How Long Does Alcohol Stay In Breast Milk

How Long Does Alcohol Stay In Breast Milk – Although the harmful effects of alcohol consumption during pregnancy are well documented and recommendations to avoid alcohol during pregnancy are clear, the risks of alcohol consumption during breastfeeding are less well known.

When patients ask healthcare professionals for guidance on the safety of consuming alcohol while breastfeeding, they often receive conflicting advice. Providers and patients are advised to navigate the limited information available on this highly relevant topic.

How Long Does Alcohol Stay In Breast Milk

How Long Does Alcohol Stay In Breast Milk

Due to the lack of definitive data on breastfeeding and alcohol consumption, recommendations from professional organizations vary (Table 1).

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Whereas the American Academy of Pediatrics (AAP) states that occasional alcohol consumption equivalent to 8 oz of wine or 2 cans of beer per day may be acceptable and that waiting 2 hours after the last drink before breastfeeding is sufficient.

The Academy of Breastfeeding Medicine offers similar advice and also acknowledges that the long-term effects of alcohol in breast milk are unknown.

The American College of Obstetricians and Gynecologists (ACOG) has guidelines directed at parents recommending waiting at least 2 hours after one drink before breastfeeding; However, the ACOG panel opinion recommends that “a mother should be encouraged by her healthcare provider to wait 3-4 hours after one drink before breastfeeding.”

Alcohol is ubiquitous in our society, and many women want to resume drinking alcohol while breastfeeding after abstaining during pregnancy. In 2019, more than half of the United States it. Adults drank alcohol in the last 30 days. About 26% of the adult population reported binge drinking (for women, 4 or more drinks on one occasion) and 6.3% reported heavy drinking (for women, 8 or more drinks per week) in the past month.

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Although about 50% of lactating women reported using alcohol at least occasionally, only 13% said they had received advice from a health care provider about the risks of alcohol consumption while breastfeeding.

Due to high alcohol consumption and the fact that 58% of children in the United States that. Breastfeeding for at least 6 months, healthcare providers will encounter questions from patients about the safety of consuming alcohol while breastfeeding.

Any recommendation to restrict breastfeeding as a result of maternal alcohol consumption must be carefully balanced against the known health benefits of breastfeeding for mother and infant. Although data are limited on this topic, much is known and should be communicated to patients during pregnancy and postpartum.

How Long Does Alcohol Stay In Breast Milk

Therefore, the alcohol level in milk closely parallels the alcohol concentration in the mother’s blood. The alcohol content of milk reaches its maximum about 30-60 minutes after the consumption of an alcoholic drink, but the maximum can be delayed by an additional hour if alcohol is consumed with food.

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The total bioavailability of alcohol in lactating women is about 25% lower compared to non-lactating women, resulting in a lower peak blood alcohol level, but the time to peak blood alcohol level is the same.

If an infant consumes milk at the time of peak alcohol concentration, the estimated amount of alcohol consumed by the infant is about 5% to 6% of the mother’s weight-adjusted intake.

The elimination of alcohol from breast milk largely depends on the mother’s weight and the amount of alcohol consumed. The more alcohol is consumed, the more it will be in the milk.

After drinking a standard single drink (Figure 1), alcohol is typically detected in milk for approximately 2.5 hours for a 132.3 lb (60 kg) individual. If another drink is consumed, the time to eliminate alcohol doubles and alcohol remains detectable in milk for nearly 5 hours. In the event of an overdose, alcohol may be detected for more than 9 hours.

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Although alcohol test strips are used to determine the presence of alcohol in milk, it is more reliable to use nominal analyzes to determine when milk is free of alcohol (Table 2).

Table 2. Time from the beginning of consumption until alcohol is cleared from breast milk for women with different body weights

Once milk containing alcohol is consumed, it is absorbed by the baby. Calculations estimate that an infant’s blood alcohol level would reach around 0.005% after consuming breast milk after the mother’s consumption of 4 standard drinks.

How Long Does Alcohol Stay In Breast Milk

The rate at which an infant can metabolize alcohol is about half that of an adult due to immature metabolic processes that detoxify alcohol.

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Little and colleagues hypothesized that the infant brain may be exceptionally sensitive to alcohol even in this small amount due to the infant’s rapid brain growth and immature metabolism.

