Smoking And Breastfeeding
Are Smoking And Breastfeeding Compatible?
Asking if smoking and breastfeeding are compatible seems like a silly question. The obvious answer is "of course not". Yet reality dictates that mothers who breast feed their babies are sometimes smokers. Since both cigarette smoke, in this case, second-hand smoke, and nicotine, which will find its way into the mother's milk, are definitely harmful, it still would seem to make sense if a smoker decided not to breast feed her baby.
Breastfeeding Is The Priority Issue - The truth of the matter is, though smoking and breastfeeding are not compatible, the mother should continue to breast feed. The reason for this is the benefits of breastfeeding greatly outweigh the risks attendant in the mother's smoking. Most physicians and obstetricians will agree that a smoking mother should breast feed their child rather than switching over to a formula for "safety" considerations.
Smoke Problems - This doesn't mean that the mother should puff away on a cigarette while breastfeeding. That's just giving the baby a double dose of trouble. If the mother cannot quit smoking, which is the best solution, she should certainly not smoke while breastfeeding, and for that matter should not smoke around the baby at all. By not smoking around the baby the risks involved in inhaling second-hand smoke are at least lessened, but what about the nicotine?
Nicotine Problems - When a breastfeeding mother smokes, a certain amount of nicotine is going to find its way into her milk, which the baby will ingest. Now the baby, though not a smoker, will have nicotine in its system, with all the problems that can bring, including withdrawal symptoms when it finally switches over to formula. If there is sufficient nicotine in the milk, the taste can be altered, even to the point where the baby will refuse the milk. The mother therefore should allow as much time to elapse as possible between the last cigarette and a breastfeeding session. Nicotine in the blood system has a half life of about 2 hours. If one can wait 4 hours, the concentration of nicotine will decrease by 75% and after 6 hours it will decrease by nearly 90%. Some nicotine will always be present, long after the mother has had her last cigarette, though in increasingly smaller concentrations. Of course the baby has its own ideas as to when it wants to be fed, so that has to be taken into account.
The Patch - Sometimes, a mother will, in attempting to cease smoking, use the nicotine patch. Even if she isn't smoking, the patch cause nicotine to continue to be absorbed into her system, but in smaller amounts than if she were smoking cigarettes. Some of this nicotine will find its way into the baby. Still, given the health-giving properties of the mother's milk, any risk associated with nicotine from the patch are greatly outweighed by the benefits of the milk. One of these benefits, probably one of the most important ones, is that mother’s milk serves to build up the immune system in the baby, which formulas seldom do.
What Not To Do - There are two worst case scenarios. One is, if the mother is wearing a nicotine patch but continues to smoke, the nicotine present in her blood will be more concentrated, and a higher concentration of nicotine will be passed on to the baby. The second worst case scenario is when the mother switches to a formula, fearing that her smoking may be harmful to the baby. Now the baby may still be exposed to second-hand smoke, yet because it is no longer getting milk from its mother, its immune system is not being strengthened, as it should be. In either scenario, the risks of the child becoming ill now or at a later stage in its life, increase, sometimes dramatically.
The message to the mother is - “stop smoking, but if you can't, continue breastfeeding, just don't smoke while doing so”.