You’ve decided breastfeeding is best for your baby – but should you stay off the bottle yourself? Women are often warned to not consume alcohol during pregnancy, as there is plenty of evidence that it poses a severe and avoidable risk to the unborn baby.

The risks of consuming alcohol while breastfeeding are not as well known. Breastfeeding mothers receive conflicting advice about whether alcohol consumption can have an effect on their baby, which often leaves mothers feeling like they have more questions than answers.

Effects of drinking and breastfeeding

The level of alcohol in breast milk remain close to those in the mother’s bloodstream. Levels will be at their highest between 30 and 60 minutes after drinking, or 90 minutes if you’ve been drinking with a meal. It takes two hours for a unit of alcohol (a small glass of wine, or half a pint of ordinary-strength beer) to leave a mother’s blood.

While large amounts of alcohol in breast milk can have a sedative effect, it’s more likely to make your baby agitated and disrupt sleep patterns. Alcohol also inhibits a mother’s let-down (the release of milk to the nipple). Studies have shown that babies take around 20% less milk if there’s alcohol present, so they’ll need to feed more often.  Some babies may notice an altered taste to the milk and refuse it altogether.

Within Reason

First-time mums often choose to avoid alcohol altogether, but those who already have children tend to be less concerned.

If you do want to have a drink, have one with a meal shortly after feeding your baby so there is time to process the alcohol before the baby needs to feed again.  But it is still advisable to make alcohol the exception rather than the rule – that means only having a drink once or twice a week maximum.

Because alcohol does not stay in breast milk forever, there is no need to express milk that may be tainted with alcohol only to throw it out. The alcohol in breast milk goes back into the bloodstream as the alcohol leaves the mother’s system. If you wait to breastfeed three or more hours after drinking, your breast milk will have naturally cleared the alcohol. If you plan to drink heavily, you may consider expressing before you start drinking so you have breast milk free of alcohol on hand to feed your baby.

Moderate to heavy drinking while breastfeeding can have a detrimental effect on your baby in terms of their physical growth and appearance as well as gross motor skills. For these reasons, as well as the impact heavy drinking can have on your ability to care for your young child responsibly, it is wise to avoid moderate to heavy drinking while breastfeeding.

A baby who has long sleep at night may allow mothers to drink one alcoholic drink. However, this is not advisable due to safety reasons. Alcohol intoxication prevents you from caring for your baby safely. In addition, if you are co-sleeping with your baby, avoid alcohol because the effects of alcohol can increase the risk of suffocating the baby.

An infant’s liver is very small and immature, which makes alcohol processing slower. Studies on body processes show that babies three months and below process alcohol at half the rate compared to adults.  Although the harms of alcohol and breastfeeding lack significant evidence, experts recommend total alcohol abstinence for breastfeeding mothers until the infant reaches its third month.

Alcohol intake causes dehydration, which adds up to lack of fluids caused by breastfeeding. Drink a glass of water after or while drinking alcohol to counteract the effects of dehydration. Aside from fluid replenishment, drinking water can also decrease alcohol level on both blood and milk.

Abstinence

Many professional organisations advise abstinence during breastfeeding, and if you have any doubts about your ability to manage and limit your alcohol intake, then abstinence is the safest option.

Women coping with post-natal depression, or who are managing without much extra support, would be advised to avoid alcohol because it can be easy to blur the boundaries.

Some practical tips for cutting down on alcohol:

  • Opt out of rounds.Drinking in rounds can make you drink a lot faster than you’d like or realise. Opt out or try choosing non-alcoholic options.
  • Watch out for cocktails.They can contain more alcohol than you might think.
  • Invest in a nonalcoholic drink recipe book. Get creative with non-alcoholic cocktails.
  • Try smaller measures.If you are drinking wine, opt for a small glass.
  • Go diluted.Try a more diluted alcoholic drink such as a spritzer or shandy.
  • Space with soft drinks.Have a soft drink or two after an alcoholic drink to help you stay hydrated.
  • Be wary of people refilling your glass regularly – that one glass of wine can easily turn into several glasses without you realising. 
  • If you have a group of friends who encourage your drinking, make it clear what your limits are from the start, or minimise social events with them in the meantime.
  • Include food. Make sure you eat with your glass of wine or beer.
  • Seek advice. If you are really concerned about your drinking and need support, then seek professional advice and assistance.

Breast or bottle?

So would a woman who wants to enjoy a drink now and then be better off switching to bottle-feeding? The evidence suggests that breast milk from a mother, who has the occasional small glass of wine or beer is still better for the baby than formula.  Breast milk contains all the immunological and other special properties that are best for the baby.  The most important thing is to know your boundaries and stick to them.