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Effects of Smoking, Alcohol, and Medicines On Breastfeeding


Smoking, alcohol, and medicines can all affect breastfeeding. Harmful substances can pass to your baby through your breast milk. Learn about the ways that these affect breastfeeding so that you can safely breastfeed your baby.


Seek care immediately if:

  • Your baby has breathing problems, seems more sleepy than usual, or is not breastfeeding well.
  • Your baby feels cold, shivers, or his or her skin looks blue or pale.
  • Your baby shows signs of dehydration, such as sunken eyes, dry skin, fast breathing, or few or no wet diapers.

Call your baby's doctor if:

  • Your baby is 4 or more days old and has fewer than 6 wet diapers each day.
  • Your baby is 4 or more days old and has fewer than 3 bowel movements each day.
  • Your baby is breastfeeding fewer than 8 times each day.
  • Your baby is not gaining weight or looks like he or she is losing weight.
  • Your baby is crying more than usual.
  • Your baby is vomiting, or develops a skin rash.
  • You have been using illegal drugs and breastfeeding.
  • You have been breastfeeding and drinking more alcohol than your healthcare provider says is safe.
  • You have been taking medicines that you have been told not to take while breastfeeding.
  • You have questions or concerns about breastfeeding.

What you need to know about smoking and breastfeeding:

Breastfeeding mothers should not smoke. Nicotine goes into your breast milk. Your baby is exposed to these chemicals through breastfeeding and inhaling cigarette smoke. Smoking can also decrease the amount of breast milk you make. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine. Ask your healthcare provider for information if you currently smoke and need help quitting.

How to decrease the harmful effects of smoking while breastfeeding:

If you choose to smoke, it is still best to breastfeed your baby. Breastfeeding can help protect your baby from breathing problems and SIDS. You can decrease the effects of smoking by doing the following:

  • Do not smoke or use e-cigarettes in your home. Go outside. Do not allow others to smoke or use e-cigarettes in your home.
  • Wait to smoke until after a breastfeeding session. The harmful chemicals in your breast milk decrease about 1 hour after you finish smoking.

What you need to know about alcohol and breastfeeding:

Alcohol goes from your bloodstream to your breast milk. The amount of alcohol in breast milk is highest 60 to 90 minutes after you drink alcohol with a meal. Alcohol affects the taste of your breast milk and may cause your baby to drink less than normal. Drinking alcohol regularly or in large amounts can also decrease your milk supply. Alcohol may also affect your baby's sleep.

How to decrease the harmful effects of alcohol while breastfeeding:

If you plan to drink alcohol, breastfeed your baby first. Wait at least 2 hours after you drink before you breastfeed again. This will allow your body to get rid of the alcohol so the amount in your breast milk will decrease. If you abuse alcohol, you may not be able to breastfeed. Alcohol abuse is when you drink too much alcohol or drink it too often. Talk to your healthcare provider about drinking alcohol while breastfeeding.

What you need to know about medicines and breastfeeding:

  • Some medicines may go into your breast milk and affect your baby. Certain medicines can decrease your milk supply, make your baby very sleepy, or affect your baby in other ways. Tell your healthcare provider about all of the medicines you use, including over-the-counter medicines. Tell him or her how often and how much medicine you use. Your healthcare provider can usually recommend other safe medicines, if needed.
  • Medicine used during labor and delivery may affect breastfeeding. Your baby may have trouble latching on to your breast for the first 24 hours if you had anesthesia or medicine to decrease pain. To help your baby breastfeed, hold him or her close to you, with his or her skin touching yours. You also may need to express milk to feed your baby. Ask your healthcare provider for more information about expressing milk.
  • Talk to your healthcare provider if you want to take a birth control pill. Generally, birth control pills do not affect a breastfeeding baby. Some types of pills contain high doses of estrogen. This can decrease your milk supply. Ask your healthcare provider about types that do not contain estrogen. You can also use other forms of birth control, such as a condom, diaphragm, or cervical cap.

Decrease the effects of medicines while you are breastfeeding:

  • You may need to stop breastfeeding while you are taking certain medicines. You may need to express your milk and dump it out while you use certain medicines. You may need to do this if you take medicines for a short time that may be harmful to your baby. This helps your breasts to keep making milk until you can breastfeed again. If possible, feed your baby stored breast milk until your healthcare provider tells you that it is safe to breastfeed again. Rarely, you may need to stop breastfeeding completely if you need to take certain medicines for a long period of time. You can feed your baby stored breast milk, breast milk from a donor milk bank, or infant formula from a bottle.
  • Work with your healthcare provider to limit medicines. You may have to take some medicines while you are breastfeeding. If possible, take the lowest dose you can for the shortest time possible. Try to take short-acting medicines. For example, some allergy and cold medicines come in short- and long-acting forms. Short-acting forms mean they stay in your body a short time.
  • Time medicines according to your baby's breastfeeding needs. Take short-acting medicines right after a breastfeeding session. Take long-acting medicines right before your baby sleeps for the longest amount of time. These medicine timings will make it more likely the medicine will be out of your body before your baby's next breastfeeding session.

What you need to know about illegal drugs and breastfeeding:

  • Do not breastfeed if you use illegal drugs. Illegal drugs pass from your bloodstream into your breast milk and are harmful to your baby's health. Some examples of illegal drugs are cocaine, heroin, LSD, methamphetamine (meth), and phencyclidine (PCP).
  • The effects of marijuana on breast milk and a breastfeeding baby are not known. For this reason, it is safest not to use marijuana at all while you are breastfeeding. It is not safer to eat or drink marijuana than to smoke it. Talk to your healthcare provider if you use medicinal marijuana. He or she may be able to recommend other medicines to use until your baby is no longer breastfeeding. If you use medicinal marijuana for pain, your provider can recommend ways to control pain without medicine.

Follow up with your healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.

For support and more information:

  • American Academy of Pediatrics
    345 Park Boulevard
    Itasca , IL 60143
    Phone: 1- 800 - 433-9016
    Web Address:
  • La Leche League International
    957 North Plum Grove Road
    Schaumburg , IL 60173
    Phone: 1- 847 - 519-7730
    Phone: 1- 800 - 525-3243
    Web Address:

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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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