude towards drinking and pregnancy, while many others will also scare the pantsy pants off you and make you feel like a monster for having a even a single glass of wine while nursing. THANKS, “SOURCES.”)

Alcohol also leaves your milk the same way it leaves your bloodstream, so the whole “pumping and dumping” idea is unnecessary — pumping milk doesn’t speed up the process, and that same milk would be perfectly safe to feed your baby once your body has metabolized the alcohol.

But here’s the thing: Everybody metabolizes alcohol differently. Hell, most women don’t even metabolize alcohol the same way every day, since even your menstrual cycle can effect how long it stays in your system or just how much you absorb into your bloodstream. So that’s why there’s a lot of uncomfortable guesswork and wildly conflicting information about whether it’s okay to a glass of wine or a cocktail or two or more or what.

So I personally opt to take the guesswork out and use these handy little Milkscreen tester strips. If there’s alcohol in your breastmilk, you will get a positive result on the strip. Then you can test again in an hour, two hours, whenever, to know whether it’s passed through your system or not.

I should point out that even a positive result on the strip does not necessarily mean you’re tanked and lactating poison: The strips are VERY sensitive. You will get a positive result if there’s an alcohol percentage of just 0.02% in your milk, which still falls below the amount (0.03%) where any possible change/impact on the baby has even been anecdotally noted. (Mostly changes in sleep patterns — alcohol in breastmilk has been reported to make babies fussier and wake up more.)

You also don’t need to keep a constant, steady supply of strips lying around for as long as you breastfeed: I’ve bought exactly one package with each baby and quickly “learned” how much is okay and how soon I would be in the clear. And personally, it was a lot more and a lot sooner than I thought, and it pretty much reinforced the “sober enough to drive” advice from Kellymom. If you FEEL actually, actively impaired, there’s alcohol in your milk and you need to wait. But one drink or even two, with food (unless you’re a serious lightweight), is unlikely to register any danger. BUT AGAIN, we’re all different. There really can’t and shouldn’t be one set guideline for everybody. Know thyself and thy liver, I suppose.

And remember the timing window — it takes alcohol time to show up in your system, blood or milk. You don’t necessarily need to start giving the baby formula or pumped milk the second a drink touches your lips. At that point, your milk is still beyond pristine. You actually want to be more mindful about feedings that may come an hour or so later. (And yes, the age of your baby matters too. Newborns under three months old will be much more sensitive to even trace amounts of alcohol.) So as weird as it sounds, it’s safer to have the drink right when your baby is nursing or immediately after, thus giving you the maximum time window of a couple hours before they want to eat again. If you nurse at 9 pm when your baby goes to sleep, for example, and have your cocktails right around then, you MOST LIKELY be just fine to nurse again when he wakes up at 2 am, a full five hours later.

But again, the Milkscreen test strips will let you know for sure, so I think they are very much worth the money for the peace of mind and the lack of math and guesswork.

Photo credit: Thinkstock

About the author

Amalah

http://www.amalah.com
Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy's daily mothering adventures at Amalah. Also, it's pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to amyadvice@gmail.com.

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.


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16 Responses to “Alcohol and Breastfeeding”

  1. Olivia Dec 19 at 2:19 pm Reply Reply

    I only have my own experience, so this is in no way scientific. I drank alcohol for the first time after my baby was born when she was about three months old. I’m a light-weight drinker normally, and after not drinking for a year two beers or two glasses of wine was my limit before feeling tipsy. I often (heh, often. I drank only sporadically, like once every couple of months) drank while she was nursing. However, I never tested my milk and if she was hungry within an hour I went ahead and nursed. Meh, she seems perfectly fine today. My mother said she was given a glass of wine in the hospital after giving birth to me, so I tend to think a lot of the info on drinking and breastfeeding is alarmist and agree with Kellymom’s guideline.

  2. Stephanie Dec 19 at 2:43 pm Reply Reply

    I’m of the everything in moderation category. I am pregnant with my second, and I do have a half glass of wine here or there, during dinner. As for breastfeeding, I felt better nursing my baby and then drinking a glass or two of wine. The lactation consultant I took a breastfeeding class with gave the same advice as Kellymom, so that’s probably a good one to follow.

  3. Ladotyk Dec 19 at 2:51 pm Reply Reply

    I too used to enjoy a glass wine while nursing. Makes a great Christmas card photo!

  4. Karen Dec 19 at 2:51 pm Reply Reply

    Don’t forget that alcohol (and caffeine) is dehydrating so be sure to follow up any consumption with adequate water.

  5. Jen Dec 19 at 3:09 pm Reply Reply

    I followed the kellymom guidelines, although I am not a big drinker anyway. I drank a drink or two with dinner and stopped drinking before feeling a buzz.
    One tip- the best time to drink is actually while you are nursing the baby- meaning baby on the boob and drink in hand. :) That way, you know the alcohol isn’t in your system yet and that the baby probably won’t be hungry during the peak time the booze is in your system.
    If you use the test strips, here is what my sister in law did- if she got a positive test she didn’t dump the milk. She put it into the fridge and then mixed it with the milk from a few other pumping sessions when she hasn’t been drinking. That way, she wasn’t wasting the milk and she wasn’t giving the baby a boozy bottle at daycare.

