Can I have a drink if I'm breastfeeding?

Coming up to the silly season, I get asked the same question over and over again... Is it ok for me to have a glass of wine when I'm breastfeeding?

It can be tricky to get a straight answer when looking for information about drinking alcohol and breastfeeding. One reason for this is that official sources tend to be very risk-averse. 

For example, the Center for Disease Control states, “Not drinking alcohol is the safest option for breastfeeding mothers.” Yet in the very next sentence they admit that “moderate alcohol consumption, meaning up to one standard drink in a day, is not known to be harmful to the infant.” If that’s the case, why are we making a blanket statement that mothers shouldn’t drink at all?

Even the Australian Breastfeeding Association mirrors this zero-tolerance stance, saying, “The safest option when breastfeeding is to avoid drinking alcohol altogether. “

In addition to being risk-averse, government bodies and health organisations have a tendency to infantilise mothers and make breastfeeding harder than it needs to be. It’s time we started trusting mothers to unpack complex issues for themselves.

So let’s dive in a little deeper.

Is it dangerous to drink alcohol while breastfeeding?

Can you enjoy a cheeky glass of wine while breastfeeding over the holidays? Should you crack open a ice-cold beer while breastfeeding on a sweltering summer day? And how about that hen’s night — yea or nay to margaritas?

Many experts agree that it is safe to have a drink whilst breastfeeding. There’s no concrete evidence to show that a mother having one or two standard drinks occasionally will harm her breastfed baby.

For example, in this well-researched KellyMom article, she says, “Current research says that occasional use of alcohol (1-2 drinks) does not appear to be harmful to the nursing baby.”

Dr Jack Newman, who runs the wonderful International Breastfeeding Centre in Canada, shared this interesting post about a mother who had her breastmilk tested for alcohol at a toxicology laboratory. It was found that “The alcohol content in breast milk immediately after drinking is equivalent to a 0.0274 proof beverage. That's like mixing 1 oz of 80-proof vodka (one shot) with 2919 oz of mixer.”

Unless further evidence comes to light, the rhetoric that not drinking is the “safest option” seems to be fear-based. It’s as though people think mothers will be unable to restrict themselves to a single drink, so they obfuscate the data with appeals to emotion. Kind of like promoting abstinence instead of teaching about contraception (spoiler: it doesn’t work).

Mothers also deserve to know that any risk from breastmilk with a small amount of alcohol is far less than the risk of formula feeding. For example, formula feeding increases the risk of dying from SIDS by up to 50% throughout the first year of life. This kind of data is often not shared with mothers as it’s considered too “scary.” Yet, it’s okay to use fear to stop mothers enjoying a glass of wine?

Every decision comes with risks and benefits, and the more of the big picture mothers can see, the better equipped they are to make choices.

Should breastfeeding mothers pump and dump?

Mothers are sometimes advised to “pump and dump” after drinking alcohol — in other words, to express milk and throw it away. They are told—incorrectly—that this will reduce the alcohol level in their breastmilk.

In fact, the only thing that will decrease the alcohol level in breastmilk is time. And the only reason you need to pump is to relieve engorgement and maintain your milk supply whilst you are waiting.

It's possible many cultural phenomena converge on this topic to perpetuate the pump-and-dump myth. It probably helps sell breast pumps. It could be related to our general attitudes towards women, harshly judging any mother who is having too much fun. Or perhaps it's something to do with our mistrust of women's bodies, preferring machines and bottles and formula.

Pumping and dumping will not reduce the amount of alcohol in your breastmilk. Plus, it's inconvenient, adds to the mental load, and makes a mother worry unnecessarily. The last thing we need is another barrier to breastfeeding!

As a general rule, if you only have 1 or 2 drinks on special occasions, like New Year’s or birthdays, you have nothing to worry about.

If you are still concerned, breastfeed your baby while you drink — this is especially fun if you do it in public! But seriously, it takes about 30-60 minutes for alcohol to enter your bloodstream (and therefore your milk). So by feeding your baby while having your drink, you’re ensuring the breast milk they consume is alcohol-free.

It takes roughly two hours per standard drink for the alcohol to leave your milk. So if you don’t want to breastfeed while there is still alcohol present (even a tiny amount) you can have some expressed milk ready in case your baby needs to feed again earlier than that.

When to avoid drinking and breastfeeding

What does the research actually tell us about drinking and breastfeeding?

Drinking three or more standard drinks every single day may be a problem for your health and your baby's health. If that is the case, it is worth speaking to your healthcare provider about ways to decrease your reliance on alcohol.

Some people don’t drink every day, but they may occasionally binge drink. This is defined as having more than six units of alcohol in a single session. Binge drinking can make you less aware of your baby’s needs and more likely to engage in risky behaviours, so it’s important that another non-drinking adult be present to care for your baby.

The biggest alcohol-related risk is actually not that it might affect the baby through breastmilk. It’s far more likely — and dangerous — that intoxicated parents could drive while drunk, or fall while holding the baby.

Sharing a sleep surface while intoxicated is also a more risky behaviour than breastfeeding while intoxicated. Never share a bed or other sleeping surface with your baby if you have been drinking. Drinking affects your natural reflexes, and drinking while bed-sharing has an increased association with sudden infant death syndrome (SIDS).

For most sensible and smart mothers, the fact that you are worried about this probably means you are already an awesome mum. It’s time we stop undermining breastfeeding and making it hard and complicated for women. Go ahead and enjoy one or two drinks this holiday season.