Breastmilk and Booze:  Do the Two Mix?

By Barbara Behrmann, Ph.D.

Few things in life are as anxiety provoking as becoming a parent and assuming responsibility for the well-being of our children.  And few cultures cultivate this anxiety as much as the U.S.  Ironically, sometimes a desire to assuage our fears ends up feeding them instead.

Take breastfeeding.  A new product is on the market that enables women to test their milk for the presence of alcohol.  Simply saturate the test pad with some breast milk, wait two minutes, and if the pad changes color, voila!  Alcohol is present in the milk.  

The brainchild of two mothers, their desire was to give moms “a little extra peace of mind,” and  “eliminate uncertainty” so moms can decide whether or not to nurse after having had that beer at the neighborhood potluck.  If there's alcohol in the milk, they say, moms may want to consider an alternative feeding source, such as previously stored breast milk or formula.

So what’s the problem?  Why am I not jumping on the Milkscreen bandwagon? 

Dangerous Assumptions

The assumption underlying a product like Milkscreen is that breast milk is a potentially dangerous substance from which babies need protection.  This is almost never the case.  When it comes to alcohol, there’s a huge difference between getting roaring drunk and having an occasional glass of wine.

Milkscreen does not differentiate.  Either there is alcohol in your milk, or there’s not.  The results are the same whether you had a single glass of champagne or a full six-pack.

Yet experts agree that drinking alcohol in moderation is not incompatible with breastfeeding.  “Prohibiting alcohol is another way we make life unnecessarily restrictive for nursing mothers,” asserts Dr. Jack Newman, a member of the LLLI Health Advisory Council.

Nor is it necessary to “pump and dump” your milk if you have had a drink or two.  Think about it.  Women take plenty of over-the-counter and prescription medication and continue to safely nurse their children.  Even smokers are encouraged to nurse because in spite of the presence of nicotine in their milk, their own milk is still preferable to formula.  And why the obsession of breast milk safety in the first place?   As lactation consultant Linda Smith asserts, “Nobody is marketing a test for the safety of formula!”

This isn’t the first time moms have received the message that babies must be protected from their mothers’ dangerous bodies.  For example, The American Academy of Pediatrics cautions women against sleeping with their babies, even when the parent is merely “excessively tired.”  (Know any new mother who doesn’t fit that criterion?)  Yet the reality is that bed-sharing itself is dangerous only under certain conditions.  Instead, the AAPs simplistic blanket statement turns every mother’s body into a potentially lethal instrument.  (Click here for more information on co-sleeping.)

Getting back to the breast, formula remains a far more risky choice than good old-fashioned  breast milk.  In her fascinating and provocative book, Having Faith:  An Ecologist’s Journey to Motherhood, biologist Sandra Steingraber presents a frightening assessment of the degree to which traces of pesticides and toxic chemicals are found in the breast milk of women all over the planet.  Yet Steingraber remains a staunch proponent of breastfeeding and indeed nursed her own children for several years each.  Why?  Because formula is still riskier than breast milk, even when that that milk has traces of alcohol in it.  “We spend an awful lot of time balancing small theoretical hazards of breast milk against actual hazards of formula,” asserts Wiessinger.

Undermining Women’s Confidence

In addition to preying on fear, a product like Milkscreen actually undermines women’s confidence.   “We have evolved into a gadget-oriented society,” asserts lactation consultant Amy Spangler.  “And the more products moms feel they have to buy, the more overwhelming breastfeeding seems.”  More importantly, the more rules associated with breastfeeding, the less likely women will choose to nurse, Spangler adds.  “Mothers need to learn to trust themselves,” she says.  “They don’t need to test their milk.  Even mouthwash with alcohol could theoretically alter the accuracy.   I would hate to see mothers giving formula or previously expressed milk when they should be breastfeeding.”

Parenting:  The Real Issue

Who is most likely to purchase the product?  The well-to-do mother who probably hasn’t had more than a drink or two.  In other words, the women least likely to have a baby put in harm’s way.   A mother conscientious enough to buy Milkscreen isn’t likely to be regularly tying one on.  “The bottom line?” asserts lactation consultant Linda Smith, “If a mother is so drunk that she’s at risk of dropping the baby, she needs help with the baby!”

