Can You Drink Alcohol While Breastfeeding?
Since having baby number two and making the decision to breastfeed again, I’ve also found myself wondering can you drink alcohol while breastfeeding without causing harm to your baby? I’m sure the same question races through most breastfeeding mums’ minds, so here’s my interpretation of what I’ve uncovered.
My “relationship” with alcohol
Prior to being pregnant with my first son, I would say I was a moderate social drinker of alcohol. My husband and I would often enjoy a bottle of wine between us at the weekend or whenever we went out for dinner, and we enjoyed the occasional night out with friends, with the focus on having a drink. We frequently embarked on what I would call your typical late 20s / early 30s kind of night out, things were nowhere near as crazy as early 20s Caroline (who could make a severe dent in a bottle of Captain Morgan rum on a night out). We were becoming responsible adults, and we had realised that alcohol could be enjoyed to a nice tipsy state whereby we didn’t write off the whole weekend with a hangover.
And then the baby growing commenced…
Back in 2014, my first pregnancy was tough for me. I had to cut out a few of my favourite foods – blue and mould ripened cheeses, pate, and deli meats – and I knew I had to cut down on alcohol consumption. The NHS guidance back then said to limit consumption to no more than one or two units of alcohol per week during pregnancy, and because it was my first child I followed the guidance to the letter. When we did have special occasions such as weddings and birthdays, I chose to drink one glass of wine, but other than that I cut out alcohol.
Breastfeeding boy number one, again, I followed the guidance to the letter, as do most first time mums who don’t want to be judged for doing anything “wrong”. This meant continuing as I did during pregnancy, since the guidelines were the same. After more than a year of only drinking one glass of wine at any time, I was pining for a taste of my former freedom. I continued to breastfeed until my boy was 6 months old, and by then, I was ready to celebrate the end of my restriction with a girls night out.
Fast forward to pregnancy number two, 2016. Feeling like I already knew what I was doing, I didn’t even bother reading the NHS guidelines again. At three months pregnant, I found myself eating sushi from a takeaway in Hamburg airport and then it hit me that I wasn’t supposed to eat sushi, unless I had checked that the fish had been frozen first. Thankfully no food poisoning ensued, but I did have a slight panic and realised I should probably refresh my memory on foods to avoid while pregnant, since there had been a lot of baby brain forgetfulness in my life since 2014.
Sure enough, in the space of just 2 years, the NHS guidance had changed: the list of foods to avoid seemed to have been completely rewritten, and I also found that the new suggestion was for pregnant mothers to abstain from drinking alcohol completely during pregnancy.
Wait a minute, what???
Hmm, so maybe I wouldn’t have gotten pregnant again had I known that I was now supposed to not drink alcohol AT ALL. I was a more than a little put out by this, and so I felt the need to try and find what must be new scientific evidence to support this change in recommended practice.
After some investigation, I discovered that the reasoning was that although scientists know lots about the result of excessive drinking during pregnancy (e.g. foetal alcohol syndrome), but the effect of drinking a small amount of alcohol is unknown. Ok, so maybe it was time to reassess my occasional glass of wine in pregnancy…
Breastfeeding in 2017
I gave birth to beautiful boy number two in December 2016 (note the above is not a picture of me and the boy breastfeeding, I’m not one for sharing those special moments with the whole world!), and once I got past the initial hazy newborn days, found myself craving a nice glass of red wine with my steak. Knowing that the guidance for pregnancy and alcohol had changed, I had a quick look into what the recommendation for breastfeeding was in the modern day. Interestingly the guidance still seems the same as in 2014, and so my one or two units of alcohol wasn’t cause for alarm.
But what if I don’t want to stop at one glass of wine? After all, a glass of wine doesn’t really tide me through a meal, and being allowed two glasses would be heaven in my eyes.
Not surprisingly there is little in the way of published scientific research on breastfeeding and alcohol consumption. We see that women are constantly preached to that “breast is best”, but with women also being told to strictly limit their alcohol consumption, we run the risk of deterring some mothers from breastfeeding. It’s a huge commitment to ask of mothers to continue to restrict their alcohol drinking after pregnancy, especially when there is little scientific proof that to do so will cause harm to your baby.
So… can you drink alcohol while breastfeeding?
I’ve tried to research into medical studies on the matter, and read numerous articles online in forming my opinion on the matter, but please do remember this is only my interpretation of the findings of any such studies:
- The amount of alcohol which passes through to the breast milk is believed to be less than 1% of what the mother consumes. So if you drink a glass of 10% wine, this is the equivalent of your infant drinking a 0.1% glass of wine. Worth bearing in mind is that most fruit juices contain a similar level of alcohol to this.
- The amount of alcohol in breastmilk correlates to the amount of alcohol in the mother’s blood. If the mother has a blood alcohol level of 0.08% (the limit for legally driving in the U.K.) then her breast milk will also have an alcohol level of 0.08%. Again, less than most fruit juice.
