Dear Dr Mitchell,
I just had a baby three months ago and I am breastfeeding, but not exclusively. I supplement with formula. Can I have the occasional beer or glass of wine, then pump and dump? Or will I have to forego alcohol for as long as I'm breastfeeding?
You can safely enjoy a glass of wine whilst still breastfeeding. A moderate amount of alcohol will not harm your baby in any way. Alcohol is metabolised one to three hours after consumption, so you should wait for about two hours after one drink, or two hours after each drink consumed, before breastfeeding your baby. This timeframe is important to safely allow the alcohol to be metabolised. It is recommended that you should stick to one to two alcoholic drinks per week when you are breastfeeding.
A standard drink contains 14 grams of pure alcohol. One drink of alcohol may be 12 fluid ounces of beer, five fluid ounces of wine, or 1.5 fluid ounces of distilled spirits. A breastfeeding mother should limit alcohol intake based on her weight.
You should avoid the habitual use of alcohol. Alcohol has been proven to inhibit the let down of breast milk and decrease milk production. This results in your baby having a lower milk intake than usual despite more frequent feeding. Alcohol also dehydrates your body and makes you lose body fluid more quickly. The taste of your breast milk will also change with the ingestion of alcohol and this may cause the baby to refuse your breast milk.
Pumping and dumping the breast milk does not speed up the process to metabolise alcohol and clear it from the body. The alcohol leaves the breast milk in the same way it leaves your bloodstream. The milk you would consider pumping and dumping would be safe to feed your baby once your body fully metabolises the alcohol.
Remember though that your baby is small with an immature liver and so cannot process alcohol as well as an adult. Infants under three months old process alcohol at about half the rate of adults. Alcohol can affect babies' eating and sleeping patterns. This can result in a significant decrease in the amount of milk consumed. Breastfed babies become drowsy and fall asleep more quickly after their mothers drink alcohol and they also sleep for a shorter amount of time.
Alcohol in breast milk may also hinder the baby's development and this is seen in mothers who drink at least one drink daily during the baby's first three months of life.
It is wise to fully abstain from drinking alcohol until the baby is at least three months old. If you must drink a glass of wine, then you can pump and store your milk before having a drink, then feed your baby the expressed milk from a bottle. Another option is to feed your baby formula in the hours following your alcohol consumption.
To reduce the risk of dehydration you should increase your intake of water and eat beforehand or while you are having a drink. This helps to lower the amount of alcohol in your blood and breast milk.
The more drinks you have, the longer it takes for the alcohol to clear from your system. The lower your weight for height ratio, the longer it takes to clear the alcohol from your blood and breast milk. If you have had too much to drink, do not breastfeed until you are sober, and if you pump the breast milk while you are inebriated, throw away the expressed milk. You can't safely care for your baby or sleep with the baby in your bed if you are intoxicated.
Babies have a much harder time breastfeeding when their mothers drink alcohol, so it is safer to abstain.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to firstname.lastname@example.org; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.