I do not get terribly concerned about non-alcoholic women having an
occasional drink while lactating, tho I do provide factual info on transfer
into milk (which happens virtually indentically to the way and in the
amounts that alcohol passes into serum.)  However, an alcoholic resuming
drinking is different.  Alcoholism is a progressive disease.  It continues
to progress whether the alcoholic is drinking or not. If an alcoholic
re-lapses, they re-enter the disease at the same place they left it, and are
very soon in the same shape they were when they were finally motivated to
get sober. (Which is usually a pretty sick and intense phase or they
wouldn't have BEEN motivated to seek sobriety.)  Alcoholism is characterized
by the risk of both relapse and denial.  The people around the alcoholic
often make excuses about "stress" etc. but the truth is that alcoholics
cannot drink at any level, and not to confront that honestly is to enable
the drinking to go on.  This, if mother is an alcoholic, is profoundly risky
to the baby -- not solely because of the risk of alcohol exposure through
the milk, but because drinking alcoholics are dysfunctional.  The woman
needs intervention.  I personally would confront her with the statement:
"You have told me that you are an alcoholic.  This means that if you are
drinking you are in re-lapse.  You need to seek help because your ability to
parent and your own health are at risk."  Have I said these words to a
client myself?  Yes, and I would say them again in a heartbeat. It is a
statement which I would make with her husband or partner present, as the
spouse is very often also in denial. The truth in this situation is
absolutely the most loving thing for all concerned.
Barbara

Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html