Nursing while drinking

Asguard · May 1, 2009

Bells said: ↑

I think the whole time I was breastfeeding with both of my children, I had only had a small sip of champagne and that was it. I was told it was safe to have a glass of wine every once in a while, but I never did so. I think the champagne was for my wedding..

I never touched a drop while pregnant. And one sip when breastfeeding and then downing copious amounts of water.. I was probably being paranoid, but I just didn't want my son to get the alcohol in his system.

It isn't illegal to drink while pregnant or breastfeeding. As the article says, she was found guilty for other things.

If she was that intoxicated that she posed a risk to the child while feeding it (stone blind drunk and falling over type and could have dropped the child), then I can understand why they would have asked her to stop.
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Foetal alcohol syndrome

New Australian alcohol guidelines for low-risk drinking have been released by the NHMRC in collaboration with the Department of Health and Ageing. These are available on www.nhmrc.gov.au. Better Health Channel information will be updated shortly.

Alcohol consumed by a pregnant woman can harm her unborn baby. Foetal alcohol syndrome (FAS) includes a range of features seen in some babies who were exposed to alcohol before birth.

Two other terms – foetal alcohol effects (FAE) and alcohol-related neurodevelopmental disorder (ARND) – refer to effects on a baby who has some but not all of these features.

An accurate diagnosis can help provide appropriate care for the child and prevent recurrence in a later pregnancy.

Research varies on the number of babies affected
Research into the number of babies born with FAS varies. Figures range from 0.02 to 2.7 per 1,000 babies born. Foetal alcohol effects may be more common than this but the exact rate is unknown. The syndrome appears to occur more often in Indigenous communities. This could be related to drinking patterns, nutrition and environmental factors.

Alcohol and the risk to unborn babies
Babies severely affected by FAS are at risk of dying before they are born. Current knowledge suggests there is no safe level of alcohol consumption during pregnancy, but there is no convincing evidence that a small intake is harmful.

Heavy alcohol consumption in the early months of pregnancy is regarded as particularly dangerous.

Peak health organisations say pregnant women should avoid alcohol
The National Health and Medical Research Council (NHMRC), Australia’s peak health research organisation, recommends that pregnant women should never become intoxicated (drunk) and should consider not drinking alcohol at all. The World Health Organization recommends that pregnant women should be advised not to drink alcohol.

Signs at birth that might indicate FAS
At birth, FAS signs can include:

Low birth weight
Smaller than normal head circumference (microcephaly)
Small eyes
Flattened face
Flattened bridge of the nose
Underdeveloped vertical ridges that run from the nose to the upper lip (philtrum)
Thinner than normal upper lip
Small lower jaw (micrognathia)
Heart defects
Tightening of muscle, tendons, ligaments or skin restricting movement of elbows or knees (joint contractures).
A low birth weight or smaller head circumference alone may represent foetal alcohol effects.

Lifelong effects
Foetal alcohol syndrome is not always diagnosed at birth. Diagnosis may be made later, when the child is having problems with learning or behaviour, or the condition may never be diagnosed. The effects of this syndrome last for life.

