In a message dated 11/18/2005 12:08:51 AM Eastern Standard Time,
[log in to unmask] writes:
When it comes to the brain of a developing newborn, I'd rather err on the
side of safety with alcohol and suggest a moderate approach such as the
Institute of Medicine recommendations - not too restrictive, but still protective.
Yesterday, Rachel Myr just gave us one more reason to
suggest sensible moderation in terms of the mother's ability to care for her
infant.
Dear Friends:
Susan's lovely post gives lots of pertinent details about sample size
and reminds us that p values are the most telling.
One problem with the Menella study about alcohol is that the amount the
baby ingested at a feed before the mother drank was taken as baseline. As we
know amounts ingested vary among feeds. Who is to say that some babies taking
less at a subsequent feed means anything?
I am also concerned about this "err on the side of safety" notion.
Everyone has their own interpretation of that, which leads to non-evidence based
practice. A classic example of that is the Physician's Desk Reference which
says that no drug is safe to take while breastfeeding.
I don't know of any study showing that a mother breastfeeding and
drinking alcohol has harmed any infant (and I am not talking about the drunken
mother that rolled over on her baby, which is a different and serious concern). I
am talking about the baby ingesting some molecules of alcohol because the
mother has had some alcoholic drink. Even the Little study could not be
replicated.
Of course if mom is drinking, then we have to raise the question about
how safe her baby will be if she does become inebriated.
Even the concept that drinking alcohol when pregnant is controversial
when one examines the evidence from other countries. Some european countries
tell pregnant women that 7 units of alcohol per week is alright, as long as
they are spread out over the week and not all in one day; there is evidence to
base this recommendation.
In the States, women are told 'no alcohol' while pregnant, in part
because health care providers don't trust that adult women can be responsible, and
because FAS and related syndromes are serious public health issues. I see
the blanket prohibition as an extreme, which creates its own problems, the
least of which is that folks lie about what they are doing.
As for the notions about pumping and dumping, I see elements of morality
and fear upon which the recommendations are made. We are all upset about
those when applied to bed-sharing, yet many will accept them when applied to
alcohol.
Alcohol has been part of human history for eons.....................I am
not aware of any cultural beliefs about alcohol and breastfeeding except for
the Irish notion that Guiness is good for nursing mothers. Are there any
others in the world?
warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Maternal-Child Adjunct Faculty Union Institute and University
Film Reviews Editor, Journal of Human Lactation
www.breastfeedingalwaysbest.com
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