Dear follow Lactnuts,

On the issue of alcohol lots have been said and lots not.
Susan Burger reminded us that absence of evidence does not equal evidence of absence, which we surely always must keep in mind when looking for scientific grounds for our recommendations. Nikki Lee points out that the exact alcohol amount in milk might not be as big an issue as the mothers capability to safely and responsibly perform her parental tasks after alcohol consumption. I agree that this probably is true.
What has not been said (or what I've missed when still on no-mail) is the issue of weighing of risks and preserving breastfeeding. If mom has been drinking and is not allowed or chooses not to breastfeed what will baby have instead? Can we assume she has a stash of frozen milk ''just in case''? Does she have a sister of friend who will feed her baby along with her own? Or will baby get ''just one bottle'' of formula? And how do we measure or compare the risks of a bottle of formula against the risks of one feeding with mom's milk with 0.2 promille of alcohol? do we choose the known risk or the not (yet) proven risk?
Another thing to consider is the risk that mother do not start breastfeeding or stop prematurely for the sake of being able to have a drink again after 9 months of abstinence. Is having an occasional alcoholic breastfeeding more dangerous than a full infant-life of formula?
Ofcourse we could try and have all women breastfeed and not drink alcohol. I think the chance for success is the same as just telling teens to not have sex and expect to see no more teen-pregnancies. As certain as teens will have sex when hormones rage, moms will breastfeed and have a drink. Better give full and honest information and ways to safely do what both teens and moms will do.

Warmly,

gonneke, IBCLC in PP, LC lecturer in southern Netherlands

 
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