A person affected by FAS may experience a range of difficulties including:
Low IQ (around 70 – an IQ of 100 is considered average)
Developmental delays
Behaviour problems
Learning difficulties
Memory problems
Increased risk of behaviour problems – for example, attention deficit hyperactivity disorder
Increased risk of mental health difficulties such as depression and psychosis
Increased risk of alcohol and drug misuse.
Alcohol and the developing foetus
Alcohol crosses the placenta from the mother’s blood into the baby’s bloodstream. This means the baby shares the exact blood alcohol level of its mother. The effects of alcohol on a foetus include:
Harm to the development of the foetal nervous system, including the brain; some studies show that alcohol can kill developing brain cells or slow their growth
Undernourishment of the growing baby by blocking the absorption of vitamins, glucose and other nutrients
Triggering of earlier-than-normal cell changes in the baby’s face, resulting in the typical FAS facial features
Reduction in the amount of oxygen available to the baby, although how this happens is unknown; it is possible that alcohol narrows the blood vessels in the placenta, umbilical cord or both, restricting blood supply.
The exact incidence is unknown
The incidence of foetal alcohol syndrome varies from study to study for a number of reasons:
While FAS is considered internationally to be the leading preventable cause of intellectual and developmental problems, there is little public awareness of the syndrome in Australia. Parents and doctors may not realise that FAS is the cause of a child’s developmental problems.
FAS is hard to isolate because alcohol is often not the only drug consumed during pregnancy. Evidence suggests that a woman who drinks while pregnant is also more likely to smoke cigarettes, use non-prescription and over-the-counter drugs, or take recreational drugs such as cannabis. Like alcohol, these substances cross the placenta and affect a growing baby’s development. A pregnant woman who misuses alcohol may also not eat properly, which may affect her baby’s health.
There is no single medical test that can diagnose FAS – this leads some researchers to believe that the actual rate may be much higher than estimated.
Many children diagnosed with alcohol-related symptoms are in care (not living with their families). Many factors, as well as alcohol, could contribute to their delayed development.
FAS may not be diagnosed at birth. Doctors don’t always know if a woman has been misusing alcohol during pregnancy, so the symptoms of FAS may not be looked for. FAE is usually not diagnosed at birth.
An affected child may be diagnosed with another condition such as autism.
There are many environmental and individual factors that can contribute to learning and behavioural problems; alcohol may be one of many.
Risk factors
There is no evidence that drinking modest amounts of alcohol during the first trimester is safe, but most babies affected by FAS are born to mothers who drink excessively throughout pregnancy. Some authorities regard women who consume seven or more alcoholic drinks per week, or more than two drinks on multiple occasions, as drinking to excess.

Risk factors associated with an increased risk of FAS include:
An older mother (advanced maternal age) – women over the age of 30 years who drink moderate to heavy amounts during pregnancy are more likely to have babies affected by FAS than younger women who drink the same amount when pregnant.
Poverty – alcohol consumption is higher in low socioeconomic groups; poor nutrition may also be a factor.
Genetic susceptibility – while FAS seems to be related to the amount of alcohol consumed, not all babies are affected in the same way by alcohol. Not every baby exposed to alcohol in the uterus develops FAS; the reason for this is unknown. Researchers believe that some babies are more sensitive to the effects of alcohol than others because of genetic differences.
Other drugs – drugs taken during pregnancy (including tobacco, prescription drugs, illegal drugs and caffeine) may increase the effects of alcohol on the foetus.
Lack of knowledge – research shows that most Australian women are unaware that alcohol consumed during pregnancy can harm the baby. In one Western Australian study, only 22 per cent of women knew about FAS and about one-third thought it was safe to drink moderate amounts of alcohol during pregnancy.
Lack of medical advice – about two-thirds of pregnant women are not given medical advice on drinking alcohol during pregnancy or they may not know about the guidelines relating to alcohol consumption in pregnancy.
Diagnosis
There is no specific medical test for FAS. Diagnosis relies on:
Recognising the pattern of features
Ruling out other possible medical causes
Questioning the mother on her alcohol consumption during pregnancy.
Treatment
There is no cure for FAS. Treatment is available for the child, including special education programs and behaviour modification therapy.

Where to get help
Your doctor
Royal Women’s Hospital, Drug Information Line Tel. (03) 9344 2277
Monash Medical Centre, Monash Drug Information Service Tel. (03) 9594 2361
Australian National Organisation for Fetal Alcohol Syndrome and Related Disorders (NOFASARD) Tel. 0418 854 947
DrugInfo Clearinghouse Tel. 1300 858 584 – for information www.druginfo.adf.org.au
DirectLine Tel. 1800 888 236 – for counselling and referral
Things to remember
Fetal alcohol syndrome (FAS) refers to a range of features that affect some babies exposed to alcohol before birth.
There is no cure for FAS and its effects last a lifetime.
The World Health Organization recommends that pregnant women should avoid alcohol. NHMRC recommends that pregnant women should never become intoxicated and should consider not drinking.
You might also be interested in:
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/foetal_alcohol_syndrome?opendocument
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The goverment advice is NO achole during pregancy because there has been no evidence to say that any level is safe. Some kids will be born to mothers who drink constantly and be fine, others will be born to a mother who has only had that one drink and be serverly impared. Its not worth the risk.

