Alcohol and Breastfeeding
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Alcohol (ethanol) passes quickly into breast milk and may reach levels equal to or higher than the mother's alcohol blood level. However, alcohol is not "trapped" in breast milk and will return into the mother's bloodstream as the mother's alcohol blood level decreases [1].  Overall a breast fed infant would be expected to receive about 6 percent of the maternal dose of alcohol after moderate social drinking [2].
Acetaldehyde, the toxic metabolite of alcohol, does not appear to pass into breast milk  [2].

Reported undesirable effects of alcohol on the nursing infant have included disruption of sleep patterns [5,6], hypoglycemia [7], and reduced breast milk intake [8,9]

There are conflicting reports on the effects of ethanol ingested through breast milk on the development of motor skills (picking up small objects, tying shoes, walking,  kicking, etc.) in nursing infants. One study of 400 infants concluded that alcohol intake of more than 1 drink per day during nursing had a slight detrimental effect on infant development of motor skills. All of the infants had normal mental development [10]. A larger study of 915 18-month-old toddlers did not find a any unfavorable effects on motor skills associated with alcohol ingested by infants through breast milk [11].

The American Academy of Pediatrics has classified alcohol as a drug "Usually Compatible With Breastfeeding" [3]. The American Academy of Family Physicians considers an occasional alcoholic drink compatible with breastfeeding [4].

Casual use of alcohol such as 1 glass of wine is unlikely to cause either short- or long-term problems in the nursing infant. Women who wish to drink socially  may reduce exposure to their infants by storing milk before drinking and /or waiting for complete alcohol elimination from the breast milk. The calculator "Estimated Time Until Zero Level of Alcohol in Breast Milk"  may be used to estimate the time it would take to eliminate alcohol in the breast milk after consuming a given number of alcoholic drinks.

Online Resources: LactMed, Alcohol

Lawton ME. Alcohol in breast milk.Aust N Z J Obstet Gynaecol.1985 Feb;25(1):71-3. PUBMED
2. Kesaniemi YA.Ethanol and acetaldehyde in the milk and peripheral blood of lactating women after ethanol administration.J Obstet Gynaecol Br Commonw.1974 Jan;81(1):84-6. PUBMED
3 .Transfer of drugs and other chemicals into human milk. Pediatrics. 2001;108:776-89.
4.The American Academy of Family Physicians. AAFP Policy Statement on Breastfeeding. Accessed 10-5-05
5.Mennella JA and Garcia-Gomez PL Sleep disturbances after acute exposure to alcohol in mothers' milk. Alcohol.2001;25(3):153-8. PUBMED
6.Mennella JA and Gerrish CJ .Effects of exposure to alcohol in mother's milk on infant sleep. Pediatrics. 1998 May;101(5):E2. PUBMED
7. Lamminpaa A. Alcohol intoxication in childhood and adolescence. Alcohol Alcohol 1995;30:5-12. PUBMED
8. Mennella JA. Regulation of milk intake after exposure to alcohol in mothers' milk. Alcohol Clin Exp Res. 2001;25(4):590-3. PUBMED
9. Mennella JA, Beauchamp GK. The transfer of alcohol to human milk. Effects on flavor and the infantís behavior. N Engl J Med 1991;325:981-5. PUBMED
10.Little RE, et al. Maternal alcohol use during breast-feeding and infant mental and motor development at one year. N Engl J Med.1989 17;321(7):425-30.PUBMED
11. Little RE, et al. Alcohol, breastfeeding, and development at 18 months.Pediatrics.2002 ;109(5):E72-2. PUBMED

Created: 10/5/2005
Update: 10/5/2005
Update: 12/15/2008


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