This letter is in response to the recent threads posted by Mary Ann Krainz
and Carole Jernigan regarding alcoholism and breastfeeding.  Alcoholism
currently is estimated to affect at least ten percent of the population,
including pregnant and breastfeeding moms.  If we expect breastfeeding to
become more mainstream, the issue of alcoholism and breastfeeding is going
to become more and more common.  The medical model of alcoholism regards
alcoholism as a disease.  It is important that lactation health care
providers, supporters and educators recognize options available to these
mothers and the role of lactation helpers in educating these mothers, and
mainstream health care providers.  If a mother with diabetes or heart
disease wrote in, we would have a wide range of resources within the
breastfeeding community to offer to these mothers.  We would not dismiss the
entire population as "tragic," and therefore, hopeless and dismiss this
population.  Lactation supporters are not expected to be social workers any
more than we are expected to be attorneys, pediatricians and obstetricians.
However, we have built a vast wealth of resources in the breastfeeding
community of helpful, breastfeeding-friendly attorneys, pediatricians and
obstetricians, hospitals, etc.  We also strive to educate mainstream service
providers about breastfeeding practices.  This resource-education network
can very well include chemical dependency.

The alcoholic breastfeeding mother is probably intensely aware of the
gravity of her situation.  For her to admit the severity of her drinking to
a lactation support person takes a degree of courage.  She probably lives in
a great deal of fear.  The lactating mother has an extremely high
motivational factor in seeking help for her alcoholism.  It would be much
simpler for her to just give her baby formula than to keep nursing her baby
and live in fear.  The desire to salvage the breastfeeding relationship is
an excellent motivational tool in helping the alcoholic mother to achieve
and maintain sobriety.  Most alcoholics seek treatment when there has been a
positive or negative change in their lives that is affected by their
alcoholism.  This is why many new moms seek treatment.  The mother who is
additionally trying to salvage a breastfeeding relationship has a double
motivation to seek treatment *and* to remain sober.  The fear of being
"found out" that she is breastfeeding and drinking heavily may prevent many
alcoholic lactating mothers from seeking treatment.  In addition, they may
be fearful of having to abandon the breastfeeding relationship in order to
enter treatment or comply with treatment options.


Here in Southern California, there is a chemical dependency treatment center
that not only welcomes breastfeeding mothers, it actively incorporates the
breastfeeding relationship as a tool in building a successful recovery
program.  The treatment center will provide access to a hospital breast pump
during the in-hospital detoxification phase.  In outpatient treatment, hours
are modified for the breastfeeding relationship, and strong support of the
breastfeeding relationship is given as part of the mother's treatment
program.  Prescribed antidepressants are breastfeeding compatible.  The
director of the treatment program is extraordinarily well-educated in the
culture breastfeeding-friendly practices and parenting beliefs.  Resources
such as this should be just as common and accessible to the breastfeeding
community as the resource network that we are able to utilize for other
service providers.

We know that breastfeeding increases feelings of positive regard between the
mother and infant, these feeling are even more critical to the alcoholic
mother and her child.  The children of alcoholics are just as deserving of
every bit of effort, compassion, willingness, education and resources that
we would offer a mother suffering from any other disease.

Kirsten McLean
B.S.W., mother-to-mother support


Original Post:
Mary Ann Krainz wrote in asking for help with alcohol
abuse and breastfeeding...IMHO, if a breastfeeding
mother, or *anyone*, is literally incapable of
STOPPING after 1-2 drinks, this is one of the
hallmarks of alcoholism/alcohol addiction, and needs
to be addressed by specialists in that field.
Regardless of the alcohol in the breastmilk (though
this is important) a parent who is *impaired*, by
alcohol or other drugs, and is powerless to stop, is
not a fully safe and effective parent, and needs help.

Back when I was an LVN, most of the patients I worked
with were addicts.  It is tragic to see.  Nothing, and
I do mean NOTHING, matters to an addict except *the
next fix*.  Marriages fall apart, families
disintigrate, health and sanity destroyed, careers are
ruined...all for the sake of *the next fix*.

Just my thoughts...
Carole

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