Effects of Smoking, Alcohol, and Medicines On Breastfeeding
WHAT YOU NEED TO KNOW:
What do I need to know about the effects of smoking, alcohol, and medicines on breastfeeding?
Smoking, alcohol, and medicines can all affect breastfeeding. Harmful substances can pass to your baby through your breast milk. Learn about the ways that these affect breastfeeding so that you can safely breastfeed your baby.
What do I need to know about smoking and breastfeeding?
Breastfeeding mothers should not smoke. Nicotine goes into your breast milk. Your baby is exposed to these chemicals through breastfeeding and inhaling cigarette smoke. Smoking can also decrease the amount of breast milk you make. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine. Ask your healthcare provider for information if you currently smoke and need help quitting.
How can I decrease the harmful effects of smoking while breastfeeding?
If you choose to smoke, it is still best to breastfeed your baby. Breastfeeding can help protect your baby from breathing problems and SIDS. You can decrease the effects of smoking by doing the following:
- Do not smoke in your home. Go outside to smoke. Do not allow others to smoke in your home.
- Wait to smoke until after a breastfeeding session. The harmful chemicals in your breast milk decrease about 1 hour after you finish smoking.
What do I need to know about alcohol and breastfeeding?
Alcohol goes from your bloodstream to your breast milk. The amount of alcohol in breast milk is highest 60 to 90 minutes after you drink alcohol with a meal. Alcohol affects the taste of your breast milk and may cause your baby to drink less than normal. Drinking alcohol regularly or in large amounts can also decrease your milk supply. Alcohol may also affect your baby’s sleep.
How can I decrease the harmful effects of alcohol while I breastfeed?
If you plan to drink alcohol, breastfeed your baby first. Wait at least 2 hours after you drink before you breastfeed again. This will allow your body to get rid of the alcohol so the amount in your breast milk will decrease. If you abuse alcohol, you may not be able to breastfeed. Alcohol abuse is when you drink too much alcohol or drink it too often. Talk to your healthcare provider about drinking alcohol while breastfeeding.
What do I need to know about medicines and breastfeeding?
- Some medicines may go into your breast milk and affect your baby. Certain medicines can decrease your milk supply, make your baby very sleepy, or affect your baby in other ways. Tell your healthcare provider about all of the medicines you use, including over-the-counter medicines. Tell him or her how often and how much medicine you use. Your healthcare provider can usually recommend other safe medicines, if needed.
- Medicine used during labor and delivery may affect breastfeeding. Your baby may have trouble latching on to your breast for the first 24 hours if you had anesthesia or medicine to decrease pain. To help your baby breastfeed, hold him or her close to you, with his or her skin touching yours. You also may need to express milk to feed your baby. Ask your healthcare provider for more information about expressing milk.
- Talk to your healthcare provider if you want to take a birth control pill. Generally, birth control pills do not affect a breastfeeding baby. Some types of pills contain high doses of estrogen. This can decrease your milk supply. Ask your healthcare provider about types that do not contain estrogen. You can also use other forms of birth control, such as a condom, diaphragm, or cervical cap.
How can I decrease the effects of medicines while I am breastfeeding?
- You may need to stop breastfeeding while you are taking certain medicines. You may need to express your milk and dump it out while you use certain medicines. You may need to do this if you take medicines for a short time that may be harmful to your baby. This helps your breasts to keep making milk until you can breastfeed again. If possible, feed your baby stored breast milk until your healthcare provider tells you that it is safe to breastfeed again. Rarely, you may need to stop breastfeeding completely if you need to take certain medicines for a long period of time. You can feed your baby stored breast milk, breast milk from a donor milk bank, or infant formula from a bottle.
- Work with your healthcare provider to limit medicines. You may have to take some medicines while you are breastfeeding. If possible, take the lowest dose you can for the shortest time possible. Try to take short-acting medicines. For example, some allergy and cold medicines come in short- and long-acting forms. Short-acting forms mean they stay in your body a short time.
- Time medicines according to your baby’s breastfeeding needs. Take short-acting medicines right after a breastfeeding session. Take long-acting medicines right before your baby sleeps for the longest amount of time. These medicine timings will make it more likely the medicine will be out of your body before your baby’s next breastfeeding session.
What do I need to know about illegal drugs and breastfeeding?
- Do not breastfeed if you use illegal drugs. Illegal drugs pass from your bloodstream into your breast milk and are harmful to your baby’s health. Some examples of illegal drugs are cocaine, heroin, LSD, methamphetamine (meth), and phencyclidine (PCP).
