This is from my saved file :

It takes one - three hours for alcohol to clear from the breast milk, Adult
metabolism of alcohol is approximately 1 oz in three hours.
Alcohol passes freely into mother's milk and has been found to peak about 30
to 60 minutes after consumption, 60 to 90 minutes when taken with food
(Lawton 1985). Alcohol also passes freely out of a mother's milk and her
system. It takes a 120 pound woman about two to three hours to eliminate
from her body the alcohol in one serving of beer or wine (Schulte 1995).
However, the more alcohol that is consumed, the longer it takes for it to be
eliminated. It takes up to 13 hours for a 120 pound woman to eliminate the
alcohol from one high-alcohol drink. The effects of alcohol on the
breastfeeding baby are directly related to the amount the mother consumes.


Definitions:

occasional drink- one or fewer drinks per day > 1 oz.
moderate to heavy or chronic- two or more drinks per day < 2.5 oz.

AAP states, AAP considers occasional alcohol consumption compatible with
breastfeeding.  Alcohol passes freely into and out of mother's milk and has
been found to peak about 30--60 minutes after consumptions, or 60 --90
minutes when taken with food.  (AAP Comm. on Drugs) Pediatrics 1994; 93(1):
137-55.

Factors affecting alcohol absorption:

maternal wt, amount of adipose tissue (120 lb. woman takes 2-3 hours to
eliminate 1 oz.) food in mother's stomach, speed of consumption, and
estrogen levels.

Infant age and wt, exclusive breastfeeding

Some effects:

decreases milk-ejection reflex
inadequate caregiving skills
drowsiness, deep sleep, sleep disorders
weakness, decrease in linear growth
abnorlmal wt. gain
change in ordor of milk
lower psychomotor skills

Of course, please note that some of the above effects are only seen when the
mother is a heavy, chronic drinker and the baby is young, and/or small.

My experience has been to suggest that the mother breastfeed just before
consuming alcohol.  Even better would be if she eats something with protein
in it, then have her wine, or beer or whatever.

Anderson, P. Drug use during breastfeeding.  CLin Pharmacy 1991:
10:594-623.

Briggs, G., Freeman, R., and Yaffee, S. Drugs in Pregnancy andLcatation, 4th
ed.

Carlson, H. et al. beer-induced prolactin secretion:  a clinical and
laboratory study of the role of Salsolinol. J. Clin. Endocrinol Metab.
1985; 60:673.

Little, R. et al. Maternal alcohol use during breastfeeding and infant
mental and motor development at one year. New England J Med. 1991;
325(14): 981-85.

Menella, J.A. and Gerrish, C. J. effects of exposure to alcohol in mother's
milk on infants sleep. Pediatrics 1998; 101(5):e2.

Schulte, P. Minimizing alcohol exposure of the breastfeeding infant.  J
Humam Lact 1995; 11(4):317-19.



Alcohol Clin Exp Res 1997 Jun;21(4):581-585


Infants' suckling responses to the flavor of alcohol in mothers' milk.

Mennella JA
Monell Chemical Senses Center, Philadelphia, PA 19104, USA.

Contrary to medical folklore, previous research has demonstrated that
alcohol consumption by lactating women diminished milk intake by their
infants during breast feeding. To determine whether this decrease in milk
consumption was due to the infants responding to the altered flavor of the
milk that also resulted, we evaluated the infants' intake and sucking
responses to alcohol-flavored human milk outside of the context of breast
feeding, thereby separating the changes due to the infants response to the
flavor from any other changes that could also result from acute maternal
alcohol consumption such as alterations in milk ejection or the composition
of milk. The testing procedure consisted of a two-bottle preference test
that was composed of four, 60-sec trials in which the mother's milk flavored
with alcohol was alternated with the mother's milk alone in an ABBA or BAAB
design. Attached to the nipple of each bottle was a transducer that
responded to pressure changes produced by the infants' suckling. There was
no suppression of sucking or intake in response to the ethanol-flavored
milk. Rather, the infants consumed significantly more and sucked more
frequently when drinking the alcohol-flavored milk compared with the
unaltered milk. That experience with the flavor of alcohol in mothers' milk
modified the infants' responses to alcohol flavor is suggested by the
relationship between the reported frequency of mothers' drinking during
lactation and the infants' rhythm and frequency of sucking when feeding the
alcohol-flavored milk. These findings indicate that infants can readily
detect the flavor of alcohol in mother's milk but that the decrease in
consumption at the breast after maternal alcohol consumption is apparently
not due to the infants rejecting the flavor of alcohol in their mothers'
milk.