On the matter of achole while breast feeding

Abstract
This paper both reviews the current literature and explores anecdotal information as reported by Nursing Mothers' (now Australian Breastfeeding Association) breastfeeding counsellors relating to breastfeeding and the use of alcohol, caffeine, nicotine and marijuana. All of these drugs do enter breastmilk to some extent and can have a detrimental effect on the production, volume, composition and ejection of breastmilk, as well as a direct adverse effect on the infant. Breastfeeding mothers should be encouraged to restrict their intake of these so-called recreational drugs. It is acknowledged that this is a particularly stressful period in a mother's life and that she may need additional support and practical suggestions to limit the exposure of these drugs to the infant.

Keywords: breastfeeding, alcohol, caffeine, nicotine, marijuana
Breastfeeding Review 1998; 6(2): 27-30

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INTRODUCTION
For every family, adjusting to a new child is a stressful time. A new mother may find herself turning to caffeine, nicotine, alcohol or even marijuana as a way of coping with her new life. In many cases a mother will not even recognise these substances as drugs. All of these drugs do enter breastmilk to some extent and can have a detrimental effect on the production, volume, composition and ejection of breastmilk, as well as a direct adverse effect on the infant.

This paper reviews some of the current literature relating to breastfeeding and the use of recreational drugs, as well as anecdotal information as reported by Nursing Mothers' (now Australian Breastfeeding Association [ABA]) breastfeeding counsellors. A woman's choices depend on her knowledge base. Many mothers will be unaware of the potential impact of her behaviour on her ability to breastfeed optimally. This information may empower mothers to make informed choices about their use of these so called recreational drugs while they are breastfeeding.

ALCOHOL
Traditionally, women have been told that drinking alcohol will help increase their milk supply and strengthen their baby. Alcohol is generally not considered harmful to the infant if the amount and duration are limited (American Academy of Pediatrics 1989). Some recent studies have suggested that even modest amounts of alcohol may have a significant long-term effect on the breastfed baby (Little 1989; Schulte 1995), making a safe level of alcohol exposure to the breastfed baby hard to define.

Anecdotally, Nursing Mothers' (now ABA) breastfeeding counsellors report instances of babies being drowsy and fussy at the breast after being breastfed by a mother who has been drinking alcohol. Mothers who have been drinking often relate the experience of delayed let-down reflex and a perceived reduced supply. Mothers also report a lower tolerance to alcohol whilst breastfeeding. This may be so, as the low oestrogen levels present during amenorrhoeic lactation are associated with higher blood alcohol levels.

Studies have shown that within thirty minutes of its ingestion, the equivalent of one standard drink changes the smell of breastmilk and has a mildly sedative effect on the baby. Excessive amounts may lead to drowsiness, deep sleep and weakness. A drowsy baby may not suck well which may lead to a reduction in supply. One recent report suggests a 23% reduction (156 ml to 120 ml) in breastmilk production following ingestion of beer (Hale 1998). The altered smell of the milk may account for any fussiness. Any drug that causes drowsiness in the infant may be implicated in SIDS.

Alcohol may theoretically inhibit oxytocin release. Oxytocin is the hormone that causes contraction of the cells surrounding the alveoli and interlobular ducts, forcing milk out into the larger ducts for the baby to remove. Anecdotally, one drink relaxes the mother and improves the let-down reflex whereas large doses of alcohol are believed to have an adverse effect on the let-down or milk ejection reflex. Studies have shown that maternal doses of alcohol greater than 1-2 g/kg can interfere with the let-down reflex (Cobo 1973), though there is considerable variation between individual mothers.