  6. Myriam Dec 19 at 3:18 pm Reply Reply

    Jen, that is a great advice I never heard before. I don’t drink much, because I have Type 1 diabetes, but I do enjoy a glass of wine a dinner on occasion, especially during the Holidays. I’m still nursing my 1 year-old, and if she skips her 8PM feeding I usually have to pump. If I ever need to PUI (pump under the influence), I won’t waste that milk!

  7. Kate Dec 19 at 3:22 pm Reply Reply

    I have been nursing my four month old and frequently have one or two drinks but leave it at that. He nurses often enough that if I had more to drink I’d have to either miss a nursing session to let the alcohol metabolize (won’t do it, since I’m plagued by low supply as it is) or pump and dump. Pumping and dumping sounds like a reasonable solution until you are faced with the prospect of actually pouring your own precious milk down the drain. I just… can’t do it. So, @Jen , I like you SIL’s idea of mixing the milk! I probably won’t do it with NYE milk :), but I might indulge in a third beer and try it then!

  8. Alyssa Dec 19 at 8:14 pm Reply Reply

    When I wanted to drink while nursing, I followed the rules above about waiting at least 2 hours before nursing if I had a few drinks, but didn’t get drunk.
    Buuuut since I had a breast pump if I knew I wanted to have a couple drinks in the evening I would pump enough to get me through a night feeding or 2 and then I wouldn’t have to worry about boozy milk. I always tried to have a bit in the freezer for situations like that, among others, like for work and such. I know you said you plan to pump soon, so why not spring for the pump early and have that as an option?

  9. Candace Dec 19 at 10:53 pm Reply Reply

    Milkscreen! Absolutely amazing! Everyone metabolizes differently, so rules of thumb aren’t helpful. And they now sell it at Target, I saw it the other day in the baby section, near the baby bottles. Try it! Great for peace of mind!

  10. KimC Dec 20 at 6:16 am Reply Reply

    I am another one who would have a beer (yeah, I like beer, whatever) WHILE I was nursing the baby. Then the sweet baby goes to bed, I have MAYBE one more, I go to bed and when she woke up about 6 hours in, we were good to go. I also drank occasionally at barbecues and dinners out, with both kids. One is almost 5 (side note, why am I freaking out about her being almost five?) and SUPER SMART, the other is eighteen months and a devious little toddler of DOOM:) Everyone is fine. Everyone is basically healthy. I don’t feel like I ever did anything wrong. Enjoy a cocktail! Relaxing and all.

  11. Heidi Dec 20 at 11:03 am Reply Reply

    Can I just say how refreshing and heartening it is to see people making actual suggestions and comments about this question, without anyone yet getting all Judgey McJudgerson about perils of drinking and nursing? Since my two boys were extended nursers–2 1/2 years for the first, 3 years and still going for the second–giving up any indulgence for the duration just seemed ridiculous. I enjoy a nightly beer, generally a couple of hours before my 3-yr-old’s bedtime “snuggle.” 

  12. Kimtoo Dec 20 at 11:23 am Reply Reply

    I read an aritcile in a science magazine about alcohol and pregnancy. It was a British magazine , and apparently drinking while pregnant is common enough that they focused on how many drinks in one evening was dangerous (answer: 3 is getting dodgy, 4 definitely too much) and they defined occasional drinking as up to 7 drinks in a one week period (which, to me, moves right out of occasional, past often, and into the regularly category, but whatever.)

    My point is, have a drink, don’t get drunk, your baby will be fine. (And KimC, mine just turned 5, and Holy Cow, my baby is a whole hand of fingers. It is huge., Huge, I tell you!)

  13. MR Dec 20 at 11:53 am Reply Reply

    Since your baby does a long stretch at night, you can do what I do: put LO to bed, then poor your drink of choice. As long as you aren’t getting plastered, you’ll be fine by the time LO wakes up to nurse. And that way you can enjoy your drink with some quiet adult only time. Cheers!

  14. Corie Dec 20 at 2:24 pm Reply Reply

    Just a note about the testing strips – if you use them, make sure to read them right away (or as soon as you have the results – 2 minutes, I think?) because if you wait too long it’ll come back saying there’s too much alcohol in your milk, even if you initially came back in the clear. Twice I dumped milk after only one beer because I forgot to check my test strips on time, and the strips told me that there was too much alcohol in my milk. the third time it happened I remembered to check the test strip on time but left it sitting on the counter while I put the milk in the fridge and finished cleaning my pump parts, and by the time I turned around to throw it away, it had turned. Just keep that in mind!

  15. wendy Jan 13 at 3:57 am Reply Reply

    thank you amy! so glad that you’re spreading reasonableness! the woman who taught my breastfeeding class said pump n’ dump was no longer considered necessary. and though i don’t recall her specifically saying “too drunk to drive, too drunk to feed,” that’s essentially what she got to, though w/out the very informative bit about the ~2hr metobolizing part. hrm.

    anyway, having an extended nurser (2.5 yrs at end of month), i do have people asking me, “oh! will you have to pump and dump when you get home?!?” Since i usually have a single drink or 2 glasses of wine, i’ve never worried about alcohol in my milk AND those times i’ve had more, it’s on nights i wasn’t home for bedtime, so wouldn’t be nursing til 6am anyway.

  16. jen Apr 14 at 8:03 pm Reply Reply

    Thanks so much for this article!  It’s so hard to find realistic information in this world where everyone has fear of liability for everything…so nice to hear comments from real and reasonable moms, too!

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