Alcohol and Breastfeeding, a review of the issues

Abstract

Moderate alcohol use by breastfeeding women appears to be relatively common. Alcohol concentrates in breast milk at levels slightly higher than in maternal blood, peaking at 30-60 minutes after consumption. Most studies find no link with the duration of breastfeeding unless drinking is fairly heavy (>2 standard drinks/day). However, seven studies have found that moderate maternal alcohol consumption was associated with a shorter duration of exclusive breastfeeding; one found no difference and one found an increase. Alcohol affects oxytocin release, leading to reductions in breast milk consumption in the following hours. Infant alcohol exposure may increase fussiness and reduce sleep, both temporary if the mother does not continue to drink. These effects on the infant and on the breastfeeding process could be interpreted by mothers as signs of infant dissatisfaction with their breast milk, “insufficient milk,” or other commonly expressed causes for suboptimal breastfeeding patterns. Chronic alcohol consumption, even if moderate, may have a number of more serious effects, including on infant development. In the early weeks or months of life, infant toleration of alcohol is lower than it is at later stages of infancy, and the early breastfeeding process is more susceptible to disruption. Therefore, it may be wise to advise mothers to continue their abstinence from alcohol during pregnancy into the first few months of breastfeeding. Little research has been done on how often women time their drinking so as to avoid infant exposure to alcohol. Health workers and others sometimes propagate myths that alcohol, especially alcoholic beer, is beneficial to breastfeeding. Research is needed in different cultures into whether various forms of cautionary messages are likely to discourage moderate drinkers from initiating breastfeeding or to shorten its duration, and which type of messages if any actually lead to a reduction in drinking during breastfeeding.

Maternal Tobacco and Alcohol Use in Relation to Child Malnutrition in Gauteng, South Africa: A Retrospective Analysis

“…However, in high-income countries, a varying prevalence of alcohol use among women who were breastfeeding was reported in Australia (47%) [ 61 ], Canada (20%) [ 62 ], Netherlands (19%) [ 63 ], Norway (22%) [ 64 ], and United States (29% and 36%) [ 65 ]. Researchers have acknowledged that a substantial level of alcohol use during breastfeeding has noticeable effects on infants [ 66 ]. The possible mechanisms refer to the issue of doses of alcohol that might be delivered to the infant via breastmilk, making it impossible for infants to oxidize alcohol, as a result, affecting the development [ 25 , 67 ].…”

Motivos associados à interrupção do aleitamento materno exclusivo até seis meses de idade em lactentes acompanhados em Estratégias de Saúde da Família da cidade de Registro, São Paulo

“…O consumo de álcool pode interferir na produção, no volume e na excreção do leite materno durante o período de amamentação 30 . Além de alterar o padrão de sono do recém-nascido 31 , o consumo de álcool também pode reduzir a ingesta do leite materno pelo lactente, em decorrência da diminuição na produção de leite e modificação no odor após a ingesta alcóolica 31,32 , resultando no risco para a interrupção precoce do AME, pois a criança pode apresentar choro constante, levando a falsa percepção de que o leite materno não é suficiente.…”

Effect of differently worded messages about alcohol on intent to breastfeed among university women in South Korea

“…A review in the previous issue of World Nutrition (https://worldnutritionjournal.org/index.php/wn/article/view/623) found that approximately half of breastfeeding women drink alcohol, varying from 83% to 9% (Greiner 2019). The same review found that two studies showed no relationship between alcohol consumption and breastfeeding initiation.…”

“…Research on the impact of maternal alcohol consumption during breastfeeding (also reviewed by Greiner (2019) is very limited, with very few findings tested by even a second study. A few studies do raise concerns.…”

“…The few studies that have been done suggest that knowledge about breastfeeding and alcohol use is low among both health professionals (Mennella 2002) and mothers (Shaker, Scott, and Reid 2004). Regarding attitudes, one review found widely differing results in the proportion of study samples who agreed with the statement "Women who occasionally drink alcohol should not breastfeed," varying from 23% to 76% (Greiner 2019).…”