By Morgan Michalowski, CNM, WHNP-BC, IBCLC
Plenty of moms have strong opinions about consuming alcohol while breastfeeding, and this choice is definitely a personal one. There’s a ton of research out there about how alcohol affects breast milk-production—and I’ll share much of it below—but I believe it all comes down to your comfort level. If you think that sipping the occasional glass of merlot during your nursing days will just plague you with worry, don’t do it! The stress it will cause you is not worth the tradeoff for a temporary buzz.
That said, researchers have dug deep into this topic and there are plenty of hard facts to consider if you DO want to unwind with a margarita. Here’s a summary of the current scientific insights into drinking alcohol while breastfeeding.
What doctors & experts say about alcohol and breastfeeding
The consensus among pediatric researchers, doctors, and scientists is that the occasional use of alcohol does not appear to be harmful to the nursing baby. However, many recommend against drinking more than 1-2 drinks per week. There are several factors that may mean more or fewer drinks will work best for you as an individual, but this is a solid guideline for most nursing moms.
Thomas Hale, professor of pediatrics at Texas Tech University, states, “mothers who ingest alcohol in moderate amounts can generally return to breastfeeding as soon as they feel neurologically normal.” (2019) I love this advice because it encourages you to listen to your body. While you’re tipsy, you probably won’t want to interact with baby at all. Once you feel like yourself again, it’s safe to nurse, play, snuggle, and more.
The American Academy of Pediatrics chimes in by saying, “ingestion of alcoholic beverages should be minimized and limited to an occasional intake but no more than 0.5 g alcohol per kg body weight, which for a 60 kg mother is approximately 2 oz liquor, 8 oz wine, or 2 beers. Nursing should take place 2 hours or longer after the alcohol intake to minimize its concentration in the ingested milk.” Many of us have heard that last piece of advice before, and it’s another great, basic guideline. Give your body some time to process the alcohol before you dive back into pumping or nursing.
If you DO decide to drink while nursing …
There is no need to pump & dump milk after drinking alcohol, other than for your own comfort. Despite what many of us have been told for decades, pumping & dumping does not speed the elimination of alcohol from breast milk. Alcohol does not accumulate in breast milk, but leaves the milk as it leaves the blood; so when your blood alcohol levels are back down, so are your milk alcohol levels.
In general, if you are sober enough to drive, you are sober enough to breastfeed. Less than 2% of the alcohol you consume reaches your blood and milk, but it’s also important to consider timing. Generally speaking, alcohol peaks in your blood and milk approximately 30 minutes to 1 hour after drinking. There is considerable variation from person to person, depending upon how much food was eaten in the same time period, your body weight, percentage of body fat, and other factors. But as we discussed earlier, allowing a few hours to pass between drinking and nursing is a good practice.
If you’ve had enough alcohol to feel disorientated or if you are vomiting, do not breastfeed until you are sober. Make sure someone who is not intoxicated is present to care for your child(ren). If possible, express your milk for comfort and to maintain your supply. (Milk expressed while intoxicated should not be fed to the baby.) Binge drinking has not been studied adequately and is not recommended during lactation.
Finally, never share a bed or other sleeping surface with your baby if you have been drinking since drinking affects your reflexes. Drinking and bed-sharing have an increased association with sudden infant death syndrome (SIDS).
If you’re out on the town and away from your baby
Say you decide to go out of town and hit the bar with your friends. How should you deal with your milk supply then? Experts recommend pumping as often as baby usually nurses. (Again, this is to maintain milk supply, not to eliminate alcohol.) At the very least, pump or hand express whenever you feel full to avoid plugged ducts and mastitis.
Overview of the effects of alcohol on breastfeeding and the breastfed baby:
- There is a 23% decrease in milk volume with one drink (Mennella & Beauchamp 1991, 1993; Mennella 1997, 1999).
- 2+ drinks may inhibit letdown (Coiro et al 1992; Cobo 1974).
- Alcohol may temporarily impact your infant’s sleep-wake pattern after short-term exposure to small amounts of alcohol in breastmilk — infants whose mothers were light drinkers slept less (Mennella & Gerrish 1998).
- Daily consumption of alcohol has been shown in the research to increase the risk for slow weight gain in the infant.
- Daily consumption of alcohol (1+ drinks daily) has been associated with a decrease in gross motor development (Little et al 1989).
That last batch of statistics may feel off-putting, and there are definite risks to mixing drinking with nursing. However, done in moderation and using common-sense guidelines, you can absolutely treat yourself to a martini when you want one.
Looking for more research and expert input? I’ve gathered a list of further reading below that can help you make the right choice for you and your baby.
Resources to check out:
Drinking Alcohol & Breastfeeding, from La Leche League International
Alcohol and Breastfeeding, from the Centers for Disease Control
Beer as a Galactagogue – A Brief History by Hilary Jacobson
Alcohol and Motherhood by Carol Huotari, from Leaven, Vol. 33 No. 2, April-May 1997, pp. 30-1
Social Drugs and Breastfeeding: Handling an issue that isn’t black and white by Denise Fisher, BN, RN, RM, IBCLC. Discusses nicotine, alcohol, caffeine, marijuana, heroin, and methadone.