A case often referred to is that of Binkiewicz et al (1978) who noted a four-month-old breastfed infant who developed Pseudo-Cushing Syndrome. The mother was consuming over fifty 12 oz beers and other alcoholic beverages per week. Physical examination of the infant revealed her to be obese (97th percentile for weight) and short (below the 3rd percentile for height). The child's facial appearance was described as 'balloon-shaped' and 'moon-shaped'. The child's appearance and infant growth charts gradually returned to normal when the mother stopped drinking. The safety of consuming even moderate amounts of alcohol has been brought into doubt by a study by Little (1989). Motor development skills were found to be significantly lower in infants regularly exposed to alcohol through breastmilk compared to infants not exposed. Significant declines in motor scores were found in infants whose mothers consumed one standard drink daily. In the first year of life the infant's brain is developing so rapidly and with such complexity that any drug which interferes with that development may have untold long-term effects. Infants in the first few weeks of life detoxify alcohol at approximately half the rate of an adult and liver maturation is not complete until the infant is about three months old (Schulte 1995). Consequently alcohol exposure to a younger infant may have a greater effect than alcohol exposure on an older breastfeeding infant. There is evidence that some drugs have extended half-lives in infants and tend to accumulate. There is a suggestion that some component of breastmilk may inhibit hepatic cytochrome P450 metabolism (LeGuennec & Billion 1987). This metabolism is involved in ethanol metabolism and could lead to delay in elimination of alcohol from the infant.

Interestingly, whereas alcohol appears in the milk at levels approximately equal to that in the mother's bloodstream, no acetaldehyde (the toxic metabolite of alcohol) is found in milk even when levels are high in the mother's bloodstream.

Alcohol impairs a mother's functioning, and may make her more susceptible to depression, fatigue and lapses in judgement. Like any nutritionally vacant food or beverage, too much alcohol can divert the appetite from necessary nutrients.

It is then wise to minimise alcohol exposure to the breastfeeding infant, especially in the first three months. Some recommendations for limiting alcohol exposure include choosing low alcohol drinks, eating before and while drinking, avoiding breastfeeding for two to three hours after drinking and if necessary to express and store alcohol-free breastmilk for use after moderate to heavy drinking.

CAFFEINE
Caffeine is contained in a wide variety of beverages, food and medication. The consumption of coffee, tea, cola-based soft drink and chocolate are a part of our everyday life.

The amount of caffeine found in breastmilk after the consumption of a known amount can vary considerably due to individual differences in absorption and elimination. Peak levels of caffeine are found in breastmilk approximately 60 minutes after ingestion. One study estimated that the average dose to breastfed infants after heavy maternal caffeine intake (750 mg/day or 6-8 cups of coffee per day) was 0.6-0.8 mg/kg/day.

It is important to note that caffeine is used as a respiratory stimulant at a dose of 5 mg/kg/day in premature infants in the treatment of apnoea and near-miss SIDS. Newborns metabolise caffeine very slowly, the half-life of caffeine being 97.5 hours in a neonate, 80 hours in a newborn and 2.6 hours in a six-month-old. The hepatic cytochrome P450 enzyme system is involved in the metabolism of caffeine, and as noted previously, some component of breastmilk is believed to inhibit this system. This potential delay in elimination by the infant could result in accumulation of significant amounts of caffeine in the infant.

Nursing Mothers' (now ABA) breastfeeding counsellors often report mothers who consume high volumes of strong tea, coffee or cola complaining that the baby is jittery, colicky, constipated and generally unsettled. Caffeine may also be associated with a poor milk supply and implicated in recurrent mastitis. Careful questioning may be required to ascertain the mother's level of caffeine intake. In my own counselling experience, mothers in a hot climate may be consuming litres of cola-based drink daily. Similarly, I have known several cases of mothers consuming literally 20-30 cups of coffee per day.

Caffeine has also been shown to have an effect on the composition of breastmilk. When a woman drinks more than three cups of coffee a day, during pregnancy and the early phases of breastfeeding, her breastmilk contains one-third less iron than that of a mother abstaining from coffee (Nehlig & Debry 1994). A decrease in haemoglobin and haematocrit in mothers drinking coffee and their babies has also been observed. It is worth noting that iron deficiency anaemia is prevalent in countries where there is heavy coffee consumption.