Chilling Implications 

Despite the above concerns, perhaps the most chilling implication of this product is that it has the potential of being used to punish moms.  My feelings are not unique. “My gut reaction is that it’s one more way to attack and blame mothers and their milk,” says Smith.  In other words, if a pregnant woman can be denied treatment for drug addition and jailed instead as a child abuser, who is to say that a test like Milkscreen couldn’t be used in an attempt to prove that a woman is an “unfit” mother?  Imagine if a nighttime dose of Nyquil could result in a mother being charged with child endangerment.   Farfetched?  Perhaps, but stranger things have happened.

“In America today,” says Lynn Paltrow, Executive Director of the National Advocates for Pregnant Women, “where more and more health problems are being addressed thorough the criminal justice system and hospitals are increasingly becoming the sources of reports to criminal justice authorities, marketing new drug testing products specifically aimed at pregnant and breastfeeding women raises concerns about how that information will be used and the likelihood that it will be used to lead to punish women, rather than to an increase in education and access to health care services.”

The Bottom Line

Despite the ease with which we pass judgment of other people’s parenting decisions, being able to verify the presence of alcohol in a woman’s milk should not be used to punish moms.  Besides, lactation consultant Wiessinger asserts, “If ‘any alcohol at all were an issue, all of Europe would be walking around with poorer motor skills and a lower IQ.

I’m not trying to be cavalier about alcohol or child endangerment.  But if we as a society would learn to trust women, maybe women would gain more confidence in their mothering without resorting to a misleading and simplistic test.

Sidebar:  Breastfeeding and Alcohol: 

What You Need to Know

●Drinking alcohol in moderation is not incompatible with breastfeeding.  So says The American Academy of Pediatric’s (AAP’s) Committee on Drugs and other doctors and breastfeeding experts in the know.  Thomas W. Hale, long considered the expert of the impact of drugs and medications on mother’s milk, states that alcohol in breast milk is not considered harmful to a baby if the amount and duration is limited. 

●Use common sense.  Are you drinking on an empty stomach or will you be eating at the same time?  (Food decreases the absorption of alcohol.)  How much will you be drinking?  (The more you feel the affects, the more your baby will.  And the more you drink, the longer it will take for the affects to wear off.)  How do you metabolize alcohol?  (Heavier people can metabolize alcohol more quickly than lighter folks.)  Finally, how old is your baby?  A newborn’s liver is immature and he will feel the effects of alcohol more than an older baby.

●If you want to play it super safe, wait for two hours or so to nurse.  But know that under normal circumstances, your milk is not dangerous. 

●Drinking can affect breast milk production in the short-term by interfering with the hormones that affect nursing.  So for a few hours after having had a drink, you might produce less milk. 

●Excessive drinking is another story.  Long-term risks include a baby too sleepy to nurse or suckle effectively.  This, in turn may lead to slow weight gain and ultimately failure to thrive.  Similarly, because alcohol can inhibit milk production, heavy drinking could limit your milk supply, creating a double-whammy for your baby.  In more extreme cases, an infant's motor skill development may be hampered.  In short, if you drink a lot, don’t nurse.  And seek help.  Heavy drinking will affect your mothering ability in more areas than breastfeeding.

References: 

La Leche League:  http://www.lalecheleague.org/FAQ/alcohol.html

Thomas W. Hale, R.Ph, PhD., 2006.  Medications and Mothers' Milk (12th ed.).

(American Academy of Pediatrics:  Policy Statement:  Breastfeeding and the Use of Human Milk.)    

Barbara Behrmann, Ph.D. is a writer, researcher, and author of The Breastfeeding Café: Mothers Share the Joys, Secrets & Challenges of Nursing, University of Michigan Press, 2005. She is a frequent speaker around the country and is available for talks, readings, and conducting birthing and breastfeeding writing circles. The mother of two formerly breastfed children, Barbara lives in upstate New York.

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