- The effects of marijuana on breast milk and a breastfeeding baby are not known. For this reason, it is safest not to use marijuana at all while you are breastfeeding. It is not safer to eat or drink marijuana than to smoke it. Talk to your healthcare provider if you use medicinal marijuana. He or she may be able to recommend other medicines to use until your baby is no longer breastfeeding. If you use medicinal marijuana for pain, your provider can recommend ways to control pain without medicine.
Where can I go for support and more information?
- American Academy of Pediatrics
345 Park Boulevard
Itasca , IL 60143
Phone: 1- 800 – 433-9016
Web Address: http://www.aap.org
- La Leche League International
957 North Plum Grove Road
Schaumburg , IL 60173
Phone: 1- 847 – 519-7730
Phone: 1- 800 – 525-3243
Web Address: http://www.lalecheleague.org
When should I seek immediate care?
- Your baby has breathing problems, seems more sleepy than usual, or is not breastfeeding well.
- Your baby feels cold, shivers, or his or her skin looks blue or pale.
- Your baby shows signs of dehydration, such as sunken eyes, dry skin, fast breathing, or few or no wet diapers.
When should I contact my baby’s healthcare provider?
- Your baby is 4 or more days old and has fewer than 6 wet diapers each day.
- Your baby is 4 or more days old and has fewer than 3 bowel movements each day.
- Your baby is breastfeeding fewer than 8 times each day.
- Your baby is not gaining weight or looks like he or she is losing weight.
- Your baby is crying more than usual.
- Your baby is vomiting, or develops a skin rash.
- You have been using illegal drugs and breastfeeding.
- You have been breastfeeding and drinking more alcohol than your healthcare provider says is safe.
- You have been taking medicines that you have been told not to take while breastfeeding.
- You have questions or concerns about breastfeeding.
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Why did I start my period? I’m still breastfeeding!
Question: Why did I start my period? I’m still breastfeeding!
I am currently nursing my third child. She is seven months old and still nurses 4
6 times a day. The problem? I started my period today! Yuck! With both of my other babies it took MONTHS after they weaned to get my period back. So what is going on? Do you think that my hormones are all out of whack or something? Should I call my OB/GYN? I am totally upset…one of the best parts for me about breastfeeding (besides a hundred other wonderful reasons to nurse) is not having a menstrual cycle!
Answer: It doesn’t sound to me like there is anything wrong at all. We nursing mothers consider not having a period one of the little “perks” associated with breastfeeding, but individual experiences vary widely.
During the period of exclusive breastfeeding (no supplements, night and day nursing, and little or no pacifier use) most moms won’t have a period during the first six months. If these conditions are met, breastfeeding is a very effective method of birth control (more than 98% protection).
After delivery, mothers experience vaginal bleeding (“lochia”) for two to six weeks. Lochia consists of blood, mucus, and uterine lining the body sheds after giving birth. In the first few days postpartum, the discharge is bright red and heavy, and may contain small clots. For the next week or two, the flow will lessen and the color will change to a pinkish brown. Over the next few weeks, the bleeding will lessen and the color will change from red to pinkish brown. Passing clots after this time may indicate a problem, so you should call your doctor to discuss it.
According to Breastfeeding and Human Lactation (Fourth Edition): “Breastfeeding provides more than 98% protection from pregnancy during the first six months postpartum if the mother is “fully” or nearly fully breastfeeding and has not experienced bleeding after the 56th day postpartum. Bleeding in the first 56 days postpartum can be ignored.”
However, once you introduce any supplemental foods (formula or solids) your baby will typically cut back on nursing and you will usually start your period within a few weeks. Anything that reduces the amount of time your baby nurses, including extended periods of separation (like returning to work) or baby sleeping through the night, will increase the chances of starting your period.
When you consider how often babies nurse in the early stages of breastfeeding (newborns often eat 10-12 times or more in 24 hours), then you can see how only nursing four times a day might not be enough to suppress ovulation.
Mothers who start their period before six months will often be infertile during their first few cycles. Moms who start their period after six months are more likely to ovulate before they have a ‘warning’ period.
Some women will have full periods even when they are exclusively nursing, but this is uncommon. Moms can nurse for months or years after starting their periods. It’s not unusual for periods to be different after pregnancy. Some moms find their periods are irregular for awhile after their cycle starts back, and the flow is often lighter with less cramping than before.
