Alcohol and Breastfeeding

Alcohol and BreastfeedingBefore we took baby on a brewery tour this weekend, I read about alcohol and breastfeeding. Although my wife was willing to abstain from alcohol if necessary, it would have been disheartening for her to not be able to try one ounce samples of fresh beer.

We remain firmly committed to breastfeeding regardless of other factors. However, if my wife is able to consume a specified safe amount of alcohol on occasion then she is more likely to struggle through breastfeeding for the recommended full one year.

Since there is a large volume of research regarding alcohol consumption during lactation, we were able to make an informed decision.

All research on alcohol and breastfeeding is complicated by correlated factors not related to breastfeeding itself. The primary problem relates to drinking while pregnant.

Women who drink lots of alcohol while breastfeeding are likely to have drunk lots of alcohol while pregnant. However, since research studies rely primarily on self-reported questionnaires, few women admit to drinking lots of alcohol while pregnant even if they admit to drinking lots of alcohol while breastfeeding.

Level of alcohol use is also correlated with factors such as smoking, unsafe sexual practices, and dangerous home environment that are difficult for researchers to untangle.

As late as 2001 there was only one study which examined the development of infants and mothers’ alcohol use while breastfeeding. The original study, published in 1989 in the New England Journal of Medicine, found even heavy alcohol use — one or more drinks every day — had no effect on infants mental development. However, breastfeeding mothers who were heavy drinkers had infants who exhibited delayed motor development.

In 2002 a follow-up study was published in the journal Pediatrics. The authors were unable to replicate the earlier findings. In fact, the study concluded that after adjusting for confounding variables such as education, mother’s age, marijuana use, and high caffeine intake, infants with heavy drinking mothers actually performed better on tests of infant motor development.

The authors were quick to point out potential flaws in their own results and caution against encouraging breastfeeding to mothers to drink heavily. A contemporary study in mice confirmed the basic results by showing that drinking alcohol while pregnant was quite harmful even as drinking alcohol while breastfeeding showed no results.

Following research shows some negative consequences of heavy alcohol consumption while breastfeeding. Mothers who consume high amounts of alcohol are likely to quit breastfeeding earlier. They are also more likely to engage in negative behaviors such as smoking. High rates of alcohol consumption including binge drinking are also bad for the mother regardless of its effect on the nursing baby.

However, with the exception of the single study in 1989, research shows no negative effect on infants from their mothers consuming even one or more drinks every single day.

The American Academy of Pediatrics updated their guidelines regarding alcohol and breastfeeding following more recent studies and now cautions against regular, habitual use of alcohol while breastfeeding. The La Leche League issues similar guidance.

Other organizations appear to rely on the older, questionable study results from 1989. The Mayo Clinic cautions against any amount of alcohol while breastfeeding. In an extreme case in North Dakota, a woman was arrested for breastfeeding her infant after drinking.

Taken together, the current research on alcohol and breastfeeding make me very comfortable about my wife having one drink once a week. I’m fairly comfortable if she had a drink every other day if the drinks immediately followed a nursing session. For our brewery tour, Mommy nursed right before the tour started and then limited herself to six, two-ounce beer samples. Since those were the equivalent of a single beer and she didn’t nurse again for another two hours, virtually no ethanol was left for our baby to consume from lactation.

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