What is the relationship between alcohol intake and lactation

what is the relationship between alcohol intake and lactation

The effects of maternal alcohol (ethanol) ingestion during lactation are The time of peak milk alcohol levels varied among women between 20 and 40 . of alcohol consumption in relation to breastfeeding were not known. For one thing, alcohol dehydrates your body talk to a lactation consultant and your baby's. “Reasonable alcohol intake should not be discouraged at all. Significant amounts of alcohol are secreted into breastmilk although it is not considered harmful.

This alcohol consumption may adversely affect the infant s sleep and gross motor development and influence early learning about alcohol. Based on this science, it would seem that the recommendation for a nursing mother to drink a glass of beer or wine shortly before nursing may actually be counterproductive. That is, it protects the infant from disease and influences certain aspects of the infant' s behavior and physiology.

In essence, without successful breast-feeding, the human species would not have survived. In many cultures a centuries-old belief persists that the process of breast-milk production and breastfeeding i. For example, the consumption of small quantities of alcohol shortly before nursing is believed to increase milk yield, facilitate the release of the milk from the mammary glands where it is produced i.

In fact, this folklore was so well ingrained in American tradition that, ina major U. This product was sold exclusively in drugstores and prescribed by physicians as a tonic for pregnant and lactating women and a nutritional beverage for children Krebs Its production was halted during Prohibition because it contained more than 0.

Even in modern times, alcohol continues to be hailed as an agent that promotes lactation i. For example, women in Mexico are encouraged to drink as much as two liters i. Epidemiological studies found that although lactating women were less likely to report occasional binges of heavy drinking, the regular drinking patterns at 1 and 3 months after giving birth i.

In contrast, breast-feeding women limited their use of other drugs e. In the same survey approximately 10 percent of lactating women reported consuming at least one drink daily. Whether these women were drinking in response to the folklore mentioned above is not known.

A recent study has indicated, however, that lactating women who were either encouraged to drink or received no advice at all about alcohol reported drinking significantly more than did women who were advised not to drink Mennella The claims that alcohol benefits lactation are not accompanied by any controlled scientific evidence, and little research has been conducted in this area.

what is the relationship between alcohol intake and lactation

This article reviews the existing scientific literature on alcohol s effects on lactation. After a brief overview of the initiation and maintenance of lactation, the article describes the transfer of alcohol to human milk and the effects that maternal alcohol consumption have on the interaction between mother and infant. This discussion includes effects on milk production and milk properties e. Overview of Lactation Breast milk is produced by mammary glands located in the breast tissue. These glands are present from birth, but become fully functional for milk production only during pregnancy.

Several hormones regulate the development of the mammary glands as well as the initiation and maintenance of lactation. The most important of these hormones are prolactin and oxytocin, both of which are produced in the pituitary gland in the brain. Prolactin, together with other hormones e. In addition to its role in mammary gland development and initiation of lactation, prolactin also is essential for the maintenance of lactation.

During each feeding session, the infant s suckling at the breast induces prolactin release from the pituitary gland.

what is the relationship between alcohol intake and lactation

This prolactin release stimulates the mammary glands to produce new milk before the next feeding. The extent of prolactin release and, consequently, the amount of milk produced is determined by the intensity of the suckling. Conversely, any conditions that interfere with effective suckling will result in lower levels of prolactin release, thereby compromising milk production.

Oxytocin plays a key role in the milk let-down during nursing. Its release from the pituitary gland in response to suckling or other stimuli causes certain cells around the mammary glands to contract, thereby expelling the milk from the glands into small ducts leading to the nipple. Without this let-down reflex, the infant cannot nurse and empty the breast effectively. Transfer of Alcohol Into the Milk When a lactating woman consumes alcohol, some of that alcohol is transferred into the milk.

