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April 30th 2014 / Emma Bartley

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It is possible to drink alcohol as a breastfeeding mother without ruining your baby’s life. Boozy but otherwise responsible mother Emma Bartley explains how

“Many [nursing] mothers find themselves in a situation where they may want to drink. Maybe you are going to a wedding where wine will be served. Or perhaps you are going on a girls’ night out, or on a date with your husband. No matter the reason… it is a good idea to weigh the benefits of breastfeeding against the benefits and possible risks of consuming alcohol.”

When I read this on the La Leche League International (LLLI) website, I didn’t know whether to laugh or cry – and not just because I was p***ed at the time. I know that LLLI, which exists to promote breastfeeding, has to be very careful about what it says, but the tone of this advice makes me want to put my head in a bucket of wine. Who is this sheltered creature who only comes across wine at weddings?

Certainly not me. When I first had my daughter, I started thinking about drinking at approximately 9.30am. I didn’t start drinking at 9.30am, but it really helped to know that the option was available later. For me, a glass of wine or beer in the evening was largely symbolic – it marked the start of grown-up time, even if I mostly spent it running up and down the stairs to check on the baby. Often I’d have a bottle of non-alcoholic beer (Beck’s Blue is brilliant), but I’d have a glass of wine if I fancied it, to chill me out or just to celebrate the end of another day that we were both still alive.

Some people will think that this means I have a problem, or that I shouldn’t breastfeed. Recently in Arkansas, a waitress who saw a customer drinking while breastfeeding called the police, who arrested the mother, told her to leave her six-month-old with family, and took her to jail. The facts of that case are still unclear, and the charges were later dropped, but it shows how widely attitudes to drinking and breastfeeding vary.

This is probably because we don’t have a complete scientific picture of the risk alcohol in breastmilk poses to babies. In an ideal world, someone would do a study where Group A mothers are teetotal and Group B mothers drink a Mai Tai every day at 5pm, then the Group B babies’ heads fall off and we all know why. But no one wants to take that risk with real babies, so scientists and mothers are left guessing.

However, there’s no need to avoid alcohol altogether, as if you are clever about it you can drink without it reaching your milk. Here’s my guide to guilt-free drinking while breastfeeding.

1. Know your alcohol level

The amount of alcohol in your breastmilk is equivalent to your blood alcohol – so if you drink only small amounts, you can keep your percentage closer to SMA than Special Brew. “The key issue is the concentration of alcohol in the mother’s blood,” says Professor Paul Wallace, chief medical officer at Drinkaware. “This will depend on the strength of her drink, how quickly she has been drinking, what and how much she’s eaten, and how much she weighs.”

2. Time your drinking around the baby’s feeds

On average, your blood alcohol will peak around 30-60 minutes after you have a drink, then clear from your milk as it clears from your blood – at the rate of roughly one unit every two hours.

So if you have a small glass of wine or a beer, equivalent to one unit, at 7pm and you feed your baby at 10pm, the baby shouldn’t be exposed to any alcohol. Some people say that the best time to drink is while you are actually feeding, because the booze you’re consuming won’t reach your milk before the feed is finished and you’ll hopefully have a nice long gap until the next feed. I wouldn’t try this in Arkansas, mind you.

3. Keep a backup bottle

If the baby needs to be fed earlier than expected (sod’s law), the Australian Breastfeeding Association reckons it’s not the end of the world if you breastfeed after a drink.

But I always felt uncomfortable with that, so when my baby’s feeds were unpredictable, I used to express some milk ahead of time and keep it in the fridge or freezer (use an electric pump like the Avent or Medela or you’ll be there for the rest of your life squeezing the manual one and fretting that you don’t have any milk – they just don’t work very well). Nowadays if she wakes up teething or something we just use formula.

This is also useful if you want to have more than one drink without feeling like you are going to Hell.

4. Want to know for sure if it’s safe to feed? Find out

If you want to be absolutely sure that your milk is safe after you’ve been drinking, you can find out using a product called Milkscreen. “Milkscreen provides peace of mind for mums who wish to enjoy the occasional drink but want to make sure they do not pass alcohol on to their baby,” says Kimberly Schram from Upspring Baby, the manufacturer. “Breastfeeding can seem very restrictive and that is exactly why we invented the product.”

Milkscreen test strips are little strips of paper that detect alcohol at unsafe levels (anything over 13.1mg per 100ml). To use them, you express a drop or two of milk on to the little paper strip, wait two minutes and see if the colour changes. If it goes dark or speckled, you shouldn’t feed. If it stays cream, you’re fine.

I’ve used Milkscreen on a variety of occasions, and only once had a positive result, after I’d had a couple of glasses of wine and a cocktail – I knew I wasn’t safe to breastfeed but I wanted to see what the strip would look like. You do pay a bit of a premium buying them in the UK via Bloom and Beyond (five strips for £10 or 20 for £25), but given that every woman metabolises alcohol differently, it’s a really useful tool if you do want to drink and are worried about when you can feed your baby afterwards.

5. Pump and dump

If you are missing out one of your baby’s usual feeds, either because you’re going out or will have drunk too much to be safe, I recommend a pump and dump, i.e. expressing some boozy milk and pouring it away.

This won’t remove the alcohol from your milk – the only way to do that is to wait for it to clear from your blood, so coffee, fresh air, water etc are equally useless – but it will help to keep your milk supply up, and prevent problems such as engorgement and mastitis. And horrible lumps, which I got one morning after I did not pump and dump.

It’s also a good idea to drink plenty of water, as breastfeeding mothers get particularly dehydrated.

6. Don’t do it every day

To be on the absolute safe side, the NHS advises drinking only 1-2 units per week. Drinkaware is more permissive, suggesting that you might want to keep booze-free a couple of days per week to make sure you don’t accidentally become alcoholic.

7. Enjoy it

If you want a drink, hold the side order of angst. You may get arrested, but I very much doubt your baby’s head will fall off.

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