Caffeine is approved by the American Academy of Paediatrics for use by breastfeeding mothers. The current recommendation concedes that while occasional use appears to have little effect on the breastfeeding infant, it would seem advisable to restrict caffeine consumption to less than 300 mg/day (approximately three cups of coffee - see table) whilst breastfeeding. The mother should be warned that smoking has been found to accentuate the effects of caffeine in breastfed babies. If the mother uses a cup of tea or coffee to relax and improve the let-down reflex, another hot beverage may be as effective. It has been suggested that decaffeinated drinks, herbal teas, soup or water-based squashes may be used as alternatives to caffeine-based drinks.

Note: Methods of preparation and size of cups can vary considerably. Coffee can be boiled, filtered, percolated or prepared as espresso, Greek or Turkish 'mud' or soluble coffee. The extraction efficiency of caffeine differs for each type of preparation and ranges from 75-100%. Cup size varies from 30-190 ml. The content of caffeine varies from 19-160 mg of caffeine according to the type of coffee, size of the cup and country. Daily consumption of caffeine in the general population is 202-283 mg, which represents 2.7-40 mg/kg/day in males and females 20-75 years old.

Milligrams of caffeine per 150ml cup
Brewed or filtered coffee 90 mg
Soluble instant coffee 63 mg
Decaffeinated coffee 3 mg
Tea 32-42 mg
Cola drink 16 mg
(Nehug & Debry 1994)

NICOTINE
It is widely acknowledged that women who smoke during pregnancy do not tend to breastfeed, and are more likely to wean their babies earlier than non-smoking women. Interestingly, this phenomenon appears to be dose related: the more cigarettes smoked the less time spent breastfeeding (Saunders 1990).

Nicotine is quickly absorbed after maternal smoking and has a half-life in breastmilk of about 90 minutes. The extent of exposure of a breastfed infant is difficult to assess since at least part of the exposure is due to 'sidestream' smoke. Sidesteam smoke is not filtered and contains more nicotine, tar and carbon monoxide than 'mainstream' smoke drawn through the cigarette and into the mother's mouth and lungs. The median nicotine concentration in infant urine after exposure via breastmilk or via passive inhalation was 14 ng/ml and 35 ng/ml, respectively. It is suggested that the effects of these two modes of transmission are probably additive (Fulton 1990).

Babies who are 'smoked over' are more likely to be hospitalised and to suffer from respiratory and gastrointestinal illnesses. Studies show that these infants are more likely to be colicky and irritable and to experience a wide range of problems from apnoea (short periods when the baby stops breathing), vomiting, poor growth, squint (strabismus, cast or lazy eye), hearing impairment and unexplained death. Smoking depresses the immune system, leaving both the mother and infant more vulnerable to infection, allergy and other immunodeficiency problems (Minchin 1991).

Nicotine reduces basal prolactin levels which may lead to a decrease in milk supply. Nicotine also causes an adrenaline rush which may inhibit the release of oxytocin and interfere with the let-down reflex. One study clearly suggests that cigarette smoking significantly reduces breastmilk production at two weeks postpartum from 514 ml/day in non-smokers to 406 ml/day in smoking mothers (Hale 1998). In a counselling situation it is always advisable to ask a mother with constant low supply whether she is a smoker.

Nicotine is an appetite suppressant and can alter the taste of breastmilk. Babies may express their distaste for the milk by fussing and struggling at the breast or even refusing the breast. If the mother smokes more than 15 cigarettes a day, infants can exhibit symptoms of nicotine poisoning (Bisdom 1937). These symptoms may include vomiting after a feed, grey skin colour, loose stools, an increased heart rate and restlessness. Classically, the infant can be observed to wiggle and squirm, giving the appearance of trying to frantically 'tread water' and though they appear very tired they seem to find it hard to keep their eyes shut. Symptoms are slowly reversed when the mother decides to cut back or quit her previous smoking habit. However, infants may also suffer withdrawal symptoms such as sleep disturbances, headaches and irritability.

