The potential harm of drinking while breastfeeding

There seems a general conception that once the baby is born, drinking alcohol is then harmless or in some cases actively encouraged. This is encouraged by a combination of old wives tales and the fact that breastfeeding is considered so beneficial that organisations are reluctant to publish any information that may discourage women from breastfeeding. Certainly the known benefits of breastfeeding at this point outweigh the possible downfalls of moderate alcohol consumption while drinking.
What is concerning however is the active encouragement to drink when breastfeeding due to the myth that it increases milk supply.  In fact drinking is known to decrease the level of milk produced by the mother and to be detrimental to the release of milk 1. It also reduces the amount of milk that is consumed by the baby which is what makes women believe that they are producing more milk. Studies have shown that the baby compensated for this missed milk in the 8 to 16 hours following alcohol exposures leading to disrupted feeding patterns 2.
Mothers who drink more than two standard drinks a day have also been found to have babies with more disturbed sleep patterns 1. Perhaps due to these disrupted patterns and the diminishing milk supply they are also twice as likely to cease breastfeeding before six months 1.
There is also some potential that drinking while breastfeeding can be harmful to the baby in the long term, with one study showing decreases in psychomotor development at eighteen months in babies whose mothers drank while breastfeeding independent of the effect of drinking while pregnant. Given the rapid development of the brain in early life it is plausible that it could be vulnerable to the toxic effects of alcohol during this time. This finding could not be replicated in another study however 3. The research in this area is extremely limited and the measuring of alcohol-induced brain damage needs a plentiful measurement of long term outcomes which are currently lacking.

The recommendations
Recommendations for drinking alcohol while breastfeeding are to abstain as much as possible and to drink no more than two standard drinks in any one day. Women should be aware that alcohol takes 30-60 minutes from consumption to appear in the breastmilk 4 and should be absent from the breastmilk according to the following chart (from the NHMRC recommendations). Similar to alcohol in the blood there is no way to break down alcohol from the breastmilk quicker but it does not remain in the breastmilk outside of this time.


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