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Effects of Smoking, Alcohol, and Medicines On Breastfeeding

Medically reviewed by Drugs.com. Last updated on Feb 6, 2023.

What do I need to know about the effects of smoking, alcohol, and medicines on breastfeeding?

Smoking, alcohol, and medicines can all affect breastfeeding. Substances can pass to your baby through your breast milk. This can cause problems for your baby.

How can I decrease the effects of smoking while breastfeeding?

Nicotine goes into your breast milk. Your baby can be exposed to these chemicals through breastfeeding and inhaling cigarette smoke. Smoking can also decrease the amount of breast milk you make. If you smoke, it is still best to breastfeed your baby. Breastfeeding can help protect your baby from breathing problems and sudden infant death syndrome (SIDS). 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. You can decrease the effects of smoking by doing the following:

  • Do not smoke or use e-cigarettes near your baby. Smoke outside when you can. Ask others to not smoke or use e-cigarettes in your home or near your baby.
  • Wait to smoke until after a breastfeeding session. The nicotine in your breast milk decreases about 1 hour after you finish smoking.

How can I decrease the effects of alcohol while I breastfeed?

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 decrease your milk supply. If you have an alcohol use disorder, you may not be able to breastfeed. Alcohol use disorder means you have trouble controlling your alcohol use. Talk to your healthcare provider about drinking alcohol while breastfeeding. Do the following to help decrease the effects of alcohol when you breastfeed:

  • Breastfeed your baby before you drink alcohol. 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.

What do I 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 much medicine you use and how often. Your healthcare provider may 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 birth control that does not contain estrogen. You can also use other forms of birth control, such as a condom, diaphragm, or cervical cap.

How can I decrease the effects of medicines while I am 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. 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 do I need to know about drugs and breastfeeding?

  • Do not breastfeed if you use drugs. Drugs pass from your bloodstream into your breast milk and are harmful to your baby's health. Some examples of 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.

When should I seek immediate care?

  • Your baby has breathing problems, seems more sleepy than usual, or is not feeding 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.

When should I call my baby's doctor?

  • 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 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 are not safe to take while breastfeeding.
  • You have questions or concerns about breastfeeding.

Where can I go for support and more information?

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

Care Agreement

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