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Alcohol In Pregnancy: Part 2 — Breastfeeding

Written and published by Dr. Kalinowski in 2019

In my first blog post you heard about my favorite local breweries, and about the dangers to drinking any alcohol during pregnancy. But what about an occasional beer or glass of wine while breastfeeding, is that OK? Yes! Unlike during pregnancy, smaller amounts of alcohol are probably safe while breastfeeding.

I took a look at the alcohol profile in the best resource for safety of medications while breastfeeding – LactMed. Check it out if you have concerns about medication use in pregnancy. Here’s what I found:

The highest alcohol level in breast milk is 30-60 minutes after a drink, and the majority of alcohol has cleared from the milk 2.5 hours after the drink. The clearance of alcohol is, of course, dependent on your weight and if you have recently eaten a meal. One study determined that if a 120 lb. woman has one drink, alcohol has cleared from her milk 2.5 hours after finishing the drink and a 180 lb. woman will clear the alcohol after 2 hours. For each additional drink consumed, the same amount of time should pass. For example, if a 120 lb. woman has 3 drinks, she should wait 7.5 hours before using breast milk.

Having 1 drink per day has not been associated with any neurologic or developmental issues in infants, but higher use (2 drinks per day or more) was shown in some, but not all, studies to cause delays in development.

And what about the old wives tale of beer helping with milk let down? Well, prolactin is the hormone that helps with milk let down. Two of beer’s main ingredients, barley and hops, are actually made up of carbohydrate chains (polysaccharides) that can increase the level of prolactin. I don’t recommend using any alcohol to facilitate milk let down, however, since it does transfer to the milk supply quickly. Further, one report showed that more than 5 alcoholic beverages will have the opposite effect and actually decrease milk let down and supply.

Bottom line: during breastfeeding you can enjoy an occasional drink, but please avoid feeding within a few hours of imbibing or avoid using that milk all together if you’ve had an overindulgent evening.

Wow, writing this post really has made me thirsty. If you’re thirsty too, check out Sam’s Bottle Shop in Durham, BottleMixx in North Raleigh, or Tasty Beverage in downtown Raleigh. Each has rotating beers on tap, so you take home some fresh draft beer in a reusable container. These containers come the form of glass growlers (64 oz) or howlers (32 oz), which are best consumed within 1 week of filling. Some shops also use crowlers, which are large aluminum cans they fill and then specially seal. Crowlers preserve the taste and carbonation of the beer, allowing you to store it for much longer at home. Or, you can buy most beers as single 12 oz. bottles so you can buy just one at a time, without committing to an entire six pack. Please enjoy responsibly and never drink and drive. Cheers ya’ll!

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