Effects Of Smoking, Alcohol, And Medicines On Breastfeeding

What should I know about smoking, drinking alcohol, and taking medicines and drugs when breastfeeding?

To make sure that your breast milk is safe for your baby, do not smoke, drink alcohol, or use illegal drugs. Tell your caregiver about all of the prescribed and nonprescribed (over-the-counter) medicines that you use. Certain medicines are not safe for your baby if you are breastfeeding.

Should I smoke and breastfeed?

Breastfeeding mothers should not smoke. Nicotine and many other chemicals are found in cigarettes, cigars, pipe tobacco, and smokeless tobacco (chewing tobacco and snuff). Harmful chemicals go into your body and your breast milk when you smoke. Your baby is exposed to the chemicals through breastfeeding and through inhaling (breathing in) cigarette smoke. The more you smoke, the higher the risks to your breastfed baby. Smoking affects your breastfed baby in the following ways:

• Decreased milk supply. A low milk supply may not give your baby what he needs to gain weight normally. Because of this, you may think you should stop breastfeeding. If you think you do not make enough milk, talk to your caregiver.
  
  
• Decreased quality of your breast milk. The chemicals from smoking decrease the amounts of iodine (a mineral) and fat found in breast milk. This can decrease your breastfed baby’s growth and his ability to fight infection. Your smoking also decreases the vitamins in your baby's body, which can cause poor weight gain.
  
  
• Problems with your baby's behavior (how he acts). Nicotine in your breast milk can cause your baby to cry more than normal or for no known reason. This can make it harder to breastfeed him. If your baby breastfeeds right after you smoke, he may have trouble sleeping as long or as well. Your baby also may be able to taste nicotine in your breast milk.
  
  
• Higher risk for health problems caused by breathing in cigarette smoke (secondhand smoke). These problems include ear or lung infections and asthma. Your baby's risk for sudden infant death syndrome (SIDS) may also increase if he breathes in cigarette smoke.
  
  
• Higher risk of your baby having long-term problems with learning and behavior. If you smoke, your baby is also more likely to smoke later in life.

If I smoke when breastfeeding, how can I reduce smoking’s harmful effects?

If you smoke, quit. Not smoking is best for your health and the health of your baby. Talk to your caregiver if you need help quitting smoking. If you choose to smoke, you should breastfeed because breast milk helps protect your baby from smoking's harmful effects. Breastfeeding may help prevent colds, colic, and SIDS. The following may reduce the harmful effects of your smoking on your breastfed baby:

• Smoke fewer cigarettes. If you smoke less, your baby may have fewer problems caused by your smoking.
  
  
• Do not smoke in your home. Go outside to smoke. Do not allow others to smoke in your home.
  
  
• Wait to smoke until after a breastfeeding session. The harmful chemicals in your breast milk decrease about one hour after you finish smoking.

Should I drink alcohol when breastfeeding?

When someone drinks alcohol, it goes into that person’s bloodstream. For a breastfeeding mother, the alcohol then goes into her breast milk. If you breastfeed, avoid drinking alcohol. Alcohol is found in adult drinks, such as beer, wine, and whiskey. When you drink alcohol, it affects your breastfed baby in the following ways:

• He may drink less breast milk.
  
  
• He may sleep less than he needs.
  
  
• He may get less breast milk than he needs. Drinking five or more drinks of alcohol decreases your ability to make milk. A low milk supply may stop your baby from gaining weight as he should.
  
  
• He may not be cared for as well. When you breastfeed, it takes less alcohol to affect the way you think and act. Binge drinking is when you drink five or more drinks during one time frame. Drinking alcohol or binge drinking makes you less able to respond to and show care and concern for your baby.
  
  
• His growth may be affected. An infant’s brain keeps developing after he is born. Drinking alcohol or binge drinking while breastfeeding can cause long-term problems with your baby’s brain development.

If I drink alcohol, how can I reduce its harmful effects?

