Last update July 3, 2023
During breastfeeding, it is recommended not to consume alcohol. The level of maternal alcohol consumption that poses zero risk or is safe for the infant is unknown. (Han 2022, Ministry of Health 2020 p. 44, ABM 2015)
Alcohol is excreted in breast milk. (Schneider 2013, Chien 2009 and 2005, Pepino 2007, Palmquist 2005, Koren 2002, da-Silva 1993, Argote 1992, Mennella 1991, Lawton 1985)
Consuming alcohol during breastfeeding can cause sedation, growth retardation, irritability, psychomotor delay, and lower cognitive and academic performance (Gibson 2021, Sachs 2013, Backstrand 2004, Koren 2002, Moretti 2000, Little 1989), although data are inconsistent and scarce (Giglia 2006, Koletzko 2000) and may depend on the amount and chronicity of alcohol consumption. (Han 2022, Gibson 2020 and 2018, Wilson 2017, ABM 2015, Haastrup 2014, Little 2002)
The time needed to wait before breastfeeding so that the ingested alcohol has disappeared from milk and blood (Ho 2001) depends on the mother's weight (less weight, more time) and the amount of alcohol consumed (more alcohol, more time). Avoid breastfeeding for at least two and a half hours for every 12-15 g of alcohol consumed: one-third (330 ml) of 5% beer, a 140 ml glass of 11-12% wine, or a 40 ml glass of 40% liquor. Double these amounts would require a wait of 5 hours and triple 7.5 hours, etc. (Han 2022, ABM 2015, Giglia 2006, Koren 2002 table)
Excessive acute consumption can cause coma, convulsions, and the risk of death in the infant. (Swiderski 2011)
A case of pseudo-Cushing's syndrome that disappeared when the mother stopped drinking has been reported. (Moretti 2000)
Alcohol consumption during pregnancy is associated with a delay in milk production or lactogenesis II. (Rocha 2020)
There is controversy over whether alcohol consumption is associated with shorter breastfeeding duration (Mgongo 2013, Rebhan 2009, Giglia 2008). Although it slightly increases prolactin levels (Sarkola 1999), acute consumption sedates the infant and inhibits the mother's oxytocin secretion (Cobo 1973, Coiro 1992, Chien 2009) and therefore milk ejection reflex, reducing milk production by 10 to 25%. (Mennella 2005-2001-1998-1997-1993-1991)
Although prenatal alcohol and tobacco consumption has been linked to attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), no association between these disorders and alcohol consumption during breastfeeding has been demonstrated. (Gibson 2022)
Beer does not increase milk production (AEP LM Committee 2012, Mennella 2001-1993). After drinking non-alcoholic beer (0.0% or <1%), alcohol levels in breast milk are negligible or undetectable. (Schneider 2013)
Some medications containing high concentrations of alcohol (Agua del Carmen, Denubil) as an excipient should be avoided during breastfeeding. (Nice 2000)
It is not recommended to co-sleep with the baby if you have been drinking alcohol. (ABM 2020 and 2008, UNICEF 2018, 2017, 2014 and 2013, Landa 2012, UNICEF 2006)
Drinking alcohol does not protect against COVID19. (WHO 2020)
Alcohol, as a topical disinfectant, does not increase the levels of alcohol in breast milk and is compatible with breastfeeding. (Han 2022, WHO 2002)
Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.
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e-lactancia is a resource recommended by Academy of Breastfeeding Medicine - 2006 of United States of America
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