Breastfeeding & Drugs: Alcohol

Beer has been used for years as a galactagogue (stimulant to breast milk production). This may be due to beer's ability to increase prolactin in men and non-lactating women. The active ingredient in beer is reported to be various B vitamins or "Brewer's yeast" ( Anderson, 1995 ).

Conversely alcohol can inhibit milk ejection reflex in a dose dependent manner (particularly after a dose of 1 gm/kg of absolute alcohol). Alcohol in the blood stream passes rapidly into the milk with peak levels 30-60 minutes and 60-90 minutes after ingestion on an empty or full stomach respectively. As the blood alcohol level falls, retrograde diffusion occurs and milk levels also fall ( Anderson, 1995 ).

After maternal intake of a one time dose of .3 gm/kg of alcohol in orange juice (equivalent to 20 oz of beer or 6.5 oz of wine) only 0.5% to 3.3% of the maternal dose was transferred to the infant ( Mennella, 1991 ).

Alcohol gives a noticeable odor to breast milk which may stimulate sucking initially but decreases the total milk intake during a feeding ( Mennella, 1991 ). Infants fed breast milk with the addition of alcohol spent less time sleeping during the subsequent 3.5 hours compared to the sleep pattern of the same infant fed breast milk alone ( Mennella, 1998 ).

Use of a large dose of alcohol (750 ml of wine) by a lactating woman over a 24 hour period resulted in a case of "drunkenness" (deep sleep, deep respiration, inability to suck, and no reaction to pain) in her eight day old infant ( Anderson, 1995 ).

Chronic intake of alcohol (50 cans of beer/week and other alcoholic beverages) caused a pseudo-Cushing syndrome (short, obese with a moon- face) in a five month old infant. When the mother stopped drinking the infant's growth returned to normal ( Binkiewicz, 1978 ).

Data on the effect of moderate alcohol use by breastfeeding mothers on their infant's development at 1-2 years of age is inconclusive. An occasional alcoholic drink by a lactating woman is probably not harmful to the infant, but binge drinking or chronic drinking should be avoided.