It is not necessary to pump and express milk after consuming alcohol. This will not speed up the elimination of alcohol from milk. However, if alcohol consumption leads to delayed or missed feedings, lactating milk can maintain supply and prevent choking complications.

Contrary to popular belief that recommends the use of alcohol to stimulate milk production, alcohol has been shown to reduce milk production, at least temporarily.

It interacts with the neuroendocrine axis and interferes with the hormones that affect lactation. Alcohol inhibits the release of oxytocin, the hormone responsible for the milk let-down reaction.

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Alcohol in doses of 0.5 g/kg (which is about 8 oz of wine or 2 beers for a 132.3 lb [60 kg] person) has been shown to decrease the oxytocin response to sucking by 18%; Doses of 1.5 g/kg have been shown to reduce the oxytocin response by 80%. Therefore, lactating women who consume alcohol may experience a delay in milk ejection ranging from approximately 30 seconds for lower doses and up to 330 seconds with higher doses of alcohol exposure.

Conversely, prolactin levels rise in response to alcohol consumption. Although prolactin is a hormone important for milk production, an increase in prolactin levels after alcohol consumption is not associated with increased milk production.

Beer has a reputation for increasing milk supply. The polysaccharide found in barley and malt has been shown to increase serum prolactin levels in non-pregnant and non-lactating women. However, infants consumed 23% less milk per hour after maternal alcoholic beer consumption (versus nonalcoholic beer), and beer is not recommended for use as a galactagogue.

How Long Does Alcohol Stay In Breast Milk

Overall, babies consume about 20% less milk immediately after maternal alcohol consumption, probably due to reduced milk production. A reduction in infant milk consumption is not associated with a shorter time spent sucking or an infant rejecting the taste of the milk.

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In fact, Mennella observed that children consumed greater amounts of alcohol-flavored milk compared to plain milk when both options were offered through the bottle.

Babies appear to compensate for reduced food intake by breastfeeding more often in the 8-16 hours after maternal alcohol consumption.

Even small amounts of alcohol in breast milk have been shown to disrupt and shorten the overall duration of infant sleep. Mennella and Garcia-Gomez observed that infants after milk consumption 1 hour after 0.3 g/kg of alcohol (slightly more than 1 regular drink for a 60 kg) person and sleep were more fragmented and decreased overall in the following 3.5 to 4 hours .

When children were observed for 24 hours, they appeared to compensate by spending more time in active sleep from 3.5 to 24 hours after consuming the alcohol-containing milk.

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Schuetz and colleagues found that babies are more curious, with more frequent crying and surprise, hours after consuming alcohol-containing milk. Although some of these behaviors may be explained by maternal behavior after alcohol consumption, these findings are consistent with decreased sleep and increased infant attention observed in other studies.

The long-term effects of a baby’s exposure to alcohol in breast milk are not definitively understood. It is a challenging topic to study because the effects of dyad interactions following maternal alcohol use may play a role in neurodevelopment.

It is also difficult to measure the amount of alcohol an infant is exposed to, and information on the amount of alcohol consumed by the mother and the timing of subsequent feedings is usually not available. Conversely, there is clear evidence that fetal exposure to alcohol during pregnancy can have adverse physical and long-term neurodevelopmental consequences.

How Long Does Alcohol Stay In Breast Milk

Little and colleagues evaluated infants exposed to alcohol in breast milk for both cognitive and psychomotor development.

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Although cognitive outcomes at 1 year were not shown to be affected by maternal alcohol consumption, measurable reductions in motor development were observed. However, when infants were assessed at 18 months of age, this deficit was no longer demonstrated.

May and colleagues analyzed the results of first graders who were exposed to alcohol while breastfeeding and found that they had poorer grammar comprehension than children who were not exposed.

Gibson and Porter found no association between alcohol exposure during breastfeeding and vocabulary or early literacy scores. However, they observed dose-dependent declines in abstract reasoning and cognitive abilities between ages 6 and 7.

Subsequent analysis of the results revealed that increased or risky maternal alcohol consumption during breastfeeding was associated with dose-dependent decreases in Grade 3 (7-10 years) writing, spelling, grammar, and punctuation scores, as well as Grade 5 (9 years)-11 years ) spelling level.

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Breastfeeding women should be taught to minimize their children’s exposure to alcohol when they choose to consume alcoholic beverages. A person can be advised to express or express milk just before consuming alcohol.

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