Some mothers (but not most) will notice a temporary decrease in their supply during their period, but it builds back up quickly.
Just be aware that once you start your period, you are officially fertile again, so be careful!
The article Breastfeeding and Birth Control has more details about fertility cycles and nursing, as well as a discussion of the pros and cons of various birth control methods during lactation.
Breastfeeding and Fat Loss: Is It Harder to Lose Fat While Breastfeeding?
Breastfeeding and Fat Loss
“Nurse your baby!” the experts say, “You’ll burn so many more calories! The baby weight will just melt right off.”
Ever since my very first baby was born years ago, I’ve been suspicious of these experts who advised that breastfeeding would cause me to lose the baby weight faster. It sure never helped me. As a matter of fact, it was only after weaning that I would lose any fat at all, but then again, I was super unhealthy back then and not eating well. (Read my comparison of my healthy and unhealthy pregnancies here.)
Baby #4 was my real test. I stayed active throughout pregnancy, performing my last workout of squats and burpees just days before he was born. I was a nutrition coach and followed a highly nutritious diet. Postpartum, I have followed my pre-pregnancy workout schedule and diet, and I have made great progress, losing all but the last 5-10 pounds within the first 6 months postpartum. And so with those last few pounds not budging no matter what I do (I’m still nursing at 12 months postpartum at this writing), I have to wonder:
If you burn so many calories from nursing, about 500 on average per day, then why in the world do some mothers have such a hard time dropping the last few pounds? And why do the experts tell us the opposite is true? Here is what I found in the latest scientific studies.
Breastfeeding Does Burn Calories, but….
If you’re a breastfeeding mom, you’ve probably heard that nursing will burn 500 calories a day. This is surely the reason the experts tell us that breastfeeding will help us lose the baby weight, that’s like a killer workout!
However, so many other factors that come into play when discussing ANYONE’S metabolism, but especially a woman during her postpartum period. Like:
- Lack of Sleep: A decrease in sleep, typical of just about every new mom, can cause metabolism to slow by causing a hormonal change that can interfere with your hunger signals, causing you to eat more than you actually need.
- Stress: Stress releases cortisol, which slows metabolism, and if you’re also not sleeping much, the cortisol is not being removed from the body at night during restorative sleep. I think we can all agree that even if we are blissfully joyful, most new moms are also highly stressed.
- Less Activity, More Eating: In the first few months postpartum, most moms are sitting with baby more and may have less time for regular activity while they adjust to a new routine (even if they’re working out). In addition, the increase in energy needs for milk production can make you feel ravenous, causing you to eat more than normal, and possibly more than needed.
- Not Enough Eating: Some moms are so busy and overwhelmed in the first months of their baby’s life or mistakenly think they need to cut calories severely to lose weight and don’t eat nearly enough, which can cause the body to believe there is famine and actually store fat as an energy reserve.
- Number of Nursing Sessions: An exclusively breastfed baby who is nursing every hour or two will put a greater energy (calorie) demand on his/her mom than one who is nursing just a few times a day. Therefore, an older baby who is eating solids and nursing less often will require less energy demand on his mother’s body than a newborn. Likewise, any baby who is being supplemented with formula will also require less milk production and therefore calorie demand from her mother.
So the number that is typically thrown out there, 500 additional calories per day, can be way off and totally misleading, depending on the preceding factors.
Even with all of these factors at play, studies found that breastfeeding moms tend to start to lose more weight around the 4 month mark, and even more when they finally wean. Why is this?
One word: hormones.
Hormones During Breastfeeding
During breastfeeding, hormones are very different than any other time in life. Breastfeeding mothers experience a drop in testosterone and estrogen, which are both fat burning, and an increase in prolactin.
Prolactin is the hormone that causes your body to produce breastmilk (prolactin = pro-lactation). It is elevated during pregnancy, but is kept in check by progesterone and estrogen levels, which both drop right after the baby is born. This allows the effects of prolactin to begin and the milk to come in for the baby. Prolactin levels rise every single time the baby nurses, signaled by nipple stimulation. So what does this have to do with fat loss?
Prolactin hormone is – TA-DAHHHH – also linked to fat storage. It makes sense that our bodies would put some sort of safeguard into place to protect baby’s milk supply, and it seems that prolactin may be that safety net. Prolactin seems to keep the nursing mother from mobilizing fat stores, so that there is always an energy reserve in case of famine.
