By Karen Miles, IBCLC
You’ve been looking forward to the date for months: a rare night on the town with friends, and perhaps – a more adventurous drink than your typical breastfeeding refreshment of water! But you may feel uneasy about whether you can drink alcohol safely when nursing. We’ll help you cut through the clutter of online information on the topic, and hone in on seven essential safety tips to keep in mind when contemplating drinking and lactating.
1. Consider the let down on your letdown.
If your well-intentioned neighbor or relative tells you that beer will help you relax and let down more milk, smile and disregard their now debunked advice. According to Hale’s Medications & Mothers’ Milk current online edition, written by renowned pharmacologists Dr. Thomas Hale and Kaytlin Krutsch, alcohol can actually hinder oxytocin release – the magic hormone that affects your milk ejection reflex (aka your “milk letdown”). The result? The amount of breast milk that actually reaches your baby for a while after drinking can unfortunately be lowered, particularly with high alcohol intake.
2. Weigh the risks to your baby.
The Centers for Disease Control (CDC) warns that excessive alcohol consumption can “affect the infant’s development, growth, and sleep patterns.” According to the National Institutes of Health website LactMed, that could mean frequent short bursts of sleep and less continuous sleep for your sweetie in the hours after your alcohol consumption, if nursing your baby or feeding baby milk pumped during that time frame.
Is your baby a preemie or medically fragile? Such babies can be more affected by a nursing parent’s alcohol consumption than full-term and healthy babies. If you have a premature or medically fragile baby, talk to your baby’s pediatrician about what if any amount of alcohol is okay, and how long to wait after alcohol consumption before pumping or nursing for your baby’s specific health needs.
3. The “Pump-and-dump” method and alcohol test strips do not guarantee alcohol elimination.
The nonprofit breastfeeding support organization Breastfeeding USA warns, “Pumping doesn’t get rid of alcohol faster.” (In other words, you can't get rid of all the alcohol from your breasts by pumping and dumping the milk immediately after drinking alcohol.) That’s because alcohol levels closely mirror the nursing mother’s blood levels. Only the adequate passage of time between your last drink and your next pump or breastfeed that is fed to your baby will help minimize what is in the milk served. But of course, if after a couple alcoholic drinks you wish to pump and dump a little to prevent feeling overly full and to keep your milk supply up while waiting for some time to pass, that is totally up to you.
Breastfeeding USA also cautions that alcohol test strips, designed to detect alcohol levels in breast milk and other liquids, “are extremely sensitive, and often show false positives.” So you might want to save your money on those. Instead, follow the suggestions below.
4. Prepare pumped milk and babysitting help in advance.
Before any alcohol consumption, prepare enough pumped breast milk for the planned hours away from your baby as well as for the day after your alcohol consumption, just in case. Your babysitter or sober partner can then use that breast milk stash when you are away and when you are recovering from any alcohol consumption upon return home. It is also a wise idea to ask your babysitter or sober partner to plan to remain with your baby after your return home until you can safely care for your baby. (See tips #6 and #7 for how long to wait to breastfeed or pump-and-feed after your return home.)
5. Consider the timing.
If it’s a short outing and you don’t have much pumped milk prepared, ideally pump or nurse first and then drink within an hour afterward. That’s because “Direct feeding or pumping within 1 hour before drinking alcohol may slightly reduce the amount of alcohol in the milk,” says the Institute for the Advancement of Breastfeeding & Lactation Education (IABLE).
6. Keep alcohol intake low.
Of course, “Not drinking is the safest option for breastfeeding mothers,” says the CDC. But if consuming just one drink in a day, and waiting the CDC’s recommended wait period of “at least 2 hours after a single drink” to nurse or pump, you’re significantly minimizing any impact on your baby. But what exactly is a single drink, since alcohol content can vary widely depending on the type of drink? One serving is equal to 12 oz. of beer, 8 oz. of malt liquor, 5 oz. of wine, or 1.5 oz. of distilled spirits (gin, rum, vodka, whiskey), says the CDC. For the precise alcohol by volume (ABV) that counts as a serving, see their handy alcohol pictorial guide.
7. Factor in the multiplier effect.
The more alcohol you consume, the longer it affects your breast milk, and so the longer you should wait to nurse or pump-and-feed. According to the CDC, one drink of alcohol can be detected in breast milk “for about 2 to 3 hours”, 2 drinks can be detected “for about 4 to 5 hours”, and 3 drinks can be detected “for about 6 to 8 hours”. So be sure to wait longer than 2 hours to nurse or pump-and-feed if consuming more than one serving of alcohol.
Besides the passage of time, other factors that affect how long it takes alcohol to clear your system include whether or not you eat while drinking, your weight, and your metabolism, to name just a few factors. To view a handy chart that helps determine alcohol elimination time based on a nursing mother’s weight and the number of alcoholic drinks consumed, check out page two of this article (note: the article is older but contains a still helpful chart), Canadian Family Physician, January 2002 article, “Motherisk Update: Drinking alcohol while breastfeeding: Will it harm my baby?”
In order to lessen the alcohol multiplier effect on your milk, but retain most of the flavor you may be seeking in a drink, consider switching to a nonalcoholic cocktail or nonalcoholic beer after one alcohol serving. Although some nonalcoholic cocktails and some nonalcoholic beers contain small amounts of alcohol, “when consumed in moderation” they “have minimal risks of infant alcohol exposure via breastmilk...” reports LactMed. Or better yet, switch to water or a noncaffeinated soda after one alcohol serving.
With these tips in action, here’s hoping you have a wonderful and well-deserved night out, with fewer worries about your little one.
Karen Miles is an International Board Certified Lactation Consultant (IBCLC) and Lactation Content Specialist with Milkify.
This article is for informational purposes only and is not intended to diagnose, treat, or be a substitute for medical advice. Please consult with your healthcare provider for any questions you may have related to your own health, or your baby’s health.
