Amber, you ask:

> In your professional opinions and with your
> experience, what would/do you recommend to your clients when this subject
> is brought up?
>
I tell mothers and health professionals to be reasonable.  Alcohol
metabolizes rapidly in a person's body.  The guidelines given by Dr.
Hale are excellent.  If the mother has a glass of wine or two with
dinner, she may want to anticipate this by nursing the infant
immediately prior to dinner, then wait 2-3 hours until the next direct
nursing - 4-5 hours if she has a hard liquor drink in addition to the
wine she's drinking (making a total of 3-4 alcohol servings).

The important thing for us to remember is that her milk does not hoard
the alcohol.  As her body metabolizes the alcohol, it clears her blood,
clears her brain, and clears her milk.  In general, we can tell a mother
that if she feels sober enough to drive, she is sober enough to
breastfeed.  This assumes the mother is not an alcoholic who doesn't
know when she's sober.

One other thing:  We can never counsel a mother about drugs or alcohol
without knowing how old the baby is.  A newborn has a very immature
liver.  Minute ammounts of alcohol would be more of a burden to this
infant.  A two-year old would have a better metabolism.  This isn't to
say that we can forget about our guidelines if the baby is a toddler,
but the mother has the right to know her toddler would be able to handle
the small amount of alcohol that may be in her milk if she uses the
earlier time-line (two hours instead of three, for instance).

Good luck with your studies in nursing school.  It would be helpful to
those of us on Lactnet if you post your synopsis of what you have
gathered and learned in this area.
--
Jeanne Mitchell, Austin, TX
http://www.flash.net/~xanth/home.htm
mailto:[log in to unmask]
"You can tell the quality of a person by how
they treat people they don't need." My Dad