Sometime between the 4-6 month postpartum mark, breastfeeding mothers experience a drop in prolactin. Suddenly, metabolism may begin to increase, and studies show that these mothers will generally start to see more fat loss at this point. Again, once the baby weans, within 24 hours prolactin levels drop again, and this might explain why those stubborn final 5-10 pounds suddenly disappear as fat metabolism returns to pre-lactation/pre-pregnancy levels.
Interestingly enough, prolactin also affects sex drive and fertility, usually causing a low libido, and cessation of periods and ovulation. After the sixth month mark, your periods may return and you might be feeling like your old sexual self – this is a sign that your fertility has returned and prolactin has dropped.
So What Does It All Mean?
I went through dozens and dozens of studies for this article, trying to find a definitive answer to give you: Is it truly more difficult to lose fat while you’re breastfeeding? The truth is that the studies all contradicted each other, and at this time there is no real scientific answer, only my (semi) educated opinion: It can be for some women.
It’s important to remember that EVERYONE is different. We all live our day-to-day lives quite differently, have different hormone profiles and genetics. This is why we all have that one friend who seemed to nurse away all the baby weight and then some with little effort while you worked your butt off with frustrating results. How your body reacts to the changes that come along with nursing will most certainly be different from my body.
However, you can see that the breastfeeding mother does have a different scenario on her hands than the average woman when it comes to fat loss. We are working against hormones, stress, lack of sleep, and exhaustion.
Losing Fat While Breastfeeding
If you’re dead-set on getting off those last few pounds or have an aesthetic goal to reach, then you’ll be happy to know that breastfeeding is not a death sentence to losing the last few stubborn pounds. You CAN lose fat while nursing, it just won’t be the same game as before.
Here are a few fat loss tricks you can try if you want to try and get past the “Prolactin Plateau” (I just made that up and would like to copyright it, please) 🙂
- Instead of counting calories and and adding 500 for nursing, try just having healthy food around and just eat when you’re hungry, stop when you’re full. This takes some practice if you’re a chronic dieter, and I would HIGHLY recommend the book Intuitive Eating to help you with this.
- Fill your plate with mostly protein and veggies, then fill in the rest with fruits, healthy fats, legumes, and whole grains.
- Eat fewer starches, or try eating starches only within 2 hours of your workout. (Starches = bread, pasta, potatoes, crackers, etc, even whole wheat/grain)
- Stop doing long, steady cardio and try HIIT workouts instead. These are great for new moms because they take less time but are actually MORE efficient at calorie burning than steady-state cardio. Tryone of these HIIT workouts.
- If you do want to count calories, go to the breastfeeding calorie calculator here, add your info and subtract 15%. If this doesn’t work after a couple of weeks, you can try lowering the amount you are eating by 50 calories per day a week at a time. This will let your body know you aren’t starving so it won’t hold onto the fat, and it also won’t threaten your milk supply. I go into more detail here.
My Experience and My Thoughts
So, yes, breastfeeding did in fact put a little bit of a damper in my plans to get my pre-baby body back, visible abs and all. It became clear to me around the 5 month post-partum mark that while I COULD do it, I just didn’t freaking want to.
I realized that I could work out harder or longer, eat less starch and sugar, follow my own “get ripped plan” that I have written about here, be more strict about my calorie intake, skip the birthday cake at parties, and really focus hard on getting back that body. No excuses, right?
My focus during this first year was on SURVIVAL, people. And most of the time, survival for me meant SELF-CARE. Self-care meant:
- eating foods that nourished me and my baby, gave me energy, and made me feel my best
- exercising because I love it, for just 30 minutes of ME-time, because it gave me energy, but NOT pushing myself to exhaustion and knowing when I was too tired from sleepless nights to make myself do it.
- staying balanced and eating the cake at the party sometimes
- staying centered and meditating daily (Read Real Happiness: The Power of Meditation: A 28-Day Program)
- learning and practicing loving my reflection in the mirror NO MATTER WHAT.
And the fact is, it’s FIVE POUNDS, maybe 10 from my leanest. I’m in the same pre-pregnancy clothes, I feel great, I am healthy and stronger than ever.
Maybe the experts do think that if they tell us that nursing might make losing the baby weight more difficult, we won’t do it. I made the decision to continue anyways, but that is an individual choice for everyone and one that should be informed. Now that you know (well, kind of), will you continue to breastfeed?