In general, less than 2 percent of the alcohol dose consumed by the mother reaches her milk and blood. Alcohol is not stored in breast milk, however, but its level parallels that found in the maternal blood. That means that as long as the mother has substantial blood alcohol levels, the milk also will contain alcohol. Accordingly, the common practice of pumping the breasts and then discarding the milk immediately after drinking alcohol does not hasten the disappearance of alcohol from the milk as the newly produced milk still will contain alcohol as long as the mother has measurable blood alcohol levels.

Peak alcohol levels both in the mother' s blood and in the milk occur approximately one-half hour to an hour after drinking and decrease thereafter, although there are considerable individual differences in the timing of peak levels and in alcohol elimination rates in both milk and blood Lawton ; Mennella and Beauchamp Therefore, lactating women should not nurse for several hours after drinking until their blood alcohol levels have declined again.

Because alcohol is excreted only to a limited extent in breast milk, many clinicians consider occasional exposure insignificant except in rare cases of intoxication in which the mother of a breast-feeding infant drinks heavily or in which a child is inadvertently fed large amounts of alcohol in a bottle.

Contrary to this perception, however, the limited research that exists to date suggests that alcohol administration through the breast milk may affect the infant in several ways, such as altering milk intake and influencing infant behavior and early development and learning.

These effects are discussed in the following sections. Alcohol' s Effect on the Breast-feeding Process and the Infant As mentioned earlier, folklore suggests that alcohol consumption by a lactating woman improves milk production and, in turn, the nutrition of her infant.

Contrary to this assumption, however, studies have found that breast-fed infants consumed, on average, 20 percent less breast milk during the 3 to 4 hours following their mothers consumption of an alcoholic beverage Mennella and Beauchamp This finding is consistent with the results of similar studies conducted in rats Subramanian and Abel ; Swiatek et al. The observed decrease in milk intake did not occur because the infants nursed for shorter periods of time Mennella and Beauchampor rejected the mother s milk because of an altered flavor following maternal alcohol consumption Mennella Rather, maternal alcohol consumption reduced the amount of milk produced i.

These hormonal processes may be influenced by alcohol consumption. For example, studies in lactating rats demonstrated that although acute alcohol administration did not affect base line prolactin levels, it significantly inhibited suckling-induced prolactin and oxytocin release as well as milk production and, consequently, the pups milk intake Subramanian and Abel ; Subramanian Whether acute alcohol consumption has similar effects on the hormonal milieu in lactating women is not known, however.


Nor do researchers know whether chronic drinking affects the quantity and quality of milk produced in humans see Heil et al. Although infants consumed less milk when their mothers had consumed an alcoholic beverage compared with a nonalcoholic beverage, the mothers were apparently unaware of this difference Mennella and Beauchamp That is, mothers who had consumed an alcoholic beverage believed their infants had ingested enough milk, reported that they experienced the sensation of milk let-down, and felt they had milk remaining in their breasts at the end of the majority of feedings.

Because milk intake and the rate of milk production varies from feeding to feeding, a small difference in the infant s milk intake may be difficult for women to perceive. With breast-fed infants, the amount of milk ingested often varies, and milk usually can be expressed from the mother' s breasts after a feeding. Perhaps one reason why the folklore that alcohol is a galactagogue has persisted for centuries is that a lactating mother does not have an immediate means of assessing whether her infant consumes more or less milk in the short term.

Effect on Infant Sleep Another presumed effect of maternal alcohol consumption is to relax the infant and thus promote the infant s sleep. Studies found, however, that in the short term, acute exposure to alcohol in mothers milk altered the infants sleep-wake patterning in ways that are contrary to this medical lore Mennella and Gerrish Infants whose mothers were light drinkers during both pregnancy and lactation slept for significantly shorter periods of time during the 3.

This reduction was due in part to a decrease in the amount of time the infants spent in active sleep. Effects on Infant Development Researchers examined the longer-term effects of alcohol consumption by lactating women in an epidemiological study of breast-fed infants and their mothers.

