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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