The breastfeeding mother who wishes to quit smoking may find this is an ideal time to do it. Prolactin and the endogenous opioids released during suckling may actually blunt the worst of her withdrawal symptoms (Minchin 1991). Transdermal nicotine patches used in nicotine withdrawal have been used in breastfeeding mothers. Nicotine levels can be expected to be less in patch users than those found in smokers, assuming the patch is used correctly and the mother abstains from smoking. The mother should be made aware that the patch is delivering nicotine into her system constantly and it may be desirable to only wear the patch for part of the day (manufacturer, pers comm 1997).

Exposure to nicotine can also alter the composition of breastmilk. Breastmilk from a mother who smokes contains many chemical by-products of smoking such as nitrates and nitrites, it may contain pesticides and dioxins and have higher cadmium and lead levels than breastmilk from a non-smoking mother (Minchin 1991). Breastfed infants, whose mothers smoke, may have lower levels of certain vitamins. For example, vitamin B12 may be reduced, as it is needed to detoxify cyanide from cigarette smoke (Saunders 1990).

Smokers may choose to give up breastfeeding because they fear contamination of their milk is a greater risk to the baby than artificial feeding. It is important to remember that artificial milks do not have any of the unique nutritional or immunological advantages of breastmilk and that it is preferable to continue breastfeeding. It is actually more important to stop smoking in families where infants are artificially fed (Chen 1989).

To reduce potential harm from smoking all parents should be encouraged to:

quit if at all possible.
smoke outside the house and car.
smoke only AFTER feeding to reduce nicotine exposure. Try to use other comforting techniques for the baby for 90 minutes after smoking. (This is difficult with a young baby who is feeding frequently, but may be possible once baby has established routines).
avoid vegetables containing considerable amounts of nicotine - eggplant, green and pureed tomatoes and cauliflower. Ten grams of eggplant provides the same amount of nicotine obtained in three hours in a room with minimal tobacco smoke (Laurence 1985).
breastfeed exclusively for the first six months to maximise the infant's protection against respiratory disease, and continue to breastfeed as long as possible.
do not take the baby into smoky environments.
MARIJUANA
The active component of marijuana, delta-9-tetrahydrocannabinol (THC) is fat soluble and is rapidly distributed into brain and adipose (fatty) tissue. The analysis of breastmilk in chronic heavy marijuana users shows an eightfold accumulation in breastmilk compared to plasma. Infants exposed to marijuana through breastmilk will test positive in urine screens for two to three weeks.

Breastfeeding infants absorb and metabolise THC and their exposure occurs at a time when growth and development, particularly glial and myelin formation in the central nervous system, is progressing at a rapid rate (Tennes et al 1985; Astley & Little 1990). Animal studies have shown that structural changes occur in the brain cells of newborn animals exposed to marijuana through their mother's milk. Marijuana purportedly impairs DNA and RNA formation. Although long-term studies have not been completed, results observed in humans suggest serious and long lasting effects (Astley & Little 1990).

If the mother smokes marijuana while breastfeeding or in the presence of the infant, there is also the effect of the sidestream smoke to be considered. Infants exposed to marijuana through breastmilk often exhibit signs of sedation, weakness and poor feeding patterns. Marijuana has been implicated in the reduction of basal prolactin levels and therefore, in possible decreased milk production.

Marijuana use causes reality distortion, which may make it hard to cope with an emergency situation, difficulty in performing small motor activity and after the 'high' wears off, a desire for sleep, usually quite deep, in which the mother may be unresponsive to her baby's needs.

The use of marijuana by breastfeeding mothers is contraindicated by the American Academy of Pediatrics. The long-term effects of early exposure, especially on the infant's rapidly-developing brain are unknown. Breastfeeding mothers should be advised not to smoke. It has been suggested that breastfeeding should be avoided if the mother is a heavy user and withheld for several hours after occasional use. Measures should be taken to reduce the infant's exposure to sidestream smoke as discussed previously.

