Facts About Smoking While Breastfeeding

Valorie Delp
Smoking while breastfeeding is not without risk.

Women who smoke may have many questions about whether or not they can breastfeed, or if they have to quit smoking in order to breastfeed. While it is common knowledge that smoking is not healthy for mom or baby, many moms who smoke will be happy to know that you can breastfeed, even if you are a smoker. In fact, it is generally thought that even if you smoke, breastfeeding is still a good option for feeding your baby.

Will the Baby Get Nicotine Through Breast Milk?

Yes, your baby can get nicotine through the breast milk. However, according to La Leche League, if you smoke fewer than 20 cigarettes a day, the amount of nicotine that the baby is getting is so minimal that it poses little risk. The risk of nicotine addiction increases if a mother smokes 20 to 30 cigarettes per day. This is actually true for most drugs that a mother will take while breastfeeding, including caffeine, over-the-counter pain killers, and even antibiotics.

How Nicotine Changes Breast Milk

According to Social Drugs and Breastfeeding by Debbi Donovan, IBCLC, nicotine flavors breast milk. This makes sense, as it's generally considered common knowledge that if a mother eats a lot of a particular food, that can flavor her breast milk as well. This may cause babies to refuse to nurse or shorten the length of time they are willing to nurse.

In addition, studies suggest that smoking seems to decrease the fat content in breast milk, which makes it harder for the baby to get enough calories and benefit from the healthy fats that boost brain development.

Nicotine and Your Baby's Behavior Patterns

Nicotine has been associated with a variety of behavior patterns in infants. While further research is still necessary, preliminary studies link nicotine levels in an infant with a host of undesirable behavior patterns. Babies whose mothers smoke:

  • Are more likely to suffer from colic
  • Get less sleep, and have significant changes in their sleeping patterns
  • Get insufficient iodine in their systems, which may lead to developmental brain damage

Second-Hand Smoke

While your baby is not going to get a significant dose of nicotine through breast milk, he will be breathing in nicotine from the air along with all of the other by-products of cigarette smoke. On top of that, the Social Drugs and Breastfeeding pamphlet points out that the cumulative effect of nicotine absorption means that your baby is getting up to ten times more nicotine than a baby who is bottle fed, whose mother smokes.

Smoking and Milk Supply

According to one study, Milk Product by Mothers of Premature Infants: The Effects of Cigarette Smoking, smoking significantly lowers a mother's milk supply by decreasing prolactin levels in the blood. In addition, these researchers found that smoking changed the content of the breast milk, making it less fatty which decreases the calories the baby is getting from a feeding.

What About Nicotine Replacement Therapy?

Although Nicotine Replacement Therapy (NRT) products are not licensed for use by breastfeeding mothers, they are considered safe for breastfeeding mothers, and preferable to smoking. According to Wendy Jones PhD, MRPharmS as published at Breastfeeding Network.org, babies are exposed to less nicotine through an NRT product. Your blood level of nicotine after smoking is 40ng/L. However, with an NRT product, the blood level of nicotine is about 17ng/L. In addition, your baby isn't exposed to the other chemicals present in second-hand smoke.

If you're going to use an NRT product, the research by Wendy Jones, PhD suggests that you do the following:

  • Do not continue to smoke if you use the NRT. Only use an NRT to help you quit smoking.
  • Patches produce lower nicotine levels over a prolonged period of time and are preferable to gum, which produces widely varied levels. However, if you do use gum, chew it after a feeding to limit your baby's exposure.
  • Nasal sprays should also be used after feeding to limit your baby's exposure to nicotine.

Should You Breastfeed if You Smoke?

It is up to a mother to make the choice about whether or not to breastfeed. However, the benefits of breastfeeding far outweigh the risks of smoking and breastfeeding. In fact, breastfeeding helps counteract against some of the risks of smoking by providing much-needed antibodies, and help in lung development. If you are a smoker, and cannot quit, you can minimize the, t risk for your baby by:

  • Avoid smoking until after you have fed the baby, and avoid feeding the baby right after you have smoked. According to Social Drugs and Breastfeeding, the half-life of nicotine is about 97 minutes, which means that it takes that long for nicotine to work its way out of your system.
  • Try using a smoking cessation aid to quit smoking.
  • Always go outside to smoke, so you can minimize the effects of second-hand smoke on your baby.

Breast Is Still Best

Although there is no doubt that a baby is exposed to nicotine by a smoking mother, and that nicotine and other smoking by-products can be harmful, breastfeeding is still the best nutritional option for your infant.

Facts About Smoking While Breastfeeding