Mamas on Bedrest: Beer and Babies-Should they Mix?

October 27th, 2011

This post was originally a podcast that I produced in 2008 after interviewing Julie Jumonville, creator of MilkScreen (TM). Jumonville noted that following the birth of their babies, many women wanted to have a drink and were concerned about the baby receiving alcohol. She faced this very issue following the birth of her own children and hence Milkscreen (TM) was born.

While I am not advocating for or against alcohol while breastfeeding, here is simply another piece of information and another resource for mothers to consider when trying to make the best decision for themselves and their babies.

Is it safe to drink alcohol while nursing?

This is such a difficult question and the answer will vary depending on who you ask.  Whether or not a woman decides to have a glass of wine or a beer while nursing depends on her own moral values, the importance she places on nursing, and her personal views on alcohol.  For me, there was never a question.  I did not drink alcohol while I was nursing.  Alcohol is not an important part of my life and even when I am not nursing, I often don’t drink in social situations.  Furthermore, I had such difficulty sustaining a pregnancy that when I did finally carry a pregnancy to term, there was nothing that I was going to do that would even give the slightest harm to my baby.  Now many people may think that I was over reacting and they are probably right.  But again, for me, my values and my situation, alcohol had no place.

As a trained clinician, I also have difficulty rationalizing drinking alcohol while nursing.  Americans have “challenges” when it comes to alcohol; we tend to drink too much and experience some major calamities as a result.  Accidents and fatalities as a result of being under the influence of alcohol cannot be ignored.  More pertinent to this discussion, we know that mothers who drink while pregnant risk their babies developing fetal alcohol syndrome with subsequent developmental abnormalities and delays.  But what about once the baby is born?  Is an occasional glass of wine or other alcoholic beverage dangerous to a baby?

The American Academy of Pediatrics (AAP) recommends avoiding alcohol while nursing, because alcohol passes through breast milk to the baby. A newborn has a very immature liver, so minute amounts of alcohol place more of a burden upon their livers. Until about 3 months of age, infants detoxify alcohol at approximately half the rate of an adult. An older baby or toddler can metabolize the alcohol more quickly. The AAP has this position statement on the AAP’s webpage on breastfeeding and diet (www.aap.org),

“If you choose to drink alcohol, drink it just after you nurse rather than just before.”

Many women drink a bit of alcohol with the mistaken belief that it will increase their breast milk production.  This wives tale has been disproven. Julie Mennella, PhD, of Philadelphia’s Monell Chemical Senses Center tested alcohol to see its effect on breast milk production. What Mennella and her colleagues found is that in women who drink moderate amounts of alcohol (0.4g/kg) their milk production actually goes down because levels of oxytocin, a hormone responsible for milk production and subsequent ejection, dramatically drops in response to the alcohol. Additionally many women in the study reported feeling more relaxed and had increased breast fullness after they drank moderate amounts of alcohol. Mennella explains that these effects are due to increases in the hormone prolactin which increases significantly with alcohol consumption and causes sensations of sedation, dysphoria and drunkenness in addition to the feeling of breast fullness. The effects of alcohol peak approximately 45 minutes after alcohol consumption.1

Nursing mothers also need to know that breast milk containing 30 milligrams per deciliter or more (0.03%) of alcohol causes infants to drink less breast milk and to sleep less and awaken more frequently. Although most women clear alcohol from their breast milk in 30-90 minutes, these facts are not well known and sadly many women dump their breast milk for hours after they drink not knowing that their breast milk no longer contains harmful levels of alcohol. In an effort to bring clarity to this issue and more importantly, to extend the life of breastfeeding for many mothers, Milkscreen™ was developed.

Milkscreen™ was created by Julie Jumonville.  In October 2002, Jumonville was battling post partum depression following the birth of her son and her doctor had recommended a trial of the antidepressant Zoloft. Jumonville was very concerned about the effects the medication would have on her baby and was unwilling to take anything that could be passed through her breast milk and have even the tiniest negative effect on her child.  A civil engineer, Jumonville researched the medication thoroughly and once convinced no harm would come to her baby, she agreed to take the antidepressant for a limited amount of time.

But medication was not Jumonville’s only hurdle when it came to breastfeeding.  She often attended business functions and was offered wine or other adult beverages. She knew the dangers of heavy alcohol consumption on an infant but wondered if the occasional glass of wine was in anyway detrimental. Looking for answers she found that breastfeeding guidelines are sketchy at best and most women err on the side of caution, pumping their breast milk and dumping it if they have consumed alcohol. Some women, confused by conflicting guidelines and strict dietary restrictions stop breastfeeding altogether. Jumonville wanted answers and the engineer in her wanted concrete facts.  When Jumonville’s research revealed the aforementioned facts, she set out to educate nursing mothers and in the process developed the Milkscreen™ tests.

Milkscreen™ is simple to use. After drinking alcohol a woman tests her breast milk alcohol levels by expressing a few drops of breast milk onto the test strips (mothers can also dip the test strips in expressed breast milk.) If after two minutes the test strip turns from off white to light brown, the alcohol levels in the breast milk are too high (higher than 0.02%) and baby should be fed stored breast milk, formula or wait to nurse until the alcohol levels in the breast milk are no longer a cause for alarm. The amount of alcohol passed through to breast milk varies among women as does the time it takes for alcohol to completely leave a woman’s system. With Milkscreen™, a woman has a definitive indicator of when she can safely nurse after drinking alcohol.  The tests come in packages of 3, 8 and 20 and can be found at stores like Babies R Us and online at stores like Target.com.

Now I want to be clear.  I am not advocating drinking while nursing or trying to get women not to drink alcohol while nursing. The decision to drink alcohol while nursing is very controversial and each woman has to examine her own values in order to reach the decision that best suites her needs.  But what I wanted to do here, as I always try to do is educate women and offer solutions.  For women who decide to have the occasional glass of wine or beer, Milkscreen™ provides the reassurance that their babies will remain alcohol free.  It’s just one more tool in a busy mom’s arsenal.

1. Julie A. Mennella, M. Yanina Pepino and Karen L. Teff. The Journal of Clinical Endocrinology & Metabolism Vol. 90, No. 4 1979-1985. Copyright © April, 2005 by The Endocrine Society

What is your take on drinking alcohol while nursing? Share your thoughts below. You can also see what’s being said on Facebook and Twitter (@mamasonbedrest)

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