CONCLUSION
In addition to the medical issue, there are also broader social issues in this discussion of breastfeeding and the use of recreational drugs. These encompass the legal ramifications and moral obligations of such use. In this age of increasing litigation, there may be potential for the future generation to apportion blame on the present generation for any harm that the mother's actions may be seen to have had on an infant. Already the Family Court is considering the issues of smoking, alcohol and other drugs in relation to the residence and contact of infants. Breastfeeding mothers should be encouraged to restrict their intake of these so-called recreational drugs. It should be acknowledged that this is a particularly stressful period in a mother's life and that she may need additional support and practical suggestions to limit the exposure of these drugs to the infant. In all cases it should be stressed that while the problem is the mother's use of these drugs while breastfeeding, the choice should be to give up the drug rather than to give up breastfeeding.

Terms used to describe drug levels in the body

AHL:
This is the most commonly recorded adult half-life of the drug. Short half-life drugs are preferred as they generally enter milk at lower levels. They also do not tend to accumulate in the infant's plasma.
M
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:
The milk
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lasma ratio. This is the ratio of the concentration of drug in the mothers' milk divided by the concentration of drug in the mothers' plasma. A low (<1.0) ratio is preferred as this is a good indicator that only a small percentage of the drug is transferred into milk.
PK:
The Peak is the time interval from the mother taking the drug until it reaches the highest level in her plasma. It is preferable to choose drugs that have a short peak, and to avoid breastfeeding at the peak.
REFERENCES
American Academy of Pediatrics 1989, Committee on Drugs: the transfer of drugs and other chemicals into breastmilk. Pediatrics 84: 924-936.
Astley SJ, Little RE 1990, Maternal marijuana use during lactation and infant development at one year. Neurotoxicol Teratol 12(2): 161-168.
Binkiewicz A, Robinson MJ, Senior B 1978, Pseudo-Cushing syndrome caused by alcohol in breastmilk. J Pediatr 93: 965-967.
Bisdom W 1937, Alcohol and nicotine poisonings in nurslings. J Am Med Assoc 109: 178.
Chen Y 1989, Synergistic effect of passive smoking and artificial feeding on hospitalization for respiratory illness in early childhood. Chest 95: 1004-1007.
Cobo F 1973, Effect of different doses of ethanol on the milk-ejecting reflex in lactating women. Am] Obstet Gynecol 115: 817-821.
Fulton B 1990, The Galactopharmacopedia, recreational drug use in the breastfeeding mother. Part 2: illicit drugs. J Hum Lact 6(1): 15-16.
Hale TW 1998, Medications and Mothers' Milk. Seventh Edition. Pharmasoft Medical Publishing, Texas.
Lawrence R 1985, Breastfeeding: A Guide for the Medical Profession. CV Mosby Co, St Louis. p520.
LeGuennec JC, Billion B 1987, Delay in caffeine elimination in breastfed infants. Pediatrics 79: 262-268.
Little RE 1989, Maternal alcohol use during breastfeeding and infant mental and motor development at one year. New Engl J Med 321: 425-430.
Minchin MK 1991, Smoking and breastfeeding: an overview. J Hum Lact 7(4): 183-188.
Nehlig A, Debry G 1994, Consequences on the newborn of chronic maternal consumption of coffee during gestation and lactation a review. J Am Coll Nutr 13(1): 6-21.
Saunders S 1990, Smoking and breastfeeding. Child Antenat Nutr Bull 11: 2-3.
Schulte P 1995, Minimizing alcohol exposure of the breastfed infant. J Hum Lact 11(4): 317-319.
Tennes K, Avitable N, Blackard C, Boyles C, Hassoun B, Holmes L, Kreye M 1985, Marijuana prenatal and postnatal exposure in the human. Nat Inst Drug Abuse Research Monograph 59: 48-60.

http://www.breastfeeding.asn.au/bfinfo/drugs.html
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CutsieMarie89 · May 1, 2009

takandjive said: ↑

I think Orly's pointing out that's pretty unrealistic in some cultures. It's very easy to slip up and have a glass. Or if you're getting married and you have a sip of champagne. It's not good to ever give your kids red dye #40, but we do, in moderation. The point is, we spend so much time beating up moms who slip and have a beer while breastfeeding that we let the real problems slide under the radar because they remain hidden, rather than talking about it.
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She thinks what I said is overly paranoid and maybe it is but I'm really not a fan of giving developing infants recreational drugs. I apologize for my tone earlier, but this is one issue I'm really not cool with. I work with toxic chemicals at a museum, I could probably drink some and they wouldn't kill me, but I'm wouldn't go out my way to expose my baby to them.

