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Thread: Does smoking decrease milk supply?

  1. #1
    Carol_2007 Guest

    Default Does smoking decrease milk supply?

    Does smoking cause untoward effects in breastfeeding women? My sister has recently become a mother and she smokes a lot. We have all advised her that smoking will cause the biggest hazard for her child and to sop doing so at least till her daughter is a few months old. She hates to look like “mother” type so recently bought really stylish nursing top with bra from Topmommy and behaves like she is 18.


  2. #2

    Join Date
    Feb 2003
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    Melbourne, Victoria, Australia, Australia
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    8,980

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    Yes it does. It's covered in this article on the main site here: http://www.bellybelly.com.au/article...g-in-pregnancy
    Kelly xx

    Creator of BellyBelly.com.au, doula, writer and mother of three amazing children
    Author of Want To Be A Doula? Everything You Need To Know
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  3. #3

    Join Date
    Oct 2004
    Location
    Cairns QLD
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    5,471

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    Hi Carol,

    My sister is also a smoker during pg & BFing. I find it rather disgusting but hey what do you do?

    here is some info that you can forward on to your sis if you like, of just to read yourself.
    ABA website
    NICOTINE
    It is widely acknowledged that women who smoke during pregnancy do not tend to breastfeed, and are more likely to wean their babies earlier than non-smoking women. Interestingly, this phenomenon appears to be dose related: the more cigarettes smoked the less time spent breastfeeding (Saunders 1990).



    Nicotine is quickly absorbed after maternal smoking and has a half-life in breastmilk of about 90 minutes. The extent of exposure of a breastfed infant is difficult to assess since at least part of the exposure is due to 'sidestream' smoke. Sidesteam smoke is not filtered and contains more nicotine, tar and carbon monoxide than 'mainstream' smoke drawn through the cigarette and into the mother's mouth and lungs. The median nicotine concentration in infant urine after exposure via breastmilk or via passive inhalation was 14 ng/ml and 35 ng/ml, respectively. It is suggested that the effects of these two modes of transmission are probably additive (Fulton 1990).



    Babies who are 'smoked over' are more likely to be hospitalised and to suffer from respiratory and gastrointestinal illnesses. Studies show that these infants are more likely to be colicky and irritable and to experience a wide range of problems from apnoea (short periods when the baby stops breathing), vomiting, poor growth, squint (strabismus, cast or lazy eye), hearing impairment and unexplained death. Smoking depresses the immune system, leaving both the mother and infant more vulnerable to infection, allergy and other immunodeficiency problems (Minchin 1991).



    Nicotine reduces basal prolactin levels which may lead to a decrease in milk supply. Nicotine also causes an adrenaline rush which may inhibit the release of oxytocin and interfere with the let-down reflex. One study clearly suggests that cigarette smoking significantly reduces breastmilk production at two weeks postpartum from 514 ml/day in non-smokers to 406 ml/day in smoking mothers (Hale 1998). In a counselling situation it is always advisable to ask a mother with constant low supply whether she is a smoker.



    Nicotine is an appetite suppressant and can alter the taste of breastmilk. Babies may express their distaste for the milk by fussing and struggling at the breast or even refusing the breast. If the mother smokes more than 15 cigarettes a day, infants can exhibit symptoms of nicotine poisoning (Bisdom 1937). These symptoms may include vomiting after a feed, grey skin colour, loose stools, an increased heart rate and restlessness. Classically, the infant can be observed to wiggle and squirm, giving the appearance of trying to frantically 'tread water' and though they appear very tired they seem to find it hard to keep their eyes shut. Symptoms are slowly reversed when the mother decides to cut back or quit her previous smoking habit. However, infants may also suffer withdrawal symptoms such as sleep disturbances, headaches and irritability.



    The breastfeeding mother who wishes to quit smoking may find this is an ideal time to do it. Prolactin and the endogenous opioids released during suckling may actually blunt the worst of her withdrawal symptoms (Minchin 1991). Transdermal nicotine patches used in nicotine withdrawal have been used in breastfeeding mothers. Nicotine levels can be expected to be less in patch users than those found in smokers, assuming the patch is used correctly and the mother abstains from smoking. The mother should be made aware that the patch is delivering nicotine into her system constantly and it may be desirable to only wear the patch for part of the day (manufacturer, pers comm 1997).



    Exposure to nicotine can also alter the composition of breastmilk. Breastmilk from a mother who smokes contains many chemical by-products of smoking such as nitrates and nitrites, it may contain pesticides and dioxins and have higher cadmium and lead levels than breastmilk from a non-smoking mother (Minchin 1991). Breastfed infants, whose mothers smoke, may have lower levels of certain vitamins. For example, vitamin B12 may be reduced, as it is needed to detoxify cyanide from cigarette smoke (Saunders 1990).



    Smokers may choose to give up breastfeeding because they fear contamination of their milk is a greater risk to the baby than artificial feeding. It is important to remember that artificial milks do not have any of the unique nutritional or immunological advantages of breastmilk and that it is preferable to continue breastfeeding. It is actually more important to stop smoking in families where infants are artificially fed (Chen 1989).



    To reduce potential harm from smoking all parents should be encouraged to:

    quit if at all possible.
    smoke outside the house and car.
    smoke only AFTER feeding to reduce nicotine exposure. Try to use other comforting techniques for the baby for 90 minutes after smoking. (This is difficult with a young baby who is feeding frequently, but may be possible once baby has established routines).
    avoid vegetables containing considerable amounts of nicotine - eggplant, green and pureed tomatoes and cauliflower. Ten grams of eggplant provides the same amount of nicotine obtained in three hours in a room with minimal tobacco smoke (Laurence 1985).
    breastfeed exclusively for the first six months to maximise the infant's protection against respiratory disease, and continue to breastfeed as long as possible.
    do not take the baby into smoky environments.

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