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pediatrician - Dr. Victоr Аbdоw
Rоckville, МD, USА.


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Is it allowed to take Alcohol during lactation?
Is it safe for a nursing mother and a child?

While breastfeeding it is recommended to avoid use of alcohol or do it occasionally and moderately (ABM 2015). Drinking beer does not increase milk production (Mennella 1993-2001, Comité Lm AEP 2012). Long term consumption may cause: sedation, failure to thrive, psychomotor delay in the infant (Little 1989, Moretti 2000, Koren 2002, Backstrand 2004, Sachs 2013), although the data are inconsistent (Little 2002, Haastrup 2014, ABM 2015). One case of Pseudo-Cushing Syndrome was reported that disappeared after alcohol stop by the mother (Moretti 2000). It is controversial that alcohol consumption is associated with shorter duration of breastfeeding (Giglia 2008, Rebhan 2009, Mgongo 2013). Despite of low increase of Prolactin serum level (Sarkola 1999), acute consumption affects the infant with sedation, and, inhibits Oxytocin secretion in the mother (Cobo 1973, Coiro 1992, Chien 2009) and hence affects the ejection reflex of breast milk with a decrease of 10% to 25% of milk production (Mennella 1991-1993-1997-1998-2001-2005). Excessive acute ingestion by the mother may induce coma, seizures and danger of death in the infant (Swiderski 2011). Both beer 0.0% and non-alcoholic (<1%) may be drunk by the nursing mother (Koletzko 2000, Schneider 2013). Increase of anti-oxidant properties of the milk have been recognized (Codoñer 2013). Elapsing time required to resume breastfeeding after occasional consumption of alcohol by the mother in order to ensure disappearance of milk and blood (Ho 2001) depends on mother's body weight (lesser weight needs longer time to wait), and, on the amount ingested (higher amount needs longer time). Stop breastfeeding for longer than two and a half hour for every 10 - 12 g of ingested alcohol: 330 mL of 4.5% beer, 120 mL (1 glass) of 12% wine, or, one cup of 40% - 50% liquor. Suggested time-periods to stop breastfeeding for a 60 kg of body weight woman are: 1 glass of wine = 2.5 hours; 660 mL of beer = 5 hours; 3 cups of liquor = 7.5 hours (ABM 2015: See reference values at Can Fam Physician 2002) Some medicinal products containing high concentrations of alcohol as an excipient should be avoided during breastfeeding (Nice 2000). Avoiding bed-sharing is recommended to mothers who have drunk alcohol (UNICEF 2006, ABM 2008, Landa 2012, UNICEF 2013). When topically used as disinfectant, alcohol is compatible with breastfeeding (WHO 2002).

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Types of risk

VERY LOW RISK
It is allowed while breastfeeding. It is not dangerous for a baby. It is moderately safe. more...

LOW RISK PROBABLE
Possible presence in breast milk is allowed. Follow the doctor's recommendation. more...

HIGH RISK PROBABLE
An unsafe drug, it is necessary to assess the risks while taking. Use safer analogs. more...

VERY HIGH RISK
It is not recommended. You need to stop breastfeeding or choose a safe analog. more...