Publication Types:


Clinical trial
Randomized controlled trial
PMID: 9194908, UI: 97338348

Dev Psychobiol 1993 Dec;26(8):459-466


Beer, breast feeding, and folklore.

Mennella JA, Beauchamp GK
Monell Chemical Senses Center, Philadelphia, Pennsylvania 19104.

Beer consumption by nursing women altered the sensory qualities of their
milk and the behavior of their infants during breast-feeding in the short
term. The infants consumed significantly less milk during the 4-hr testing
sessions in which their mothers drank alcoholic beer compared to when the
mothers drank nonalcoholic beer; this decrease in milk intake was not due to
a decrease in the number of times the babies fed. Although the infants
consumed less of the alcohol-flavored milk, the mothers believed their
infants had ingested enough milk, reported that they experienced a letdown
during nursing, and felt they had milk remaining in their breasts at the end
of the majority of feedings. Moreover, the mothers terminated the feeds the
same percentage of time on both testing days. The mechanism by which the
consumption of alcoholic beer by lactating women decreases milk intake by
their nurslings remains to be determined.

PMID: 8293892, UI: 94123877y

N Engl J Med 1989 Aug 17;321(7):425-430


Maternal alcohol use during breast-feeding and infant mental and motor
development at one year.

Little RE, Anderson KW, Ervin CH, Worthington-Roberts B, Clarren SK
Department of Epidemiology, University of Michigan, Ann Arbor 48109.

The detrimental effects of maternal drinking during pregnancy on fetal
health have been documented. The consequences for infants of maternal
drinking during breast-feeding are unknown, but research in animals suggests
that the infant could be affected by exposure to alcohol through the
mother's milk. In a study of 400 infants born to members of a health
maintenance organization, we investigated the relation of the mother's use
of alcohol during breast-feeding to the infant's development at one year of
age. Mental development, as measured by the Bayley Mental Development Index
(MDI), was unrelated to maternal drinking during breast-feeding. However,
motor development, as measured by the Psychomotor Development Index (PDI),
was significantly lower in infants exposed regularly to alcohol in breast
milk (after alcohol exposure during gestation was controlled for), with a
dose-response relation (P for linear trend, 0.006). The infants of
breast-feeding mothers who had at least one drink daily had a mean PDI score
of 98, whereas the infants exposed to less alcohol in breast milk had a mean
PDI score of 103 (95 percent confidence interval for the difference of the
two means, 1.2 to 9.8). The effect was more pronounced when mothers who
supplemented breast-feeding with formula were excluded from the analysis.
The association persisted even after we controlled for more than 100
potentially confounding variables, including smoking and other drug use
during pregnancy and in the postpartum period. We conclude that ethanol
ingested through breast milk has a slight but significant detrimental effect
on motor development, but not mental development, in breast-fed infants.

Comments:


Comment in: N Engl J Med 1990 Feb 1;322(5):338-9
PMID: 2761576, UI: 89344136

Aust N Z J Obstet Gynaecol 1985 Feb;25(1): 71-73


Alcohol in breast milk.

Lawton ME
At fixed intervals after the ingestion of alcohol by 8 nursing mothers, sets
of breast milk and blood samples were collected and their alcohol levels
compared. One set of milk samples was solely hind-milk while the remainder
were fore-milk samples. The results showed that alcohol appeared quickly in
both fore- and hind-milk at a level equivalent to or higher than the
corresponding blood samples. Elimination of alcohol from the milk was
closely related to its elimination from blood and was unaffected by breast
feeding. However, despite this, the large dilution of the alcohol contained
in the milk by the baby's body water renders the baby's resultant blood
alcohol level very low in all but the most extreme cases.

PMID: 3862407, UI: 85306782

Cindy Curtis RN IBCLC CCE
http://www.breastfeedingonline.com
mailto:[log in to unmask]

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