Photo by Steve Woods

1. Nursing after 1 or 2 drinks (including beer) causes the infant to:
a) increase milk intake.
b) decrease milk intake.
c) Milk intake remains unaffected.

2. Nursing or pumping within one hour before ingesting alcohol:
a) does not affect the level of alcohol in the milk.
b) increases the level of alcohol in the milk.
c) decreases the level of alcohol in the milk.

3. Breastmilk alcohol levels are:
a) the same as blood alcohol levels.
b) higher than blood alcohol levels.
c) lower than blood alcohol levels.

4. While food consumption can delay the peak of breastmilk alcohol levels, the peak generally occurs:
a) one hour after ingestion of alcohol.
b) two hours after ingestion of alcohol.
c) three hours after ingestion of alcohol.

5. When a baby nurses after a mother consumes alcohol, the baby sleeps:
a) better.
b) worse.
c) the same.

6. True or false: The American Academy of Pediatrics rates alcohol as “usually compatible with breastfeeding.”
a) True.
b) False.

7. What minimum level of alcohol consumption affects infants negatively and is associated with shortened duration of breastfeeding?
a) Any alcohol consumption.
b) Casual alcohol consumption (1 drink per day).
c) Daily heavy use (more than 2 drinks daily).

8. One study estimated that a breastfed infant received a certain percentage of the mother’s weight-adjusted dosage of alcohol when she consumed 1.5 drinks. That percentage was:
a) between 0.5 to 3.3% of the mother’s weight-adjusted dosage.
b) between 3.3% to 5.0% of the mother’s weight-adjusted dosage.
c) between 5.0% to 8.3% of the mother’s weight-adjusted dosage.

The Answers

1. b. Nursing after 1 or 2 drinks can decrease the infant’s milk intake by 20 to 23% in the 3-4 hours after ingestion of alcohol. However, the infants increase the number of feedings over the next several hours and total milk consumption over 20 hours is the same. Smart babies!
2. c. Nursing or pumping within one hour before drinking alcohol may slightly decrease the amount of alcohol in the milk.
3. a. Breastmilk alcohol levels closely parallel blood alcohol levels.
4. a. Breastmilk alcohol levels peak approximately one hour after ingestion of alcohol, although food consumption can delay the peak.
5. b. Babies slept more frequently for shorter periods of time during the 3.5 to 4 hours after alcohol intake.
6. a. True, the AAP category is “usually compatible with breastfeeding.”
7. c. Heavy drinking is dangerous. Casual drinking is unlikely to cause short- or long-term effects particularly if the mother waits 2 to 2.5 hours per drink before nursing.
8. a. The study showed the breastfed infant received between 0.5 to 3.3% of the adjusted dose.

How did you do? What surprised you the most?

Post from: Breastfeeding 1-2-3

2. “Our” own Carnival of Breastfeeding regular Andi of Mama Knows Breast was on the CBS Early Show this morning to talk about the Facebook breastfeeding photo controversy. It’s well worth watching the five minute piece to see how Andi made some excellent points! Congratulations Andi!

Watch CBS Videos Online

3. Read the interesting article on the history of breastfeeding featured at Blactating today.

4. Tanya at the Motherwear blog has up her annual summary of the breastfeeding research for 2008.

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(Photo shown with permission by Larar)

The Womanly Art of Breastfeeding: 7th Revised Edition states:

The effects of alcohol on the breastfeeding baby are directly related to the amount the mother ingests. When the breastfeeding mother drinks occasionally or limits her consumption to one drink or less per day, the amount of alcohol her baby receives has not been proven to be harmful. If you enjoy an occasional glass of wine in the evening, or a cold beer on a hot summer day, there’s no reason to deprive yourself of this because you are breastfeeding.

p. 328. So, if a nursing mother sips a glass of champagne for a New Year’s toast, she need not worry about the level of alcohol in her breast milk.

But what if a mother consumes more than one drink–does she need to “pump and dump”? No, she simply needs to wait the requisite amount of time after drinking before nursing her baby (of course, if the mother begins to feel overly full or engorged during that time, by all means she should pump for her comfort). A mother does not need to pump to remove her milk, nor does pumping out the milk affect the rate at which alcohol leaves the mother’s system. The level of alcohol in the milk is the same as the mother’s blood alcohol level (you know, the one used to assess drunk driving). In Medications and Mothers’ Milk Thomas W. Hale, Ph.D. notes:

Adult metabolism of alcohol is approximately 1 oz in 3 hours, so mothers who ingest alcohol in moderate amounts can generally return to breastfeeding as soon as they feel neurologically normal.

p. 323. For more information, see this discussion.

Of course, some mothers may wish to abstain from drinking any alcohol while breastfeeding, or may wish to know that any alcohol has left their system entirely before breastfeeding again. That’s where the new Milkscreen test comes in. It’s a two-minute test for the detection of alcohol in breast milk. The nursing mother saturates a reactive pad with her milk, waits two minutes, and looks for a color change indicative of the presence of alcohol in the milk. The company sells the tests for $19.95 for a box of six test strips. It’s also available through other retailers.

What is controversial about the test? The worry is that the existence of this test might scare mothers into thinking that they should not enjoy an occasional drink while nursing (and that in turn might cause them to decide to wean). I think the test is fine for nursing mothers who would like that peace of mind before breastfeeding again. I do not think the test is generally necessary. Of course if a mother feels impaired, she should not breastfeed. If she does not feel impaired and she has waited 2-3 hours per drink consumed, she can rest assured that it is safe to nurse again.

Post from: Breastfeeding 1-2-3