*Tobacco Smoking and Breastfeeding*

According to the United States Centers for Disease Control, 10.7% of
pregnant women smoke tobacco, with 50-80% of these mothers relapsing to
smoking within 6 months postpartum.

The article for this week’s Clinical Question of the Week is a literature
review of the impact of cigarette smoking on lactation, including
breastmilk composition and infant development.



*Which statement below do you think is false about the effect of maternal
cigarette smoking on lactation?*



1.       Mothers who smoke and breastfeed have a higher risk of mastitis
when they wean.



2.       Mothers who smoke and breastfeed make less milk.



3.       Tobacco smoking decreases the mother’s prolactin level.



4.       Tobacco smoking adversely affects the taste of breastmilk.



5.       Total fat in breastmilk is lower among mothers who smoke by 19-26%.



6.       Maternal smoking decreases iodine and vitamin C levels in the
breastmilk.



7.       Heavy smoking during pregnancy and breastfeeding is associated
with a higher rate of early age leukemia.



8.       Breastfeeding infants of smoking mothers have a 50% higher risk of
colic, and spend less time sleeping.



9.       A baby of a cigarette smoking mother has a lower risk of SIDS if
the mother breastfeeds.

Scroll down to see the answer - don't peek until you choose one!








The answer is 9



*Abstract*:



Environ Res. <http://www.ncbi.nlm.nih.gov/pubmed/27522570> 2016 Aug
11;151:321-338. doi: 10.1016/j.envres.2016.08.002. [Epub ahead of print]

*Tobacco smoking and breastfeeding: Effect on the lactation process, breast
milk composition and infant development. A critical review.*

Napierala M
<http://www.ncbi.nlm.nih.gov/pubmed/?term=Napierala%20M%5BAuthor%5D&cauthor=true&cauthor_uid=27522570>
1, Mazela J
<http://www.ncbi.nlm.nih.gov/pubmed/?term=Mazela%20J%5BAuthor%5D&cauthor=true&cauthor_uid=27522570>
2, Merritt TA
<http://www.ncbi.nlm.nih.gov/pubmed/?term=Merritt%20TA%5BAuthor%5D&cauthor=true&cauthor_uid=27522570>
3, Florek E
<http://www.ncbi.nlm.nih.gov/pubmed/?term=Florek%20E%5BAuthor%5D&cauthor=true&cauthor_uid=27522570>
4.

*Author information* <http://www.ncbi.nlm.nih.gov/pubmed/27522570>

*Abstract*

Approximately 10% of women report smoking during pregnancy. The number of
breastfeeding women who relapse back to smoking is even greater. Smoking
may cause adverse changes to the milk's composition by not only reducing
its protective properties, but also by affecting the infant's health. The
pathophysiological mechanisms underlying these adverse effects are not
entirely known. This article is a review of previous reports about the
effects of smoking on the lactation process, breast milk composition and
infant development. A systematic search for English language articles
published until 2015 was made, using a MEDLINE data. The key search terms
were "smoking and breastfeeding", "smoking and lactation", "smoking and
milk composition", "nicotine and breast milk". Studies have shown that
nicotine levels in breast milk of women who smoke are three times higher
than those in the plasma levels. Breast milk volume is reduced and the
duration of lactation period is shorter. Smoking causes adverse changes to
the milk's composition by not only reducing its protective properties, but
also affecting infants' response to breastfeeding and to breast milk.

Copyright © 2016 Elsevier Inc. All rights reserved.





Milk Mob Comment

By Anne Eglash MD, IBCLC, FABM

Sheesh! – What a smoking gun! There has been a great deal of research on
tobacco smoking and lactation- hence the large # of options in the question
this week!

We know that exposure to cigarette smoke is bad for infants, and in reality
for anyone. The question is whether a breastfeeding infant is partially
protected from those bad effects of cigarette smoke exposure. There are no
clear cut answers. The authors of this article point out that smoking
alters the biochemical composition of breastmilk, causing more infant
health problems such as increased colic, worsened sleep, and higher risk of
cardiac rhythm disorders.

The authors close with their recommendations on how a tobacco smoking
mother can reduce her infant’s exposure to tobacco-containing substances.
They suggest smoking as few cigarettes per day as possible, prevent infant
exposure to second-hand and third-hand smoke, and try to leave as much time
as possible between the last cigarette and time of breastfeeding.

There is no evidence that breastfeeding is contraindicated for tobacco
smoking mothers, but we need to work hard to minimize infant exposure to
tobacco through education during preconception, prenatal care, and
postpartum follow ups.



Keep your knowledge abreast with our Clinical Question of the Week!


-- 
posted for The Milk Mob by
Allison Laverty Montag IBCLC
Wisconsin USA

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