Alcohol While Breastfeeding

From J. Heisleman Ingalls, RN, MSN, OCN, CNL

Many breastfeeding moms wonder if it safe for them to have an occasional alcoholic beverage. Controversy and misinformation surrounds this topic. The conventional wisdom is to pump and dump. Or buy the alcohol “test strips.” Or even, “If you are safe enough to drive, you are safe enough to nurse.” But what happens if mama has a few drinks and feels tipsy, maybe not safe to drive…then baby wakes up to nurse? Is that safe?  Let’s look at the way alcohol is processed by the body, and transferred into the breastmilk.

Some drugs and medications stay in the breastmilk until the milk that contains them is expressed. Alcohol doesn’t work like this. Alcohol in the blood maintains a 1:1 ratio with the alcohol in the breastmilk. This means, that if your blood alcohol content (BAC) is 0.08 (over the legal limit in California) then your breastmilk alcohol content is 0.08%. Eight one-hundredths of a percent of the breastmilk would contain alcohol. It also means that as you get more sober, your milk gets more “sober.” So there is absolutely no need to pump and dump your milk the next morning, even if you go out and get trashed. (Which I am not recommending).

Compare the alcohol content of the breastmilk of a legally intoxicated mama to the alcohol content of fresh squeezed orange juice, which is about 0.9%. That means that your breastmilk when legally drunk is less alcoholic than fresh squeezed orange juice.

Bottom line: it is safe to have a drink and breastfeed. Moderation in everything is key, and this should in no way be construed as encouraging mothers to become intoxicated. But the reality of the science is that even when severely intoxicated, the mother would pose a threat to the infant by loss of motor function (dropping baby, rolling over on it, etc.) and not through the alcohol content of her breastmilk.

If you would like to see what your BAC would be after that one glass of wine, for example, please check out this link.

Case study: I am a 123# woman who loves Guinness. After baby goes to sleep I have a 12 oz. bottle of Guinness and watch a movie with DH. She wakes up fussing two hours later. Am I safe to nurse? Yes! My blood alcohol content is only 0.004948576955424729%…which is less than five-one-thousandths of a percent alcoholic. Infinitesimal.