The study assessed the relationship between the mothers' alcohol use during lactation and their infants' development at 1 year of age Little et al. The study found that gross motor development was slightly, but significantly, altered in infants who were exposed regularly i. No significant correlation existed, however, between maternal drinking and the infants' mental development.

Alcohol - Drugs and Lactation Database (LactMed) - NCBI Bookshelf

Furthermore, the motor and mental development of infants whose mothers drank less than one drink per day did not differ significantly from the development of infants whose mothers did not drink at all or who were formula fed. The association between maternal drinking and delayed motor development persisted even after the investigators controlled for more than potentially attributable to alcohol-related differences in maternal behavior, because infants of heavy drinkers who were weaned at an early age had significantly higher scores on motor development than did infants of heavy drinkers who were weaned at an older age and thus were exposed to alcohol longer Little To explain the effects of alcohol consumed through breast milk on infant development, researchers have formulated several hypotheses see Little et al.

For example, some have suggested that the developing brain is highly sensitive even to small quantities of alcohol. Others have posited that alcohol may accumulate in the infant following repeated exposure because infants may break down i. Some evidence suggests that infants have a limited capacity to metabolize alcohol, which in turn may render the alcohol dose more potent. For example, studies found that like alcohol, caffeine is excreted to a limited extent in breast milk and the dose presented to the infants is generally less than 2 percent of the maternal dose.

Most mother's alcohol use was considered to be moderate and drinking was almost always timed to minimize the amount of alcohol in breastmilk. Infants' social, mental and motor development were examined with the Ages and Stages questionnaires. The infants of mothers who used alcohol postpartum had no greater risk of adverse outcomes up to 12 months of age than the infants of mothers who were alcohol abstainers.

The authors found that greater or riskier maternal alcohol intake determined by a maternal questionnaire was associated with decreased nonverbal reasoning at 6 to 7 years in a dose-dependent manner. This correlation was not found in children at 8 to 11 years of age. The frequency and quantity of milk consumed by infants and the timing of alcohol consumption in relation to breastfeeding were not known. The effect could be overridden by administration of exogenous oxytocin, indicating that alcohol inhibits oxytocin release, not its effect on the breast.

Alcohol also increased the time for letdown to occur after nipple stimulation, from 29 seconds to 64 seconds with doses of 1 to 1. Pretreatment with naloxone blunted alcohol's inhibitory effect on oxytocin release.

what is the relationship between alcohol intake and lactation

A study on 28 lactating women who were 2 to 5 months postpartum found that the normal rise in serum prolactin was enhanced when alcohol in a dose of 0. In subjects with a first-degree relative with a history of alcoholism, the increase in serum prolactin was blunted in magnitude, rapidity, and duration both with and without prior alcohol consumption.

The caloric content and composition of milk were not different during the two test periods. Six drank beer containing 4. Their average peak serum prolactin increased to 2. The one woman who drank nonalcoholic beer had an equivalent prolactin response. Pretreatment with naloxone had no effect on the prolactin response. Compared to placebo, ingestion of 0. Pumping milk from the breasts during the ascending phase of blood alcohol enhanced the prolactin response, but pumping during the descending phase of blood alcohol blunted the prolactin increase.

Milk production was lower after alcohol ingestion, but unrelated to serum prolactin or alcohol blood concentrations. On one occasion the soup contained a dose of 0. The time for the first drops of milk to be ejected after breast stimulation with a pump was longer 4.

In addition, the triacylglycerol Participants were given a dose of 0. A breast pump was used to collect breastmilk beginning 35 minutes after ingesting the test solution. Blood samples were collected for prolactin before and at various times after beverage consumption.

The women with a family history of alcoholism had reduced serum prolactin responses to breast stimulation whether or not they had consumed alcohol. They tended to nurse their infants more frequently than the other mothers, apparently as a method of compensation. The coenzyme Q10 content of milk was higher at day 30 in the supplemented mothers. No change in oxidant markers was found in their infants' urine. Most mother's alcohol use was considered to be moderate at 14 or fewer drinks per week.

