Just wanted to add my 2 cents:

I agree with those who have posted, suggesting that moms who are alcoholic
and in relapse are not the best breastfeeding candidates.  In addition to
considering the amount of alcohol that an infant may receive via breastmilk,
I would be very concerned about a mom who is unable to control her drinking
(characteristic of alcoholism) and goes into a black out (period of memory
loss that occurs during drinking for some alcoholics).   It is difficult
enough to parent fully conscious.

However I would take this issue one step further.  A mom who admits to her
alcoholism and the fact that she is drinking again and in relapse may also be
asking for help!  Yes, denial is characteristic of alcoholism and addiction.
 Yes, these diseases are chronic and progressive.  However people can and do
go into recovery and stay in recovery.

This would be a great opportunity for that woman's support person (be it
lactation consultant, LLL leader, other health care provider, friend) to
provide information on resources for recovery.  Alcoholics Anonymous and
Narcotics Anonymous are the oldest recovery fellowships based on 12 steps.
 However there are many other recovery programs including Women for Sobriety,
Secular Organizations for Sobriety, Rational Recovery, faith based
organizations that provide recovery programs (including the Salvation Army,
Gospel Mission, Nation of Islam and other church related groups) as well as
private and publically funded treatment programs specifically for parenting
and pregnant women.

Providing lactation support is key to a great start for mother and child.  I
also think providing information, referral and support for women  to start
recovery can have long term positive effects for the woman as well as her
entire family.

Yes, addiction is an equal opportunity destroyer.  However there is great
hope with recovery.

Pierrette Mimi Poinsett MD FAAP
steering committee member
Stanislaus County Perinatal Substance Abuse Coalition
Modesto CA