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December 30, 2006

"I'm going to a New Year's party, and..." What I tell people about breastfeeding and alcohol.

This is the time of year when I get the calls that go like this:  "I'm breastfeeding and I'm planning on going to a New Year's party.  If I drink, can I breastfeed?"

I'll tell you how I answer this question, but first a little background on alcohol and breastfeeding:

Alcohol passes readily into breastmilk and generally peaks 30 to 60 minutes after consumption, 60 to 90 minutes when taken with food.  The rate at which it is eliminated depends on the mother's size, but generally takes between 1 and 3 hours per drink.  Taking alcohol with food decreases absorption.

Alcohol does not accumulate in breastmilk; it leaves the milk as it leaves the blood.  When your blood alcohol levels are back down, so are your milk alcohol levels.  Babies get roughly 2% of the alcohol in milk that a mother ingests.  Your weight affects how quickly you can process alcohol, and the older your baby is, the more efficiently he or she can process alcohol. 

Alcohol consumption in moderation is considered compatible with breastfeeding.  More specifically, La Leche League notes that "When the breastfeeding mother drinks occasionally or limits her consumption to one drink or less per day, the amount of alcohol her baby recieves has not been proven to be harmful."  Drinking more than this amount has been found to have health and developmental consequences for babies.

So, how do I answer the question about a New Year's party?  Here's the advice I generally give mothers who call me for advice about an occasional use of alcohol, such as a New Year's party:

If you're planning on having one (or perhaps two) drinks at New Year's (and for many women who haven't drunk since before pregnancy, one drink is all it takes!), you can plan on breastfeeding at the party.  To minimize the effect, you can plan on drinking right after you finish a feeding, which will mean that your body will have the most time to eliminate the alcohol from your system before you feed your baby again.  Also try to have some food with the drink, which will reduce the absorption.

If you're planning on having more than two drinks at the party, plan ahead.  Expect not to breastfeed for 2 to 3 hours for each drink you have.  For example, if you have three drinks, plan not to feed for at least 6-9 hours.  See this chart to figure out how long it will take for the alcohol to leave your system given your weight.  Have enough pumped milk availble to feed the baby for as many feedings as you will miss during that time.  Bring your breastpump so that you can pump and discard milk for the missed feedings.  To be clear:  Pumping does not speed the elimination of the alcohol from your system; you are pumping so that you don't get painfully engorged and leak all over your dress.

And this goes without saying:  Think ahead about your driving arrangements so that there is someone who hasn't been drinking who can drive you and the baby home. 

Here are some links to some sites that discuss this in more detail.

This information is presented for educational purposes, and is not a substitute for advice from your doctor or other health care provider.

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