- As the mother’s liver metabolises the alcohol and she sobers up, the alcohol level in her breast milk will also reduce.
In particular, I love this reference from paediatrician and author of Breastfeeding Made Easy, Carlos Gonzalez:
My baby boy is now eight weeks old and I freely admit that I have drank more than one or two glasses of wine since his birth. Not enough at any one time to be considered drunk (or even tipsy) but after being pregnant and severely restricting my alcohol intake, I wasn’t prepared to continue this for a further 6 to 12 months based on my findings above. Plus, being a second time mum means I’m way more relaxed about everything than I was the first time round!
How long does alcohol stay in breastmilk?
As I said earlier, once the alcohol is out of the mother’s blood, then it’s also removed by her body from her breastmilk. So really this all comes down to the individual mother and how quickly she recovers from alcohol.
As a guide, adults metabolise alcohol at a rate of one unit of alcohol per hour. So in a standard glass of 175ml of wine, which is usually around 2 units of alcohol, it would take 2 hours from when you finish the drink for the alcohol to be out of your bloodstream. Interestingly, the rate at which you metabolise alcohol is the same for all adults being 0.016% per hour¹, so this rough guide of one hour per unit of alcohol applies to everyone.
Do I need to pump and dump?
“Pump and dump” refers to expressing breast milk and then throwing it away. Let’s just say that after going through the effort of expressing, it would be heartbreaking to any mum to have to do this!
There’s a common misunderstanding that if you express milk whilst you are drunk, then you need to dispose of the milk. Granted, the milk will also contain some alcohol, but as per the quote from Gonzalez above, it’s never going to be more than 0.55% alcohol content. And remember that this would be at the extreme end of a drinking session, so I would say that as long as you drink in moderation, there’s no need to pump and dump your milk.
If you are able to withhold from expressing or feeding whilst you are intoxicated with alcohol, then any milk being held in your breasts will gradually reduce in alcohol content as your liver metabolises the alcohol in your blood. So by the time the alcohol has left your bloodstream and you are sober again, you can express or feed your baby safe in the knowledge that your milk is now alcohol free.
What if I want to play it safe?
Some mothers just don’t want to run the risk of doing anything wrong when it comes to their children. I understand this completely and it is every mother’s prerogative to act as she sees best for her children. So if you are unwilling to drink alcohol whilst breastfeeding (at least until the day you see a study which proves it will cause no harm to your child), then what should you do?
- Prior to drinking any alcohol, express enough milk to feed your baby for the time that you will be inebriated. Remember that the average person’s liver will metabolise approximately 1 unit of alcohol for every hour, so plan this in to provide milk for the next day if you are planning a big night out. See here for my recommendation of a great breast pump to help you prepare, the Medela Swing Maxi.
- If you are likely to become engorged or are worried about a dip in supply from not nursing during the time away from your baby, pump and dispose of the milk. A few paragraphs higher, I said this wasn’t necessary, but the reason I’m now saying to pump and dump is different. If you are wanting to play it safe and ensure that your baby doesn’t receive any alcohol from your milk, then any milk expressed whilst you are drinking alcohol will need to be thrown away. The most convenient way to take the edge off for painful engorgement whilst you are out and about is simply to hand express so that you don’t need to carry a pump around in your clutch bag.
- If you will not be skipping any feeds or are not worried about a dip because your supply is well established, then there is no need to pump and dump. By the time your body has fully metabolised the alcohol, your milk will also be alcohol free again and safe to feed to your baby.
- If you’re not sure whether the alcohol is out of your system, then you can purchase breast milk alcohol tests strips (yes they really do exist!) to test whether the alcohol level has returned to a safe level for your baby.
My interpretation of the evidence I’ve read is that even if you were to breastfeed your baby in a severely intoxicated state, the amount of alcohol being passed onto your baby is miniscule.
I believe in doing everything in moderation though. I’m not going to be having half a bottle of my beloved Captain Morgan and then breastfeeding my 8 week old, but equally I’m not going to stop myself from having that second glass of wine with dinner.
My advice to breastfeeding mothers is to do your own research and draw your own conclusions, but please don’t feel like you have to give up breastfeeding in order to have the freedom to enjoy a few drinks every now and again.
One thing that has struck me whilst looking into this is the minimal amount of real scientific research into the topic. Perhaps the government should consider providing funding for the research into breastfeeding and alcohol which could then be used to support the “breast is best” campaign and promote breastfeeding further among today’s society.
- Wilkinson PK, Sedman AJ, Sakmar E, Kay DR, Wagner JG. Pharmacokinetics of ethanol after oral administration in the fasting state. Journal of pharmacokinetics and biopharmaceutics. 1977;5(3):207-224
Share your opinion
I would love to hear about your own experience of breastfeeding – did you drink alcohol whilst breastfeeding? Did you know that you didn’t need to pump and dump? Did you choose not to breastfeed because you didn’t want the restriction of lifestyle in the belief that you couldn’t drink alcohol while breastfeeding? Please drop me a comment below or share with your breastfeeding friends.