Breastfeeding has health benefits for both babies and mothers. For babies, it provides protection against diarrhea, certain kinds of cancers, diabetes, and many other health challenges. For mothers, it protects against breast cancer, helps with postpartum weight loss, and encourages a unique mother-child bond that can’t be duplicated. Breastfeeding is just as beneficial for the smoking mother and her baby as it is for the nonsmoking mother and her baby.
Smoking when breastfeeding is not recommended.
Risks associated with smoking in breastfeeding
Smoking not only affects a growing baby during pregnancy, but also when you are breastfeeding. Smoking may reduce the supply of breastmilk, and the nicotine and other toxins can be passed on to your baby through breast milk.
The following is a list of potential risks associated with smoking during breastfeeding.
Babies and children who are exposed to cigarette smoke have a much higher incidence of pneumonia, asthma, ear infections, bronchitis, sinus infections, eye irritation, and croup.
Colic occurs more often in babies with parents who are smokers and mothers who smoke during breastfeeding. Research suggests that the nicotine that is passed from mother to baby (through breast milk) upsets the baby, and the passive smoke in the home acts as an irritant. Babies of smoking parents fuss more, and mothers who smoke may be less able to cope with a colicky baby (due to lower levels of prolactin).
Heavy smoking by breastfeeding moms occasionally causes symptoms in the breastfeeding baby such as nausea, vomiting, abdominal cramps, and diarrhea.
Babies of smoking mothers and fathers are 7 times more likely to die from Sudden Infant Death Syndrome (SIDS).
Children of smoking parents have two to three times more visits to the doctor, usually due to respiratory infections or allergy-related illnesses.
Children who are exposed to passive smoke in the home have lower blood levels of HDL, the good cholesterol that helps protect against coronary artery disease.
Children of smoking parents are more likely to become smokers themselves.
A recent study found that growing up in a home in which two parents smoke could double the child’s risk of lung cancer later in life.
Recommendations to help smoking mothers
Although smoking cessation remains the best course of action for breastfeeding mothers. This may not be practical for all mothers. Below is a list of recommendations which a smoking mother may try to implement.
1. Cut down on smoking
The more cigarettes you smoke, the greater the health risks for you and your baby. If you cannot stop smoking, or do not want to stop smoking, it is safer for your baby if you cut down on the number of cigarettes that you smoke. Fewer cigarettes smoked means less environmental smoke in the air, lower levels of nicotine in your milk, better health for everyone, and more time with your baby.
2. Smoke right after breastfeeding instead of just before
When a breastfeeding mother smokes a cigarette, the nicotine levels in her blood and milk increases first, and then decrease over time. Additionally, exhaled carbon monoxide (CO) increases significantly the first hour after smoking, with a continued elevated presence up to 24 hours after smoking. Therefore, smoking right after feedings minimizes the amount of nicotine in the milk, and may help minimize inhalation of heightened carbon monoxide in the first hour after smoking.
3. Smoking cessation aids
Commercial products may help you quit smoking and their use protects your whole family from carbon monoxide and respiratory irritants in the air. If you use nicotine gum or lozenges, treat them as you would a cigarette—use them right after a nursing so that blood levels of nicotine have time to fall before the next nursing.
Transdermal nicotine patches provide a steady level of nicotine in your blood and milk. That level will be lower than the level of nicotine from smoking. Consider removing the patch at night to reduce levels of nicotine during nighttime nursings. Breastfeeding mothers should be especially careful not to smoke cigarettes while using such products. Smoking relapses while using replacement products may produce very high levels of nicotine in your blood and milk that could be dangerous.
4. Smoke as far away from your baby as possible
To prevent your baby's exposure to environmental tobacco smoke and particulates small enough to inhale, any smoker in your household should smoke outside or at least in a room away from the baby. Some healthcare providers suggest that family members who smoke should always wash their hands after smoking and before touching the baby. A smoker can also wear a jacket or other outer garment while smoking to protect clothing from smoke particles. This garment may be removed before reentering the home or having any contact with the baby so the baby will be exposed to fewer smoke particles.
Take Home Message
Smoking is not recommended during breastfeeding. However, it is still best for a mother to continue breastfeeding, and work on trying to stop smoking, than to stop breastfeeding all together.
This article is written by Dr. Itumeleng Buti (MBChB)
References
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3. Rachel Nall. How Harmful Is Smoking While Breast-Feeding? [Internet] Healthline Media. [Updated 2018 February 18, Cited 2022 May 2] Available from: https://www.healthline.com/health/parenting/smoking-while-breastfeeding#TOC_TITLE_HDR_1.
4. American Academy of Pediatrics Committee on Drugs. The transfer of drugs and other chemicals into human milk. Pediatrics 2001; 108(3):776-89.
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6. Hale, T. Medications and Mothers’ Milk. Amarillo, TX: Pharmasoft Publishing, 2017.
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8. Mohrbacher, N. and Stock, J. The Breastfeeding Answer Book. Schaumburg, IL: LLLI, 2003.
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