Mother breastfeeding young child

Drugs, Drinking, & Breastfeeding

After nine long months of carrying a child and abstaining from drugs and alcohol, mothers may be tempted to use medications or engage in vices once again. Mood stabilizing medications, a few cigarettes throughout the day, the occasional drink, a morning coffee, or a relaxing joint may seem like tempting outlets to engage in while dealing with the stress of caring for a newborn.

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Many of these mothers may choose to breastfeed because they believe it is an essential aspect of the healthy growth and development of their children. These mothers should understand how different drugs can transfer from their breast milk to their infants and consequently affect their development.

If it is necessary to take medications or extremely difficult to avoid using other drugs, specific breastfeeding plans may reduce an infant’s exposure to the drugs that a mother ingests. It is crucial to understand and implement these plans to aid in the healthy growth and development of a nursing child.

infographic: drugs that affect breast milk, avoid nicotine aspirin, marijuana, st. john's wort, chaste tree berry. Caution alcohol, caffeine, sedatives, antibiotics, herbal remedies.

Medications

Common medications such as anti-anxiety medications, antidepressants, and neuroleptic drugs are not known to affect nursing infants but may be a concern. While they appear in very low concentrations in breast milk, with a milk to plasma ratio of 0.5-1.0, they may show up in the brains of nursing infants because of their long half-life 1.

Effects

If a nursing mother takes one or more of these medications, her breast milk can expose her nursing infant to the drugs. These drugs affect the central nervous system’s neurotransmitter function and may have long-term effects on the central nervous system’s development 1.

Breastfeeding Plan

When possible, a mother should choose safer drug options to avoid exposing her nursing infant to harmful medications. It is also important to wait to take any medications until right after breastfeeding or before the infant is due for a night of extended sleep and won’t need to feed for many hours 1.

Video: The Dos & Don'ts of Medicine While Breastfeeding

Nicotine/Tobacco

Nicotine absorbs very quickly and completely into the bloodstream from the respiratory tract. From there, it transfers easily into breast milk by way of simple diffusion. It is present in concentrations 1.5 to 3 times maternal plasma concentrations and has a half-life of around 60 to 90 minutes in milk and plasma 1.

Effects

Nicotine transferred through breast milk can have serious adverse effects on a nursing infant. These effects include changes in sleeping patterns, reduction in iodine supply, damage to the liver and lungs, and a decrease in glucose tolerance 2. Nicotine can also reduce the volume of breast milk that a nursing mother produces, which can lower prolactin.

Breastfeeding Plan

To avoid passing nicotine to an infant through breast milk, nursing mothers who smoke should wait to do so until directly after breastfeeding. It is also essential for the mother to wait at least 2 hours, slightly longer than the time it takes nicotine to reach its first half-life, to breastfeed again.

As an alternative to smoking cigarettes, a nursing mother can use nicotine patches. They are much safer to use while breastfeeding, as there are no findings to suggest they have any significant influence on breast milk 3.

Alcohol

Alcohol transfers easily into breast milk by simple diffusion. About 2 percent of consumed alcohol reaches the breast milk and bloodstream. While breast milk does not store alcohol, it remains present in the milk for as long as a mother has substantial blood alcohol levels. Peak alcohol levels occur a half-hour to an hour after drinking and decline after that 4.

Effects

The amount of breast milk a nursing mother produces reduces during the 3 to 4 hours that follow alcohol consumption, possibly resulting in lower prolactin. When alcohol transfers to an infant through breast milk, it may affect the infant’s sleeping patterns, motor development, and early learning 4.

Breastfeeding Plan

A nursing mother should abstain from drinking for the first three months of breastfeeding and only consume alcoholic beverages with low alcohol content after that, if possible. If it is difficult for the mother to stop drinking altogether, she should at least refrain from nursing for several hours after drinking, once blood alcohol levels have declined 4.

It is important to note that the amount of alcohol present in breast milk will only decline once blood alcohol levels decline. Contrary to popular belief, pumping breast milk and dumping it after alcohol consumption will not reduce the levels of alcohol in breast milk 4.

