Can I still breastfeed if I’ve had alcohol, caffeine or cigarettes?

Alcohol:
If you are breastfeeding, the safest option is not to drink alcohol as it will be present in breastmilk. However the reality is that some mothers do wish to consume the occasional alcohol drink. If you do plan to have a drink, educate yourself beforehand and learn the best ways to minimise risk. Alcohol can remain in breastmilk for many hours so it may be necessary to 'pump and dump' and feed your baby previously expressed milk instead. We recommend testing with Milkscreen as it is better to play it safe. Speak with your healthcare professional and also look out for the government sponsored brochures that are readily available.

Caffeine:
The best case scenario is to avoid caffeine altogther although one or two cups of coffee a day generally won't cause a problem....lucky for us mums! Try switching to decaffeinated coffee and tea or reducing caffeine intake. Remember that caffeine can also be found in chocolate, soft drinks, and some herbal teas and medications, in addition to coffee and tea. If you drink or ingest a lot of caffeine, some side effects are possible. Your baby may be more irritable and feed more frequently if you ingest a lot of caffeine. Babies can't get rid of caffeine efficiently, so it can build up in their systems. Too much caffeine can also cause sleep problems and nervousness. Some babies, particularly those under six months, may be more sensitive to mum's caffeine intake. Babies whose mothers avoided caffeine completely during pregnancy seem to react more to caffeine in mum's diet. Even if baby is sensitive to the caffeine now, he may not be when he's a little older- so if you do have to stop or limit your caffeine intake, you can try again when baby is older. If your baby is sensitive to caffeine, it will typically become less of an issue as baby gets older. Newborns have a much harder time metabolising caffeine than older infants. Preterm or ill infants might also have more problems with mum's caffeine intake. Try to limit your coffee intake as much as you can. The estimate we often hear is "less than five small cups of coffee" or 500 mg/day. Various sources suggest an upper limit for caffeine intake ranging from 300-750 mg/day.

Cigarettes:
If you smoke cigarettes, please try and quit. Your doctor should have good advice on how to do this. If you choose not to quit and are breastfeeding, try and reduce the amount of cigarettes smoked and only smoke immediately after breastfeeding.

Smoking and breastfeeding has been linked to:

  • Earlier weaning. One study showed that the heaviest smokers tend to wean the earliest.
  • Lower milk production.
  • Interference with milk let-down.
  • Lower levels of prolactin. The hormone prolactin must be present for milk synthesis to occur.
  • One study (Laurberg 2004) indicated that smoking mothers who live in areas of mild to moderate iodine deficiency have less iodine in their breast milk (needed for baby's thyroid function) compared to nonsmoking mothers. The study authors suggested that breastfeeding mothers who smoke consider taking an iodine supplement.

How smoking can affect your baby:

  • Babies and children who are exposed to cigarette smoke have a much higher incidence of pneumonia, asthma, ear infections, bronchitis, sinus infections, eye irritation, and croup.
  • Colic occurs more often in babies whose mothers or fathers smoke or if a breastfeeding mother smokes. Researchers believe that not only does the nicotine transferred into mother's milk upset baby but the passive smoke in the home acts as an irritant. Babies of smoking parents fuss more, and mothers who smoke may be less able to cope with a colicky baby (due to lower levels of prolactin).
  • Heavy smoking by breastfeeding mums occasionally causes symptoms in the breastfeeding baby such as nausea, vomiting, abdominal cramps and diarrhea.
  • Babies of smoking mothers and fathers have a seven times greater chance of dying from sudden infant death syndrome (SIDS).
  • Children of smoking parents have two to three times more visits to the doctor, usually from respiratory infections or allergy-related illnesses.
  • Children who are exposed to passive smoke in the home have lower blood levels of HDL, the good cholesterol that helps protect against coronary artery disease.
  • Children of smoking parents are more likely to become smokers themselves.
  • A recent study found that growing up in a home in which two parents smoked could double the child's risk of lung cancer later in life.

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