Dear Jaye,

Thank you so much for bringing this up!  It is one of my bug bears.  As a 
currently nursing mother, it drives me round the bend that women are 
supposedly too dumb to do the maths on this.   I field questions on this one 
a great deal, and many mothers are shocked by the actuality of the matter, 
rather than the prejudice.  Commonly, it arises with a post that says "I 
went out for my birthday last night and I didn't intend to drink and then I 
had three small glasses of wine over a six hour period.  I did pump and dump 
but please tell me I'm not harming my baby."

What drives me mad about this is that the mother has had a wonderful time 
out, and then is wracked with guilt that she has harmed her baby.   As Jack 
Newman says, just another way to present breastfeeding as difficult.

Apart from the issue of the blood level being low, alcohol is processesed 
out of the milk at the same rate as the blood - one unit per hour for the 
'common' range of body types etc.  So by the time you explain the blood 
level thing, and the time equation, most are reassured, but the very nature 
of their worry sets up even more expectation of risk.

Also, this is one area I've found, personally, that other breastfeeding 
mothers can be very judgemental.  There are those who equate having a drink 
whilst breastfeeding, with child neglect - and many will state this quite 
openly.  Recently in the online forum I post into, one mother posted about 
the dip in tester - as a way of passing on info that might reduce worry - 
and was faced with quite a sharp response about how no mother should be 
drunk in charge of a child, regardless of alcohol levels getting through to 
the baby!  One drink and you are the devil's handiwork!

Clearly, as I'm sipping a Gin & Tonic as I type, I do not hold to this view.

There are 3 issues I feel that need addressed about mother's drinking 
alcohol during a nursing relationship:

1) Do they understand the alcohol intake/blood and milk levels/alcohol 
processing equation?

Some sites on this will actually give a formula, which I find impossible to 
do!  I give the sites for them to find, and tell them that for a women of 
'normal' weight, who has eaten something, one unit of alcohol will peak in 
her milk anywhere from 30 to 90 minutes, and then dissipate over the 
following hour.   So if you wish to drink and be sure no alcohol is getting 
into the milk, act accordingly.  Equally, it's useful for them to know that 
as a rough rule of thumb, the level of intoxication they are feeling, is 
what the baby would be feeling if they nursed right now.  This analogy errs 
on the side of caution, as supported by your expert.  Informed choice is the 
key here.

  1a)  A curious sideline to above, is that most reccomendations are not to 
drink your glass of wine until after you finish breastfeeding.  I find this 
a complete nonsense.  When my baby was a newborn, I had my small glass of 
wine as he nursed.   Safe in the knowledge that the alcohol wasn't going to 
even get into my system until he'd finished feeding, and that it would most 
likely be completely gone by the time of the next feed.  Waiting until after 
the feed, reduces the clear out time before the next one.  I have no idea 
why the reccs make this statment, and would be interested in finding out.

2)  Is the mother bed sharing?

There are issues about safe sleeping, even with only a little drink.  I 
personally never drink in the evening if my husband (who cannot drink) is 
not also in the family bed.  As I have a huge toddler, this is probably no 
longer an issue, but where I draw a personal line.  My advice to any mother 
of a young baby who is in the bed, would be to make sure all alcohol is out 
of her system before she retires for the evening.  So a glass of wine early 
in the evening, either while she nursed, or was at dinner, would be fine.

3)  Has the baby had any medication?  Regardless of intoxication levels in 
the infant, that young liver will process what is there.  If my child has 
had any medication - such as for pain releif, I will not drink at all.  No 
matter how small the level is, that little liver needs all the help it can 
get processing the pain meds.

Finally, it's worth noting that many mothers still report that a glass of 
wine helps them with let down, and many ask if this is safe.  I always 
report that the science states alcohol inhibits letdown, but that many 
mothers do say it helps.

The other issue that does arise is what type of alcohol.  Stout, a very dark 
beer, has the most bio-available form of iron for the human body.  So 
sometimes, I suggest a small drink of stout, for iron, for both pregnant and 
breastfeeding mother.  In the UK, stout was once availble on prescription 
from the GP!

I also drank during my pregnancy, on the advice of a pediatrician who felt 
that one small glass of red wine per day, helped both mother and child.  Her 
opinion was based on research.  My midwife, GP and obstetrician also 
approved.  Now, if you think telling anyone you have a small drink when 
nursing is contentious, try mentioning the whilst pregnant one.

Isn't it curious, I now feel the need to point out I don't have an alcohol 
problem!

*hic*

Morgan  Gallagher
Online Lactaneer
Nursing a 26 month old

>Date:    Wed, 28 Mar 2007 12:35:49 -0700
>From:    "Jaye Simpson, IBCLC" <[log in to unmask]>
>Subject: Re: Alcohol and BF
>
>Hi All,

>I recently attended a conference in my hometown where a very well known
>speaker made the following comment:  The subject of alcohol came up.  His
>comment was that while mom may be drinking 14% (or whatever percent her
>alcoholic drink of choice may have) that is NOT what the baby is drinking.
>Even if mom is legally drunk - .08% alcohol content - that .08% is what the
>baby is drinking.  The baby's body then processes that amount down even
>more.  His comment then was that, unless mother is so drunk she cannot hold
>or care for the baby, she might as well breastfeed because the baby is not
>going to get enough alcohol to be affected.  He did add a qualifier stating
>that there would probably be many who would be shocked at this idea.I 
>admit,
>at first I was - but then started really thinking about the numbers.and
>realized that it really did make sense.

>So - What say you all?

>If this information is correct and makes sense then we can simply tell moms
>that this little 'test' is totally unnecessary - they are testing for
>alcohol in breastmilk - with that are they being given the percentage of
>alcohol in the breastmilk with this test AND more importantly - is there 
>any
>information on how the baby's body will process that amount?

>Jaye

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