AND SMOKING AND ALCOHOL
I am 35 weeks pregnant with my second boy. I didn't breastfeed
my first because work wouldn't allow pumping on work hours. I
am thinking of breastfeeding this one though because I'm not working.
Question is, I like to have a drink every once in awhile, can
I do that while I'm breastfeeding? And I'm a smoker that wants
to go on the patch, can I do that while breastfeeding? I can't
quit cold turkey, I have tried. Also, husband is concerned about
feeding in public, what can I say to him to reassure him that
it's ok to do?
Beth, I'm so glad that you are planning to nurse your new baby.
Staying at home with him will make it a lot easier, because although
many mothers do continue breastfeeding after they return to work,
it does present a lot of challenges.
worry at all about drinking occasionally while you are nursing.
The American Academy of Pediatrics has approved the use of alcohol
in breastfeeding mothers. Alcohol does pass into breastmilk more
readily than some other drugs, but unless you drink several drinks
or more a day, every day, there shouldn't be a problem.
have shown that drinking heavily over a long period of time can
slow your baby's motor development, and regular alcohol abuse
can cause slow weight gain in the baby, but there is no evidence
that having a few beers or glasses of wine will harm your baby.
drink metabolize alcohol in about 1-3 hours, so if you want to
be conservative, wait a couple of hours for each drink before
you nurse. If you have 4 beers, wait 8 hours. Having a glass of
wine or a beer or two should not cause any problems, and I would
not even worry about it. In his new book "Dr. Jack Newman's Guide
to Breastfeeding," he says "Alcohol while breastfeeding? No problem,
in moderation. No need to worry about 'pumping and dumping.' Just
put the baby to the breast, even while you have your drink - why
If you are
a heavy smoker (a pack or more a day), your milk supply may go
down and rarely, your baby may have an upset stomach. Nicotine
can interfere with your letdown reflex, so it may lower your milk
production or your baby's weight gain if you smoke heavily over
a long period of time.
Answer Book says that "if a mother smokes fewer than 20 cigarettes
a day, the risks to her baby from the nicotine in her milk are
small." If you can't quit, try to cut back, and smoke after you
nurse and not before. Even if you smoke more than a pack a day,
it's better to nurse and smoke after nursing than not to nurse
at all. There is no research to prove that nicotine in your milk
is going to cause any lasting harm to your baby, no matter how
much you smoke. Using the nicotine patch will usually result in
less than half the amount of nicotine in your bloodstream than
the amount found when you are actually smoking cigarettes, assuming
that you use the patch correctly and don't smoke while you are
using the patch. If you do both, the levels in the milk could
be harmful to the baby. If you do use the patch, you should take
it off at bedtime to reduce the baby's exposure to the nicotine.
Nicotine gum can produce larger peaks in levels of nicotine when
you chew it rapidly, so if you use the gum, you should not nurse
for 2-3 hours after using it. The patch is a better choice for
nursing mothers, but only if you are able to stop smoking completely
while you use it.
in secondhand smoke is worse for your baby than the small amount
of nicotine that gets in your milk, so try not to smoke in the
same room with the baby.
benefits of breastmilk are well documented. Breastfeeding helps
protect your baby from SIDS, respiratory infections, and certain
cancers. Try to quit, cut back if you can't quit completely, smoke
after nursing, and smoke outside, but don't formula feed your
baby because of this. Dr. Thomas Hale says in his book Medications
and Mother's Milk: "The risk of nicotine via breastmilk is far
less than the risk of formula feeding. Mothers should be advised
to limit smoking as much as possible, and to smoke only after
they have breastfed their infant."
As far as
your husband's feelings about nursing in public: this is something
that the two of you will have to work out between you. Many dads
are very uncomfortable with the idea of their wife exposing her
breasts to strangers, and that is certainly understandable. I
suggest that you practice nursing in front of him (you can use
a doll to practice before the baby comes) so that he can critique
your technique. Most people who haven't nursed a baby are surprised
at how discreet you can be. If you wear a shirt that pulls up
from the bottom (not one that unbuttons from the top), then the
baby covers part of the breast and the shirt covers the rest.
Throwing a blanket over your shoulder completes the coverage,
and most people don't even know you're nursing unless they come
up close and hear the little slurping sounds or pull the blanket
off to get a better look!
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