If you plan to drink alcohol, feed your baby first. Wait two or more hours after drinking one drink before breastfeeding. One drink is the same as one ounce of liquor, four ounces of wine, or 12 ounces of beer. Waiting this amount of time allows alcohol in breast milk to decrease. If you abuse alcohol, talk to your caregiver. Alcohol abuse is when you drink too much alcohol or drink it too often. If you abuse alcohol, you may not be able to breastfeed. Ask your caregiver to help you stop abusing alcohol.

Should I use illegal drugs when breastfeeding?

• You should not use illegal (street) drugs. When someone uses a street drug, it goes into that person’s bloodstream. For a breastfeeding mother, the drug then goes into her breast milk. Drugs that are very harmful include cocaine, heroin, LSD, marijuana (pot), methamphetamine (meth), and phencyclidine (PCP). Inhalants (drugs that are breathed in) are also very harmful and should not be used. If you use street drugs now, or have used them in the past, talk to your caregiver about breastfeeding. Problems caused by using street drugs when breastfeeding include:
  
  
  • Intoxication. Your breastfed baby can become high or stoned from the drugs that you use. This is very damaging to your baby.
    
    
  • Growth problems. The development of your breastfed baby may be affected by the drugs that you use.
    
    
  • Decreased breast milk production. Your breastfed baby may not gain weight as he should.
  
  
• If you quit using drugs before or during your pregnancy, do not begin using them again after your baby is born. If you are being treated for substance abuse and agree to stay in treatment, you may be able to breastfeed. If you have not used drugs or alcohol for at least three months, you may be able to breastfeed. You may need to give samples of urine for tests. If the tests show that you are not using drugs, you may be able to breastfeed. Ask your caregiver if it is safe for you to breastfeed your baby.
  
  
• If you started using drugs again while breastfeeding, stop breastfeeding and see caregivers right away. If your caregiver tells you that you cannot breastfeed your baby, you will need to bottle-feed him. The milk that you give your baby can be from a donor milk bank, or he may drink infant formula. If you need to bottle-feed your baby, ask your caregiver for more information.

What should I know about taking prescribed or over-the-counter medicines and breastfeeding?

• The medicine that you take may go into your breast milk and affect your breastfed baby. Tell caregivers about all of the medicines you use, including nonprescription (OTC) medicines. Tell caregivers how often and how much medicine you use. You may need to take medicine that is or may be unsafe while breastfeeding. Caregivers may change the type or amount of medicine that you take. You and your caregiver can make a plan for you while you are taking medicine and breastfeeding your baby.
  
  
• Medicine to decrease pain or anesthesia used during labor and delivery may affect breastfeeding. Your baby may have trouble latching on to your breast or feeding for 24 hours. To help your baby breastfeed, hold him close to you, with his skin touching yours. You also may need to express milk to feed your baby. Ask your caregiver for more information about expressing milk.
  
  
• Certain medicines can decrease your milk supply, make your breastfed baby very sleepy, or affect your baby in other ways. You may need to wait after taking certain medicines before breastfeeding your baby. Tell caregivers if you use any of the following types of medicine. Ask your caregiver how your medicine affects breastfeeding:
  
  
  • Antianxiety medicine: This medicine may be given to decrease anxiety and help you feel calm and relaxed.
    
    
  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
    
    
  • Anticonvulsant medicine: This medicine is given to control seizures. Take this medicine exactly as directed.
    
    
  • Antidepressants: These medicines can help prevent or treat depression (deep sadness).
    
    
  • Antihistamines: This medicine may be given to help decrease itching.
    
    
  • Birth control pills: These medicines contain hormones that help prevent pregnancy. Certain birth control pills cannot be taken soon after having a baby because they increase your risk of getting blood clots.
    
    
  • Blood pressure medicine: This is given to lower your blood pressure. A controlled blood pressure helps protect your organs, such as your heart, lungs, brain, and kidneys. Take your blood pressure medicine exactly as directed.
    
    
  • Blood thinners: This medicine helps stop clots from forming in the blood.
    
    
  • Ergot alkaloids: These medicines are used to treat certain types of headaches and hormone-related diseases.
    
    
  • Heart medicine: This medicine may be given to make your heartbeat stronger or more regular.
    
    
  • Mood stabilizers: These medicines are used to decrease mood swings.
    
    
  • Narcotic analgesics: These are strong pain medicines that are ordered by your caregiver.
    
