Breast milk offers a natural supply of nutrients to a nursing baby. It functions as a continuation of the placenta’s job as a protector against disease. Similarly the contents of the placenta and breast milk have a bearing on the baby’s development, both behaviorally and physiologically. Alcohol when drunk by a pregnant woman is readily available in the placenta and when alcohol is consumed by a breastfeeding mother it is found in breast milk.
What Happens to Alcohol in a Breastfeeding Mother's Body?
Alcohol enters the breast milk by diffusion; from the mother’s blood plasma through the capillary walls to the milk buds. This diffusion is concentration dependent; as alcohol levels rise in the mother’s blood, alcohol concentrations in the breast milk also rise. As the lactating mother’s body excretes or metabolizes the alcohol, alcohol blood levels drop. The drop causes alcohol in the breast milk to diffuse back into the mother’s blood plasma. Generally, less than 2 percent of the alcohol ends up in breast milk.
How Alcohol Affects Breastfeeding
Alcohol affects many systems in the body and milk production is no different. The consumed alcohol compromises the release of the hormones prolactin and oxytocin which are important in milk production and the nursing let-down reflex. In one study infants consumed less breast milk after the mother had consumed alcohol; this contradicts the common lore that alcohol enhances breast milk production (Mennella, Julie A., “Regulation of Milk Intake After Exposure to Alcohol in Mothers' Milk. Alcohol Effects on the Fetus, Brain, Liver, and Other Organ Systems” Alcoholism: Clinical & Experimental Research. 25(4):590-593, April 2001 abstract).
Alcohol in Breast Milk's Effect on the Baby
Once the baby ingests the alcohol tainted breast milk it enters into the baby’s GI tract. In the GI it is absorbed and becomes available to the baby’s different systems. The alcohol affects the baby’s sleep and activity levels through a mechanism that has yet to be understood. Contrary to common belief a baby’s sleep is interrupted by alcohol consumption by the mother (Julie A. Mennella and Carolyn J. Gerrish, “Effects of Exposure to Alcohol in Mother's Milk on Infant Sleep”. Pediatrics, May 1998; 101: 2 full article).
Does Pump and Dump Work?
No. Based on the absorption process of alcohol, one can see that alcohol does not accumulate or remain in the breast milk statically. The concentration of alcohol in the breast milk varies depending on the concentration of alcohol in the mother’s blood. Pump and Dump is based on the premise that one can remove all the alcohol from the breast milk by simply removing the tainted milk. This is simply not true as the alcohol will still continue to diffuse into the newly formed milk.
Store Breast Milk if Planning to Drink Alcohol
Since there is no nutritional benefit from alcohol consumption to the breast fed infant, experts recommend breastfeeding mothers to refrain from drinking while nursing. If alcohol is consumed, it is recommended that the breastfeeding mother wait at least 3 hours after consuming one unit of alcohol (one beer, one glass of wine, or one cocktail drink). Alcohol levels peak in the breast milk 30 minutes to one hour after the last drink and decrease thereafter, therefore women should store breast milk before drinking or wait until all alcohol is eliminated before continuing a breastfeeding routine.
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