Where I live, two bottles of vodka a week, is the norm for many young 
women, and two units of wine an evening, for drinking with dinner, would 
be seen as a minimal amount among well heeled professionals.  I've 
taught 14 year olds who were ingesting more than 2 units an evening on a 
regular and sustained basis.

Where I live, a glass of wine a day, is not seen as excessive during 
pregnancy, and the OB will support such.  The Government guidelines are 
actually confused on the issue, and many intelligent mothers have 
pointed this out.  Confused messages about alcohol breaks down 
confidence and does a lot of harm.

Which is why I feel that the breastfeeding and alcohol debate, should 
position itself at the gates of the 'safe drinking limits' for the 
mother, which is 2 units per day/14 units per week, which is the 
standard health guidelines for alcohol ingestion for an adult female.

It's ridiculous to me, to make comment on drinking in the mother, unless 
it's in terms of capability of taking care of the infant foremost, and 
then the health of the mother  from her alcohol ingestion. Where I live, 
very few women are not in good shape to care for their babies after 2 
units of alcohol ingested over a period of time.

What is a 'normal' amount of alcohol changes from cities to villages in 
one country, never mind from differing countries.  Likewise, what is a 
'moderate' amount changes.  Drinking alcohol is a huge cultural issue, 
and making judgements and pronouncements on anything other that the 
recommended health limits to the mother, fraught with danger for me.  
Not least of all, that in a culture that sees drinking alcohol as 
entirely normal and appropriate, stating "one or two glasses a week" is 
so below the normal ingestion levels, that it prevents some women from 
considering breastfeeding, as it is a significant intrusion on their 
normal lifestyle.

We have clear and well researched guidelines on the effects of alcohol 
in the adult female.  In the UK at least, huge amounts of money has been 
spent in getting that message across - the safe upper drinking limit for 
a female is 14 units of alcohol a week.  Above this level, health risks 
need to be seriously considered. As such, 2 units per day is not an 
issue in anyway: it is within recommended limits.  Staying within these 
guidelines makes more sense to me, in terms of getting mothers on board 
with breastfeeding.

I keep coming back to Nikki Lee's excellent point, that she wondered if 
alcohol proscription in mothers was about middle class concepts of what 
mothers, and mothering, should be.  Sticking to the 14 unit a week 
guideline removes all cultural influences from the discussion and moves 
it into science and research: and I do think this is desperately needed.

Apart from anything else, the other end of the spectrum in this debate, 
one rarely engaged with, is how much more risky is formula for the 
baby?  We acknowledge that a mother who smokes is still better off 
breastfeeding, as the baby is at so much more risk than if it was 
formula fed.  But somehow, that's impossible if it's alcohol 
consumption?  Mothers can drink and not put their babies at risk from 
neglect, and we need to respect that by not tying it to our own 
preconceptions of what 'a reasonable' amount is.

Morgan Gallagher


Rachel Myr wrote:
> Alcohol and breastfeeding is a topic about which we do not have 
> conclusive evidence on which to base sweeping recommendations.  I have 
> always maintained that it is misleading to focus on the minimal 
> alcohol content in milk, rather than on the issue of safety for 
> children when being cared for by adults who are not sober enough to 
> drive a car.  I would be concerned about any child whose mother wanted 
> to know it was all right to have two units of alcohol every single 
> day, because where I live that is very far from the norm for parents 
> of young children.

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