    
  • Nonsteroidal anti-inflammatory medicine: This medicine decreases pain, swelling, and fever.
    
    
  • Sedative: This medicine is given to help you stay calm and relaxed.

What can I do to cope with the effects of medicines that I need to take when breastfeeding?

• If you are taking medicine or getting treatments that can harm your breastfed baby, you may need to add bottle-feeding. Pump and store breast milk before starting your medicine or treatments. This milk can later be bottle-fed to your baby. You may also give him breast milk from a donor milk bank or infant formula. Talk to your caregiver if you need to add bottle-feeding to your baby’s diet.
  
  
• If you need to use short-term medicine that may be harmful to a breastfed baby, express your milk and dump it out. Expressing or pumping your milk until you can breastfeed again will help your breasts keep making milk. Bottle-feed your baby until your caregiver tells you that it is safe to breastfeed again.
  
  
• If your medicine decreases your milk supply, breastfeed, express, or pump your breasts more often. Doing this can increase your supply of milk. Ask your caregiver about using a galactogogue. This type of medicine or herb may help your breasts make more milk.
  
  
• If you are being treated for cancer or certain medical conditions, you may need to wait for a while after treatment before breastfeeding. The substances used in certain treatments may harm your breastfed baby. These substances include antimetabolites, radioactive isotopes, and chemotherapy medicine. If you are taking medicine or getting treatments that can harm your breastfed baby, you may need to add bottle-feeding. If you have questions about receiving these treatments while breastfeeding, talk to your caregiver.

When should I follow up with my caregiver?

Caregivers will want to see you and your baby for follow-up visits soon after his birth. Keep all appointments. At these visits, caregivers will talk to you about feeding your baby, and he will be weighed. Tell caregivers about changes in your baby, such as if he has trouble breathing or is sleepier than usual. Write down any questions that you have. This way you will remember to ask these questions during your next visit.

Where can I find more information?

Talk to your caregiver about the effects of smoking, drinking alcohol, and taking illegal drugs or medicines on breastfeeding. Contact the following:

• American Academy of Pediatrics
  141 Northwest Point Boulevard
  Elk Grove Village , IL 60007-1098
  Phone: 1- 847 - 434-4000
  Web Address: http://www.aap.org
  

When should I call my caregiver?

Call your caregiver if:

• You cannot make it to a follow-up visit with your or your baby's caregiver.
  
  
• Your baby is four or more days old and has less than six wet diapers each day.
  
  
• Your baby is four or more days old and has fewer than three stools each day.
  
  
• Your baby is breastfeeding less than eight times each day.
  
  
• Your baby is not gaining weight or looks like he is losing weight.
  
  
• Your baby does not seem to latch on to your breast correctly.
  
  
• Your baby acts fussy or shows signs that he is still hungry. These signs include looking more awake, being more active, mouthing, or rooting. Mouthing is when your baby puts his hands in his mouth or acts like he is sucking. Rooting is when your baby opens his mouth and turns his head to where his cheek is touched.
  
  
• You feel you are not making enough breast milk for your baby.

When should I seek immediate help?

Seek care immediately or call 911 if:

• Your breastfed baby has breathing problems, seems more sleepy than usual, or is not breastfeeding as long or as well.
  
  
• Your breastfed baby feels cold or shivers, or his skin looks blue or white.
  
  
• Your baby shows signs of dehydration, such as sunken eyes, dry skin, fast breathing, or few or no wet diapers. He may also act very tired, irritable, or unwell, or he may not be responding to you. He may also have a very fast heartbeat.
  
  
• You have been breastfeeding and drinking more alcohol than your caregiver says is safe.
  
  
• You have been using street drugs and breastfeeding.
  
  
• You have been taking medicines that your caregiver told you not to take when breastfeeding.

Care Agreement

You have the right to plan how you are going to feed your baby. To help with this plan, you need to learn as much as you can about breastfeeding. You also need to learn about the effects of smoking, drinking alcohol, and taking medicines or illegal drugs on breastfed babies. Ask your caregiver any questions you have about breastfeeding. Your caregiver can tell you the best way for you to feed your baby.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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