Breastfeeding and Drinking

HOORAY NEW MAMA! You deserve a parade after giving birth. Seriously, a day should be named in your honor. Now the big question: can you treat yourself with a tasty alcoholic beverage while breastfeeding? After mucho researching the academic literature, here is the deal: 

Well, the answer is yes, but one drink only. According to the American College of Obstetrician and Gynecologists (ACOG) and the Center for Disease Control (CDC), you should wait at least two hours after one alcoholic drink before breastfeeding [1, 2]. That is the estimated  time it will take your body to process the alcohol and get rid of it from your breast milk. The alcohol will be present in your milk if it is still in your bloodstream, which means that the more you drink, the longer you will have to wait to safely breastfeed. But how long the alcohol will be in your milk or your blood is not a simple calculation of the number of drinks multiplied by two. It depends on many factors that affect how fast your body can metabolize alcohol. The CDC recommends no more than one standard drink a day, which is about half a glass of wine (5 fl oz) or a can of beer (12 fl oz). 

Breastfeeding and alcohol don’t mix well. According to the Mayo Clinic, no level of alcohol in breast milk is considered safe for the baby [3]. Research has shown that babies that are exposed to alcohol through breast milk may have impaired motor development and changes in sleep pattern, while the moms who drink may experience decreased Letdown reflex and milk production [3]. If you experience physical discomfort and would like to adhere to your milk expression schedule after you drink, you could choose to “pump and dump,” meaning to express milk and then discarding it. However, “pump and dump” doesn’t increase the elimination of alcohol from your body. If you’re worried about your baby getting hungry, you may also express milk prior to drinking and feed your baby later. Please remember that, if you choose to drink, plan carefully to avoid exposing your baby to any alcohol via breast milk. 

How does alcohol move through my body? 

Alcohol is categorized as a depressant because it slows down the central nervous system. It causes a decrease of coordination, reaction time, and intellectual performance. Once entered the body, alcohol is absorbed by tiny blood vessels called capillaries, with about 20% absorbed through the stomach and 80% through the small intestine. Alcohol in the bloodstream is delivered to all parts of the body, including your breast and breastmilk. It is gradually metabolized by enzymes in the liver. There are two pathways through which alcohol is processed. In the first pathway, alcohol is broken down by an enzyme called alcohol dehydrogenase (ADH) into acetaldehyde, which is then broken down into a smaller molecule, acetate by enzyme aldehyde dehydrogenase (ALDH). Acetate is further processed and eventually leaves the body as carbon dioxide and water. An alternative pathway, known as the microsomal ethanol-oxidizing system, is used when the blood alcohol level is very high [4]. 

That is why it takes time for the body to process and get rid of the mimosa you had. The time it takes varies from person to person and depends on many factors, including how fast someone drinks, how much he or she weighs, and how well the body metabolizes alcohol. For instance, genetic variations can lead to differences in the ADH and ALDH enzyme activity, resulting in different efficiency of alcohol breakdown. 

References 

  1. “Breastfeeding Your Baby.” ACOG, www.acog.org/patient-resources/faqs/labor-delivery-and-postpartum-care/breastfeeding-your-baby.
  2. “Alcohol.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 28 Dec. 2019, www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/vaccinations-medications-drugs/alcohol.html.
  3. “Breast-Feeding and Alcohol: Is It OK to Drink?” Mayo Clinic, Mayo Foundation for Medical Education and Research, 3 July 2019, www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/expert-answers/breast-feeding-and-alcohol/faq-20057985.

“How Is Alcohol Eliminated from the Body?” The Alcohol Pharmacology Education Partnership, Duke University, sites.duke.edu/apep/module-1-gender-matters/content/content-how-is-alcohol-eliminated-from-the-body/.

Yvette Zhu