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Asguard · May 1, 2009

oh bells, you know i once had a reasonably heated argument with mum about drinking while pregnant. When she and her friends were pregnant the advice for women who couldnt eat because of the pregancy was to drink stout (which is actually how we came onto the topic because i ordered a gunnes
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) and her opinion was that it "never did anyone any harm". Currently the evidence says that no level of achole is safe during pregancy and that if it was recomended in the past then they were either wrong or negligent depending what resurch at that time suggested

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takandjive · May 1, 2009

CutsieMarie89 said: ↑

She thinks what I said is overly paranoid and maybe it is but I'm really not a fan of giving developing infants recreational drugs. I apologize for my tone earlier, but this is one issue I'm really not cool with. I work with toxic chemicals at a museum, I could probably drink some and they wouldn't kill me, but I'm wouldn't go out my way to expose my baby to them.
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I understand. I grew up in an environment where it's viewed in the same light as giving a kid sugar or preservatives. If you screw up and have half a glass of an old Italian wine because it was too tempting at dinner and now you have to feed the baby, you just don't keep kicking your own ass over it because it won't really affect anything.

I agree it's best if you don't.

Roman · May 1, 2009

You know, during the middle ages, everyone was drinking booze since the water would make you sick. Makes me wonder if everybody had mild FAS back then.

Asguard · May 1, 2009

yes because life expectancy for the mentally and physically handicaped was so good back then with the priests denouncing them as possesend by deamons and boring holes in there heads right?

Roman · May 2, 2009

Asguard said: ↑

yes because life expectancy for the mentally and physically handicaped was so good back then with the priests denouncing them as possesend by deamons and boring holes in there heads right?
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I didn't say severe FAS. I imagine being slightly retarded 500 years ago would have been pretty beneficial- you'd have retard strength, would accept retarded Church doctrine, and make a pretty good follower.

Hell about 60% of the population of humans is mildly retarded, and there's like 6 billion of us going strong.

Bells · May 2, 2009

Asguard said: ↑

oh bells, you know i once had a reasonably heated argument with mum about drinking while pregnant. When she and her friends were pregnant the advice for women who couldnt eat because of the pregancy was to drink stout (which is actually how we came onto the topic because i ordered a gunnes
Please Register or Log in to view the hidden image!
) and her opinion was that it "never did anyone any harm". Currently the evidence says that no level of achole is safe during pregancy and that if it was recomended in the past then they were either wrong or negligent depending what resurch at that time suggested
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I didn't touch a drop while pregnant. The sip of champagne I had was when I was nursing, not pregnant.

A lot of women in previous generations were prescribed Guiness during their pregnancy. Not in copious amounts. Some women do still have a drink during their 2nd or 3rd trimester. While no alcohol is the safest option, it really does not pay to start berating women who are in the later stages of their pregnancy who have a small wine or something. Nor is it fair to start telling women off because they were prescribed Guiness during their pregnancy. In those days, they did not know any better. Just as we don't really know that much better these days and can only go on the advice of our doctors. Hell, the hospital where I and my sister in law gave birth in (private) gave us small bottles of red or white wine with our dinners. I never drank it, but I remember she did after she had her children and no one ever said a word.

10 years ago, a pregnant woman could eat ham without any cause for concern. Now pregnant women are told to avoid all ham and even slightly runny eggs, etc.

Asguard · May 2, 2009

i didnt berate because she did it, as far as i know she never did. i was irritated because of her comment that it never did anyone any harm and we have always done it. people have to be willing to accept that evidence changes, especially science grads like my parents. thats the way we have always done it is no excuse when the evidence and warnings are so widly publised and the goverment pays a fortue each year making sure lay people have access to resurch like cochrane and the department of health resurch

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