Caffeine

If a lactating mother ingests caffeine, her breast milk will usually reach peak levels of caffeine 60 minutes after consumption. One or two cups of coffee will not have a severe effect on the nursing infant, as less than 1% of the ingested caffeine will transfer to the child. Consuming any more than that may pose some risks. Infants metabolize caffeine very slowly, which can result in a significant accumulation of caffeine in the newborn 5.

Effects

Three or more cups of coffee may cause a reduction in iron present in breast milk due to the chlorogenic acids in coffee, rather than from the caffeine content. If a nursing mother consumes coffee regularly and in large quantities, this could result in iron deficiencies in nursing infants 6.

Breastfeeding Plan

Breastfeeding mothers should minimize coffee consumption while breastfeeding to reduce the risk of iron deficiency in nursing infants. Occasionally drinking caffeinated beverages will not have a significant effect on a nursing child’s iron levels.

Marijuana

Tetrahydrocannabinol (THC) is the psychoactive component in marijuana and is fat-soluble. When a nursing mother ingests marijuana, her breast milk absorbs THC in moderate amounts. If she uses marijuana heavily, there will be higher THC levels in her breast milk than in her maternal serum 7.

Effects

The consumption of marijuana reduces a lactating mother’s milk supply and possibly prolactin. The THC content in breast milk may also be associated with a decrease in motor development and short-term effects, including sedation, weakness, and feeding pattern issues in nursing infants 8.

Breastfeeding Plan

A nursing mother should eliminate or reduce marijuana consumption while breastfeeding as a best practice in avoiding any adverse effects on a nursing child. If the mother reduces marijuana use, she should keep a supply of unaffected milk readily available for the infant to consume when she has recently ingested marijuana.

Do You Need Help?

The suggested breastfeeding plans may seem unattainable for some mothers who rely heavily upon drugs or alcohol to get through day to day life. Some mothers may try to adhere to breastfeeding plans, only to find that they cannot stop or moderate alcohol and drug consumption.

While hard drugs such as methamphetamine and heroin are not found to affect breast milk, they can vastly harm a mother’s ability to raise her child in a healthy environment. It is imperative to seek help if you or a mother close to you is struggling with an addiction of any kind.

If this sounds like you or someone you love, it is crucial to understand that you are not alone and that there are various treatment options available. Treatment from a Drug and Alcohol Rehab Center can help a nursing mother abstain from drugs and alcohol and allow her baby to achieve optimal growth and development through healthy breast milk.

Addiction Treatment For Mothers

For many mothers, even those addicted to drugs and alcohol, breastfeeding can be of incredible importance when raising children. However, it can be harmful to a nursing infant to breastfeed them while consuming heavy and regular doses of medications, nicotine, alcohol, caffeine, and marijuana.

There are many treatment options available that will allow a mother to properly care for her child while helping the mother abstain from harmful drugs and alcohol. Treatment options can include outpatient treatment centers or inpatient treatment centers that allow patients to have their children stay with them.

If you or someone you love is struggling with addiction to drugs or alcohol, do not hesitate to seek treatment. There is a treatment option that will meet your needs and help you or your loved one raise a healthy baby.

References & Resources

  1. https://pediatrics.aappublications.org/content/pediatrics/108/3/776.full.pdf
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4182966/
  3. https://www.researchgate.net/publication/8970512_Use_of_nicotine_patches_in_breast-feeding_mothers_Transfer_of_nicotine_and_cotinine_into_human_milk
  4. https://pubs.niaaa.nih.gov/publications/arh25-3/230-234.htm
  5. https://ascpt.onlinelibrary.wiley.com/doi/abs/10.1002/cpt1979254447
  6. https://pubs.acs.org/doi/full/10.1021/jf0485436
  7. https://www.nejm.org/doi/full/10.1056/NEJM198209233071311
  8. https://depts.washington.edu/fasdpn/pdfs/astley-little-1990.pdf