Lactation and booze DO mix.
As the holidays approach IBCLCs will get a surge of questions from lactating parents about how long they have to pump-and-dump (NO! Never!) after having a few drinks … or whether they should buy those pricey strips that test alcohol content in human milk.
My reply? “Boy, marketing sure works doesn’t it? You don’t need test strips for your milk, after you’ve had a few drinks, any more than you need test strips of your own blood to know if you’re too drunk to nurse. Your milk is a filter for the booze. My advice: take the test strip money and buy a lovely bottle of champagne. Be sensible. All things in moderation. No one in the house gets to be drunk anymore, and it has nothing to do with lactation, and everything to do with parenting.”
There is a difference, of course, between blood alcohol content (BAC) (what the drinking parent feels) and alcohol content in MILK that must then go through the “filtering and diluting” process of being ingested before it is absorbed in the baby’s own body/bloodstream. Lactmed’s page on alcohol is informative, including these quotes with my bracketed commentary.
“A computer simulation of breastfed infant serum alcohol levels after maternal ingestion of 250 mL of wine [8.5 ounces … or 1/3 of a bottle of wine] estimated resulting blood alcohol concentrations of 0.0033% in newborn infants and 0.0038% in 3-month-old infants.
“Another group estimated that if a woman ingested 4 standard drinks at once and breastfed her infant, the infant would attain a blood alcohol concentration of 0.049 g/L (0.0049%).”
Bear in mind: The federal limit to legally drive in the United States is a BAC of 0.08%. Note how many zeros come *after* the decimal point ^^^, to gauge the amounts that babies are feeling. It is WAY below legal definitions for driving under the influence (DUI).
The cited study for the second comment, above, also has this statement: “The amount of alcohol presented to nursing infants through breast milk is approximately 5-6% of the weight-adjusted maternal dose, and even in a theoretical case of binge drinking, the children would not be subjected to clinically relevant amounts of alcohol.”
Now, please. KNOW that I am not suggesting binge drinking or drunkeness for anyone. We are talking here about parents with infants or toddlers in their care. Alcohol in the milk is NOT what parents need to think about. Drinking responsibly is. Being told simply to pump-and-dump doesn’t solve that issue. Problem drinking is problem drinking regardless of lactation. Public health and lactation messaging that shames-and-blames parents for responsible levels of drinking (something humans have been doing for tens of thousands of years) is impractical, incorrect, and marginalizing.
Indeed, lactation has a **protective effect** for lactating parents having a toast or two. H/T to Nikki Lee IBCLC for this study:
“The systemic availability of alcohol is diminished during lactation…. Regardless of whether alcohol was consumed following a meal or on an empty stomach, the resultant BAC levels were significantly lower and AUC [the mean area under the blood alcohol time curve, an indicator of systemic availability of the drug] were significantly smaller in lactating women when compared with the 2 groups of nonlactating women. As expected, these differences were most apparent when alcohol was consumed with food. Blood alcohol concentration levels were so low at approximately 1 hour postalcohol consumption (specifically at 0.5 hours after peak BAC) that we could not calculate several of the alcohol elimination measures for the majority of lactating subjects. That such changes were due to lactation per se and not due to recent parturient events was suggested by the finding that alcohol pharmacokinetics of nonlactating mothers, who were tested at a similar time postpartum, were no different from women who had never given birth.” From the 2007 study Lactational State Modifies Alcohol Pharmacokinetics in Women.
So offer families in your care evidence-informed information, and support for the decisions they make. And download the Trash the Pump and Dump app.