ABSTRACT.Objective. To test the hypothesis that exposure to alcohol in breast milk affects infants' sleep and activity levels in the short term.Methods. Thirteen lactating women and their infants were tested on 2 days, separated by an interval of 1 week. On each testing day, the mother expressed 100 mL of milk, while a small, computerized movement detector called an actigraph was placed on the infant's left leg to monitor sleep and activity patterning. After the actigraph had been in place for ϳ15 minutes, the infants ingested their mother's breast milk flavored with alcohol (32 mg) on one testing day and breast milk alone on the other. The infants' behaviors were monitored for the next 3.5 hours.Results. The infants spent significantly less time sleeping during the 3.5 hours after consuming the alcohol-flavored milk (78.2 minutes compared with 56.8 minutes after feeding alcohol in breast milk). This reduction was apparently attributable to a shortening in the longest sleeping bout (34.5 compared with 56.7 minutes for sleeping after breast milk alone) and the amount of time spent in active sleep (25.8 minutes compared with 44.2 minutes after breast milk alone); the decrease in active sleep was observed in all but 2 of the 13 infants tested.Conclusions. Although the mechanisms underlying the reduction in sleep remain to be elucidated, this study shows that short-term exposure to small amounts of alcohol in breast milk produces distinctive changes in the infant's sleep-wake patterning. Pediatrics 1998;101(5). URL: http://www.pediatrics.org/cgi/content/full/101/5/e2; alcohol, lactation, sleep, activity, development, infant behavior. ABBREVIATION. NS, not significant. T he notion that infants can be influenced by components in their mothers' breast milk has a rich, long history.1 Physicians in the 18th century often would treat the infants' ailments by prescribing certain diets to the mother or wet nurse. 2 That such practices continue in more modern times is evident in the medical lore that recommends that nursing mothers drink an occasional alcoholic beverage, preferably before the evening feeding, to alleviate and sedate their fussy infants. 3,4 No experimental evidence supports this recommendation, although a previous study on the effects of maternal alcohol consumption on the feeding behaviors of breastfed infants reported that the infants' patterning of sleeping, as determined from logs completed by mothers, indeed was altered in the short term.
5Despite this lore, the question of whether occasional exposure to alcohol in breast milk can affect the infant continues to generate much speculation in the medical community.6,7 Because alcohol is excreted to a limited extent in breast milk, 5,8,9 occasional exposure often is considered insignificant, 8,10 except in such rare cases of intoxication when the mothers of breastfeeding infants drank quite heavily 11,12 or when infants were inadvertently fed large amounts of alcohol in a bottle. 13 Moreover, an epidemiologic study 14 found no significant difference in the ...