The answer is yes… and no… and maybe under certain conditions…
In no particular order, here are some of the most commonly questioned substances and the verdict on each one:
Obviously, no one should smoke. Ever. But there are certain risks associated with breastfeeding and smoking. Heavy smokers (20+ cigarettes a day) increase the likelihood of passing nicotine to the baby. The half-life of nicotine (the amount of time it takes for it to be eliminated from the body) is 95 minutes, so even smoking before a feeding can pass nicotine to the baby. Smoking increases the risk of SIDS and respiratory problems for the baby. Studies have found that breastfed babies of smokers were more likely to have episodes of colicky crying and fussiness than breastfed babies of non-smokers.
Also, smoking and breastfeeding is associated with early weaning, lowered milk production, and inhibition of the milk ejection (“let-down”) reflex. And it lowers prolactin levels- crucial to milk production. According to Thomas Hale, Ph D, author of Mother’s Milk and Medications (the go-to book when you have questions about how stuff in your milk affects your baby), smoking cessation aids are generally less hazardous to the baby than continued smoking.
Alcohol (in Moderation)
Drinking occasionally is fine if you’re breastfeeding. The Mayo Clinic is pretty stiff on the subject and their article generally discourages drinking and breastfeeding. And truthfully, not drinking while you are breastfeeding eliminates any chance of alcohol being passed to the baby.
However, research shows that 1-2 drinks generally doesn’t pose any risk to the baby. Thomas Hale says that mothers can return to breastfeeding after ingesting alcohol as soon as they feel neurologically normal. Many health professionals recommend keeping alcohol intake to 1-2 drinks a week while breastfeeding.
What about “pump and dump”? You can pump after drinking, but it won’t take the
alcohol content out of the milk any faster. However, if you’re away from your baby for a few hours and need to keep your milk supply up or relieve engorgement, by all means pump it and dump it. (FYI, Jane the Virgin didn’t need to drag her whole electric breast pump with for a night on the town with her best friend. She could have taken a small hand pump or even hand expressed milk to maintain supply and relieve engorgement.)
Here is my big post on marijuana and pregnancy for those of you who didn’t catch the controversy the first time around. Don’t use marijuana while pregnant and don’t use it while you’re breastfeeding either. Here’s why…
Marijuana smoke contains the same chemicals as tobacco smoke with the same risks to lung health for both the mother and baby. (American Lung Association, 2015). Any chemicals that the mother takes in through smoking marijuana are passed to the baby, just like smoking tobacco products. THC also passes to the baby during breastfeeding and it stays in the body longer than many substances. THC is stored in body fat, which means it actually stays in your body (and your baby’s body) for much longer than alcohol. Because THC stays in the body for long periods of time, you can’t consume marijuana and then breastfeed after a couple of hours and not pass THC to your baby. So “pump and dump” won’t work.
What about edibles and vaping? No and no. Edibles and vape pens still contain THC and that THC will pass to your baby. And while some research shows that vape pens result in lower tar, some of the newest research suggests that there might be a chemical trade-off in the form of toxic ammonia levels in the lungs from vaping. The effects of THC from marijuana edibles will actually last longer than the effects of THC from smoking marijuana.
Caffeine (In Moderation)
Don’t over-do it on the Starbucks or energy drinks, but other than that a couple of cups of coffee or cola are usually OK. (Chocolate is A-OK.) The amount of caffeine that ends up in a mother’s breastmilk is 1% of what she actually consumes. Babies younger than six months may take up to 80 hours to process caffeine, but in small amounts that’s usually OK. By about six months, babies can usually process caffeine in about 2-3 hours. It’s important to factor all caffeine sources into your caffeine consumption equation, so remember that even some OTC medications can contain caffeine. And if your baby seems especially fussy, alert or wakeful, consider that he might be a little more caffeine sensitive.
The majority of medications are actually safe for breastfeeding. Most doctors do not get information about medications and breastfeeding from actual research on a particular drug and lactation, but from package inserts of a book called The Physician’s Desk Reference. Both of theses resources come from pharmaceutical companies and may include out of date and/or incomplete information or disclaimers meant to cover the manufacturer’s collective @$$. One of the big medical treatments that is incompatible is chemotherapy because it uses radiopharmaceuticals. Sudafed can cause a drop in supply for some women, though it’s not generally harmful to the baby.
But other than that, pain relievers, anti-depressants, anti-anxiety drugs, cough medicines and many other types of medications are actually safe to take while breastfeeding. I do advise all expectant mothers to understand their options for pain medications that might be used during or after labor so they can make a choice that will cause fewer breastfeeding difficulties. (That’s why I included a section on it all my breastfeeding classes.)
Make sure to check out any supplements you are thinking about taking. Certain herbs can decrease milk supply or pass to the baby in harmful amounts, though culinary herbs and some herbal teas like chamomile are usually fine. Large amounts of certain candies, teas, cough drops, etc. might cause a drop in supply for some moms, but everyone is different.
Dairy/wheat/soy/peanuts/other potential allergens
If your baby isn’t displaying any signs of gastrointestinal upset or colic symptoms related to certain foods, you don’t need to avoid any foods. It might be a good idea to be cautious and avoid certain foods if there is a family history of food allergies on either parent’s side though. If your baby seems to be especially fussy, at different intervals, it might be time to keep a food diary and see if there is any pattern related to certain potentially allergenic foods. What about peanuts? Well, the latest information seems to indicate that exposure to peanuts through breastmilk may actually decrease the risk of peanut allergies. So go ahead and have that peanut butter cup. =)