#boozeandboobs series: Alcohol and Its Transfer to Breastmilk

First up in our #boozeandboobs series: the research behind alcohol and its transfer to breastmilk. 🍺🤱🏻

There’s a lot of factors that affect the absorption, metabolism (breakdown), and elimination of alcohol. A person’s sex, food, type of alcohol, amount of alcohol, length of time in which you consume alcohol, medication or supplementation use, and body weight are just SOME of the factors that affect a person's ability to handle alcohol. An "every once and awhile" drinker handles alcohol differently from a binge drinker, who handles it differently from a chronic alcoholic. You also have to consider how a child can handle alcohol in breastmilk. A newborn 👶🏼 handles it differently from a 6 month old 👦🏻, who handles it differently from a 3 year old 👧🏽, partly due to the liver's ability to metabolize alcohol at a given age.

So here's what the available research says on alcohol and transfer to breastmilk:

🍷Alcohol likes breastmilk as much as it likes blood - the milk/plasma ratio is ~1. It travels around and generally doesn't stay put. If you have a Blood Alcohol Concentration of 0.08, you have a Breastmilk Alcohol Concentration of 0.08. If we treat alcohol like the drug 💊 that it is, then we have to consider the dose an infant/toddler would receive via breastmilk. The DOSE of alcohol in breastmilk is generally low since alcohol doesn’t stay put. One small study estimated the infant dose to be 0.5-3.3% of the maternal dose. The study will be in the comments of this post. This is why those alcohol test strips for breastmilk are a waste of money 💵 - they don’t give you all the information you need to make an educated and appropriate decision regarding drinking and lactating. 👨🏼‍🏫

🍹Alcohol reaches its max concentration within 30-90+ minutes of its consumption. Alcohol absorption isn’t immediate, although absorption does start in the mouth. How long it takes to completely leave the system varies greatly from person to person. This is why you’ll hear to wait 2-4 hours per drink before providing breastmilk to your infant/toddler. There’s a tool, Koren’s nomogram, that was created to better guide lactating individuals on how long to wait between drinking and providing breastmilk IF you choose to wait. The link will be at the bottom of this post in the references.

🥂IN SUMMARY🥂

1️⃣ Consider your ability to handle alcohol as well as your infant/toddler’s ability to handle alcohol.

2️⃣ Alcohol likes breastmilk as much as it likes blood. It travels around and doesn’t stay put. You have to consider the DOSE of alcohol your infant/toddler will receive from breastmilk. The dose is generally low since alcohol doesn’t stay put.

3️⃣ Peak concentration of alcohol in breastmilk is roughly 30-90 minutes after consumption. Every person metabolizes and eliminates alcohol differently. Koren’s nomogram is helpful for determining how long to wait after a drink IF you choose to wait.

Stay tuned for the next post - pumping and dumping when consuming alcohol. 🎉

References:

  1. Mennella JA, Beauchamp GK. The transfer of alcohol to human milk — effects on flavor and the infant's behavior. N Engl J Med 1991; 325:981-985. DOI: 10.1056/NEJM199110033251401

  2. Drinking alcohol while breastfeeding. March 2005.

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