What's off limits when you breastfeed? Let's talk coffee, alcohol, & dairy

Can I drink coffee while breastfeeding?

Yes. Studies that have measured the transfer of caffeine into breastmilk have found that less than 2% of the mother’s caffeine dose is transferred to the breastmilk (Berlin, 1984). Other studies have found that there is no significant difference in infant sleep quality between mothers consuming caffeine and those that sustain (Santos, 2012). If you are looking for some more specific guidance, the American Academy of Pediatrics considers consumption of less than 3 cups of coffee per day to be safe while breastfeeding.

Bottom line: Have your coffee, but keep it to less than 3 cups per day.

Can I drink alcohol? 

You can. We know that alcohol transfers readily into human milk. But alcohol is not stored in milk. So this means it enters and exits according to blood alcohol level. Levels of alcohol in milk peak at approximately 30 to 60 minutes following ingestion, then decline rapidly if no more is ingested. The dose of alcohol in milk is rather low (<16% of the mother’s dose), but this is a function of how much the mother consumes. Meaning you drink more, more alcohol passes through to the breastmilk.

Older guidelines for determining the waiting period were rough estimates of the time required for elimination of alcohol. Today, we use body weight because it is a better predictor for how quickly a mother metabolizes alcohol. Therefore, it is difficult to say when the mother’s breastmilk is completely free of alcohol. 

In terms of milk supply, new data now clearly demonstrate that alcohol actually inhibits oxytocin release from the pituitary gland, thus it impedes the letdown process so that milk is not released from the breast as efficiently. One study showed a 23% reduction in milk release while alcohol is present in the mother’s blood (Mennella, 1991). In another study, alcohol completely blocked the release of oxytocin (Coiro, 1992). This may mean that our bodies are holding back milk when mom’s drink. Our bodies are so cool.

Bottom line: Plan it out. Feed your baby or pump before you have a drink. The AAP recommends waiting 4 hours to get any alcohol out of your bloodstream. You know your body so listen to it. If you feel buzzed, don’t breastfeed. 

What about dairy? 

Dairy is OK! It may not be if your baby has been diagnosed with cow’s milk allergy (CMA), you should be able to continue to consume dairy products (cow’s milk, yogurt, ice cream, butter, cream, etc.) as you wish. If your baby is diagnosed with CMA you will need to eliminate all dairy from your diet and you may need to supplement with a hydrolyzed formula until the dairy is completely out of your breastmilk (up to 2 weeks). Your pediatrician and Foublie coach will be able to support you in your elimination diet.

About half of babies with severe gastroesophogeal reflux (GER) do better when their mothers eliminate dairy from their diet (Cavataio, 2000). Because the elimination of dairy is only helpful in half of the babies with GER (which is extremely common in newborns) please discuss this with your pediatrician and Foublie coach before eliminating dairy from your diet. Without proper guidance, breastfeeding mothers on elimination diets are at risk for nutrient deficiencies (Holmberg-Marttila, 2001).

Bottom line: If you suspect what you are eating is impacting your baby, call your pediatrician. Start a food journal if you have any questions or want to track patterns. If you do need to change your diet, your Foublie coach can help you eliminate foods safely and with your baby’s health in mind.

 

Sources:

Berlin, C. M., Denson, H. M., Daniel, C. H., & Ward, R. M. (1984) Disposition of dietary caffeine in milk, saliva and plasma of lactation women. Pediatrics, 73(1), 59-63.

Santos, I. S., Matijasevich, A., & Domingues, M. R. (2012) Maternal caffeine consumption and infant nighttime waking: prospective cohort study. Pediatrics, 129(5):860-8. doi: 10.1542/peds.2011-1773. Epub 2012 Apr 2.

http://www.infantrisk.com/content/caffeine-intake-pregnant-and-breastfeeding-women

Backstrand JR, Goodman AH, Allen LH, Pelto GH. Pulque intake during pregnancy and lactation in rural Mexico: alcohol and child growth from 1 to 57 months. European journal of clinical nutrition. Dec 2004;58(12):1626-1634.

Mennella JA, Beauchamp GK. The transfer of alcohol to human milk. Effects on flavor and the infant’s behavior. The New England journal of medicine. Oct 3 1991;325(14):981-985.

Coiro V, Alboni A, Gramellini D, et al. Inhibition by ethanol of the oxytocin response to breast stimulation in normal women and the role of endogenous opioids. Acta endocrinologica. Mar 1992;126(3):213-216.

Giglia, R. C., Binns, C. W., Alfonso, H.S., Scott, J.A., & Oddy, W.H. (2008) The effect of alcohol intake on breastfeeding duration in Australian women. Acta Paediatrica (Oslo, Norway: 1992), 97(5), 624-629.

Cavataio, F., Carroccio, A., & Lacono, G. (2000). Milk-induced reflux in infants less than one year of age. Journal of Pediatric Gastroenteroogy and Nutrition, 30 Suppl, S36-44.

Holmberg-Marttila, D., Sievanen, H. Sarkkinen, E., Erkkila, A. Salminen, S., & Isolauri, E. (2001). Do combined elimination diet and prolonged breastfeeding of an atopic infant jeopardize maternal bone health? Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology, 31(1), 88-94. 

 

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