Can mothers drink alcohol while breastfeeding their babies?
For many years it was frowned upon, but new research claims that moderate alcohol consumption while breastfeeding is safe. Arlene Harris investigates
As festive party season kicks off, nursing mums may be feeling a bit left out. While everyone else tops up the vin rouge, they're often left to sip on a mocktail. The long-standing advice is that women shouldn't consume alcohol while they are breastfeeding due to concerns that traces of alcohol will be passed on to the feeding infant.
But a new study from Australia has claimed that not only is it safe for women to drink low levels of alcohol while breastfeeding, but it may even be beneficial for the child.
Dr Delyse Hutchinson of Deakin University Melbourne maintains that babies breastfed by mothers who "drank in moderation" had "more favourable results for personal-social development".
However, the report goes on to say that breastfeeding women who consumed alcohol were more likely to be born in Australia or another English-speaking country, be tertiary educated and have higher household incomes. Most drank at low levels and employed strategies (such as the timing of alcohol use) to minimise alcohol passed on to infants via breast milk.
According to current advice from the HSE, "the safest option when breastfeeding is to avoid drinking alcohol altogether. However, after the first month or so, some mums may want to have an occasional alcoholic drink.
"Alcohol levels in breast milk are similar to alcohol levels in your blood, so you will need to wait two to three hours until alcohol has left your system before your next breastfeed. If your baby needs a feed sooner, some previously expressed breast milk can be given."
Jan Cromie of La Leche League of Ireland (LLLI) notes that the study shows that women who drink low levels of alcohol are more likely to come from a certain socio-economic group which may be a greater contributory factor to social development than alcohol consumption.
"Mothers who drank were the same cohort as those who were more likely to breastfeed - being mature, educated and with a higher income. The implication is that mothers who socialise, are educated and of a higher income may be more likely to go out and provide different environments for their babies," she says.
"The effect could also be attributable to a stimulating environment rather than focusing on alcohol intake, which is already minimal or moderate in the majority of participants."
Child psychologist Dr David Carey agrees. "There are many factors which influence social and emotional development, the most important among them being family and school. So it is highly unlikely that maternal alcohol consumption is a significant factor."
But Tracy Donegan, midwife and founder of gentlebirth.com, welcomes the report says it could make breastfeeding easier for new mums.
"For many years, there has been a negative perception that breastfeeding limits lifestyle and enjoyment," she says. "Many women in Ireland feel they've already sacrificed so much in pregnancy to give their baby the best start and are very much looking forward to getting back to 'normal' and getting their lives back - being able to enjoy a glass of wine or two is part of that.
"As any parent will tell you, having a flexible attitude goes a long way as you grow into your role as a new mother. An 'all or nothing' restrictive approach tends to put enormous pressure and unnecessary stress on parents during one of the biggest transitions of their adult lives."
New mum Kate Mooney breastfeeds her son Charlie (six months) and explains that while his safety and development are paramount, she believes it's okay to have a drink every now and then.
"I always knew it was okay to drink a small amount while breastfeeding as I have done a lot of research into it," says the Dublin woman.
"Obviously it's not okay to open a bottle of tequila before you start feeding your baby, but a glass of wine in front of the TV does no one any harm - all of the breastfeeding mums I know have the occasional drink and I think it's important women know it's okay to do so."
Fellow new mum Emilia Cruz also enjoys a drink while feeding her eight-month-old son, Oliver.
"I don't have a problem with having a few beers or a glass of wine when I go out," she says. "I didn't drink for the first few months as I was so exhausted that alcohol was the last thing on my mind. But once I got into a routine, I enjoyed the odd drink and I still do.
"It's easy for people to believe alcohol can have a negative effect on a feeding baby and I've had people imply that I shouldn't be doing it - but I would encourage new mums to do a bit of research and find out for themselves. They will soon discover that experts agree that a glass or two does no harm whatsoever." Indeed Jan Cromie of LLLI says the most damaging aspect of drinking around a new baby is the possibility of becoming inebriated.
"Mothers who are breastfeeding and who take alcohol need to be thinking not so much about how much may have passed through their breast milk but about whether they can safely carry out the normal elements of childcare with their infant - and a small amount of alcohol is unlikely to impair these abilities," she says.
"LLLI and the American Academy of Pediatrics (AAP) both agree that small amounts of alcohol have not been shown to be harmful (to a healthy full-term infant - guidance would vary for premature infants)."
Kate argues that being told to cut out alcohol completely may put women off breastfeeding altogether.
"Breastfeeding can be very difficult for some women," she says. "And to be told that you can't have a beer or go out for an evening and unwind with friends over a glass of wine is likely to make new mums stop feeding sooner than they might otherwise do.
"We all give up alcohol while pregnant, so after 10 months of abstaining, not being able to kick back and relax with a drink for six months to a year would make a lot of women either give up breastfeeding early or just not take it up at all. We all want the best for our babies and being relaxed, happy and feeling like we have some control over our bodies means we are in a better place to look after them."
Cromie adds: "To suggest that breastfeeding mothers should not consume any alcohol at all would seem to be throwing up unnecessary barriers. Our rates in Ireland are very low so we need to be encouraging mothers to initiate breastfeeding and continue past the first few days, not giving them reasons to see it in a negative light."
Dr Nina Byrnes warns that it's important not to spread the message that drinking while feeding is perfectly safe: "Alcohol goes into breast milk in the same way as it enters the blood stream. So although the levels are quite small, if a woman is drinking while breastfeeding, she will be exposing her baby to alcohol and I would be very concerned that anyone would think, particularly in the run up to Christmas, that it's grand to drink and there are no consequences.
"As a doctor, I would encourage women to consider the amount of alcohol they are drinking and the baby's possible exposure to it. We clear approximately one unit of alcohol per hour from our blood so it would be recommended to feed at least two hours after an average glass of wine to minimise exposure," she explains.
"In moderate drinking the exposure to the baby is likely low, but I certainly don't encourage drinking while breastfeeding."