Maggie,

Chances are that if you tell this mother that she cannot BF and smoke, smoking
will win out.  It is a powerful addiction.

Instead you might discuss the hazard of smoking and formula feeding versus the
hazard of smoking and breastfeeding.  Yes she can breastfeed.  Discuss
management.  For instance, suggest that if she smokes, she might consider
doing so outside or at least in another room.  She should not be smoking in
the same room where the baby is.  Doing so will endanger her baby. She might
consider smoking after a feed rather than right before.  The nicotine levels
in her blood and milk first increase and then decrease over time.  The half
life is about 95 minutes.  Heavy smoking -- more than 20-30 cigarettes per day
-- may lead to a lowered milk supply.  There is some very good information in
the BREASTFEEDING ANSWER BOOK.

IMHO, no one will quit smoking unless THEY want to.  They have to do it for
themselves not for anyone (evey their baby) else.  That just doesn't work.  If
the desire is not there, it won't happen -- at least not for very long.  Some
of the "stop smoking" programs are quite good.  But don't push them.


Linda Barrett, IBCLC