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Smoking and Breastfeeding

By Kristie Rivers, MD, FAAP, Board Certified Pediatrician

Women smokers may wonder if it’s safe to smoke while breastfeeding. There are very few reasons a woman should not breastfeed, and smoking is not one of them. The benefits of breast milk are too numerous to overlook and should not be passed up just because the mom smokes cigarettes. However, nicotine and secondhand smoke have potentially harmful side effects that a breastfeeding mother who chooses to smoke should be aware of.

Maternal smoking is considered a major risk factor for SIDS (Sudden Infant Death Syndrome). Nicotine reduces the infant’s ability to self-resuscitate if there is not enough oxygen getting to the brain.

Studies have shown that infants exposed to secondhand smoke have a higher risk of developing respiratory tract infections, episodes of wheezing, and pneumonia in the first year of life.

Some studies suggest that babies who are exposed to cigarettes, either through breast milk or secondhand smoke, have a higher incidence of colic.

A mother’s milk supply may be affected by the cigarette nicotine.  Nicotine lowers a mother’s blood level of prolactin, reducing her milk supply. Also, her milk let-down reflex is affected, so the infant does not get as much in each feeding. As a result, a smoking mother may give up breastfeeding sooner because of her reduced milk supply.

The more a mother smokes, the more effects her baby may feel. After a mother smokes a cigarette, the nicotine levels in her blood, and subsequently her breast milk, rise significantly and then fall slowly. Nicotine stays in the body for about an hour and a half, so if Mom decides to have a cigarette, she should avoid smoking near the time her baby is due to eat.

Some mothers may consider using a smoking cessation aid, such as a nicotine patch or gum while breastfeeding. Many studies show that if used as directed, these products cause no more harm than cigarette smoking does. However, if a mother uses these products and then smokes cigarettes in addition to them, her levels of nicotine in the breast milk may become dangerously high, posing a risk to the baby.

Sources:

  • La Leche League International
  • Is it safe for a smoker to breastfeed her baby?

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