Alcohol use did not adversely affect the duration of breastfeeding. Basic Clin Pharmacol Toxicol.

what is the relationship between alcohol intake and lactation

Ethanol pharmacokinetics in lactating women. Braz J Med Biol Res. Ethanol and acetaldehyde in the milk and peripheral blood of lactating women after ethanol administration. J Obstet Gynaecol Br Commonw. Alcohol in breast milk.

The transfer of alcohol to human milk. Effects on flavor and the infant's behavior. N Engl J Med. Alcohol levels in Chinese lactating mothers after consumption of alcoholic diet during postpartum "doing-the-month" ritual.

Maternal lactation characteristics after consumption of an alcoholic soup during the postpartum 'doing-the-month' ritual. Lactational state modifies alcohol pharmacokinetics in women. Alcohol Clin Exp Res.

PMC ] [ PubMed: Alcohol and breast feeding: Elimination of alcohol from breast milk: Establishing guidelines for resumption of breast-feeding after alcohol consumption. Pepino M, Mennella J. Effects of breast pumping on the pharmacokinetics and pharmacodynamics of ethanol during lactation.

Ethanol concentration in breastmilk after the consumption of non-alcoholic beer. Alcohol concentrations in breastfed babies - physiologically based modelling as a decision aid. Pseudo-Cushing syndrome caused by alcohol in breast milk. Severe hypoprothrombinaemic bleeding in the breast fed young infants. Alcohol and nicotine poisoning in nurslings. Beer, breast feeding, and folklore. Infants' suckling responses to the flavor of alcohol in mothers' milk.

Alcohol | Breastfeeding | CDC

Regulation of milk intake after exposure to alcohol in mothers' milk. Effects of exposure to alcohol in mother's milk on infant sleep. Sleep disturbances after acute exposure to alcohol in mothers' milk. The effects of alcohol in breast milk on infant behavioral state and mother-infant feeding interactions. Maternal alcohol use during breast-feeding and infant mental and motor development at one year. Alcohol, breastfeeding, and development at 18 months. Effects of ethanol consumption during pregnancy and lactation on the outcome and postnatal growth of the offspring.

Pulque intake during pregnancy and lactation in rural Mexico: Eur J Clin Nutr. Maternal alcohol use and breastfeeding: Infant outcome at one year of age. Prospective study of maternal alcohol intake during pregnancy or lactation and risk of childhood asthma: The Norwegian mother and child cohort study. Breastfeeding and maternal alcohol use: Prevalence and effects on child outcomes and fetal alcohol spectrum disorders. Alcohol exposure in breastfed neonates associated with Chinese chicken wine.

An overview of exposure to ethanol-containing substances and ethanol intoxication in children based on three illustrated cases. Alcohol consumption by breastfeeding mothers: Frequency, correlates and infant outcomes. Gibson L, Porter M. Drinking or smoking while breastfeeding and later cognition in children. Cobo E, Quintero CA. Milk-ejecting and antidiuretic activities under neurohypophyseal inhibition with alcohol and water overload.

Am J Obstet Gynecol. Effect of different doses of ethanol on the milk-ejecting reflex in lactating women. Inhibition by ethanol on the oxytocin response to breast stimulation in normal women and the role of endogenous opioids.

Prolactin and cortisol levels following acute alcohol challenges in women with and without a family history of alcoholism. Acute effect of alcohol on estradiol, estrone, progesterone, prolactin, cortisol, and luteinizing hormone in premenopausal women. Serum prolactin increase induced by ethanol--a dose-dependent effect not related to stress.

Endogenous opioid mediation of the inhibitory effect of ethanol on the prolactin response to breast stimulation in normal women. Breastfeeding and prolactin levels in lactating women with a family history of alcoholism.

what is the relationship between alcohol intake and lactation

Short-term effects of maternal alcohol consumption on lactational performance. The effect of alcohol intake on breastfeeding duration in Australian women. Prolactin secretion after beer.