Scientific literature

The level of risk for breastfeeding is confirmed in these scientific publications:
  1. http://www.ncbi.nlm.nih.gov/pubmed/25836677
  2. https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/21-drug-dependency-protocol-english.pdf
  3. https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/21-drug-dependency-protocol-spanish.pdf
  4. http://www.ncbi.nlm.nih.gov/pubmed/24118767
  5. http://onlinelibrary.wiley.com/doi/10.1111/bcpt.12149/epdf
  6. http://www.ncbi.nlm.nih.gov/pubmed/24460824
  7. http://www.ncbi.nlm.nih.gov/pubmed/23979084
  8. http://pediatrics.aappublications.org/content/132/3/e796.full.pdf
  9. http://www.ncbi.nlm.nih.gov/pubmed/23178070
  10. http://www.ncbi.nlm.nih.gov/pubmed/23186386
  11. http://www.ncbi.nlm.nih.gov/pubmed/23484672
  12. http://www.ncbi.nlm.nih.gov/pubmed/23828056
  13. http://www.scielo.br/pdf/rpp/v31n2/en_10.pdf
  14. http://www.ncbi.nlm.nih.gov/pubmed/24107593
  15. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3852397/pdf/1746-4358-8-12.pdf
  16. http://www.unicef.org.uk/Documents/Baby_Friendly/Statements/UNICEF_UK_statement_bed_sharing_research_210513.pdf
  17. http://www.pap.es/files/1116-1449-pdf/pap53_10.pdf
  18. http://www.ncbi.nlm.nih.gov/pubmed/21332768
  19. http://www.ncbi.nlm.nih.gov/pubmed/22390134
  20. http://www.ncbi.nlm.nih.gov/pubmed/20403941
  21. http://pediatrics.aappublications.org/content/125/5/e1162.full.pdf
  22. http://www.ncbi.nlm.nih.gov/pubmed/18426631
  23. http://journals.cambridge.org/download.php?file=%2FPHN%2FPHN12_03%2FS1368980008002152a.pdf&code=e13487f1c208eae59f1f376d4cb1ef35
  24. http://www.ncbi.nlm.nih.gov/pubmed/19326332
  25. http://www.ncbi.nlm.nih.gov/pubmed/18394108
  26. http://www.ncbi.nlm.nih.gov/pubmed/18546573
  27. http://www.bfmed.org/Media/Files/Protocols/VERSION%20FINAL%20PROTOCOLO%206_Spanish.pdf
  28. http://www.ncbi.nlm.nih.gov/pubmed/18333768
  29. http://www.bfmed.org/Media/Files/Protocols/Protocol_6.pdf
  30. http://www.ncbi.nlm.nih.gov/pubmed/17392153
  31. http://apjcn.nhri.org.tw/server/APJCN/16%20Suppl%201//473.pdf
  32. http://www.ncbi.nlm.nih.gov/pubmed/17433009
  33. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2265592/pdf/nihms39801.pdf
  34. http://www.ncbi.nlm.nih.gov/pubmed/15623810
  35. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1351273/pdf/nihms-5605.pdf
  36. http://www.ncbi.nlm.nih.gov/pubmed/16128179
  37. http://www.ncbi.nlm.nih.gov/pubmed/16713502
  38. http://www.ncbi.nlm.nih.gov/pubmed/16713502
  39. http://www.ncbi.nlm.nih.gov/pubmed/15280906
  40. http://www.nature.com/ejcn/journal/v58/n12/pdf/1602019a.pdf
  41. http://www.ncbi.nlm.nih.gov/pubmed/15332353
  42. http://whqlibdoc.who.int/hq/2002/55732.pdf
  43. http://www.ncbi.nlm.nih.gov/pubmed/11852608
  44. http://www.cfp.ca/content/48/1/39.full.pdf
  45. http://www.ncbi.nlm.nih.gov/pubmed/11986478
  46. http://pediatrics.aappublications.org/content/pediatrics/109/5/e72.full.pdf
  47. http://www.ncbi.nlm.nih.gov/pubmed/11852608
  48. http://www.ncbi.nlm.nih.gov/pubmed/11986478
  49. http://www.ncbi.nlm.nih.gov/pubmed/11329500
  50. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802835/pdf/nihms163467.pdf
  51. http://www.ncbi.nlm.nih.gov/pubmed/11585986
  52. http://www.ncbi.nlm.nih.gov/pubmed/11810962
  53. http://pubs.niaaa.nih.gov/publications/arh25-3/230-234.htm
  54. http://www.ncbi.nlm.nih.gov/pubmed/11839458
  55. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2799509/pdf/nihms163463.pdf
  56. http://www.ncbi.nlm.nih.gov/pubmed/11013791
  57. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2145042/pdf/canfamphys00031-0055.pdf
  58. http://www.ncbi.nlm.nih.gov/pubmed/11155610
  59. http://www.ncbi.nlm.nih.gov/pubmed/11065057
  60. http://www.ncbi.nlm.nih.gov/pubmed/10397281
  61. http://www.ncbi.nlm.nih.gov/pubmed/9802517
  62. http://www.ncbi.nlm.nih.gov/pubmed/9849117
  63. http://www.ncbi.nlm.nih.gov/pubmed/9194908
  64. http://www.ncbi.nlm.nih.gov/pubmed/8118156
  65. http://www.ncbi.nlm.nih.gov/pubmed/8293892
  66. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2799511/pdf/nihms163461.pdf
  67. http://www.ncbi.nlm.nih.gov/pubmed/1523347
  68. http://www.ncbi.nlm.nih.gov/pubmed/1530279
  69. http://www.ncbi.nlm.nih.gov/pubmed/1574949
  70. http://www.ncbi.nlm.nih.gov/pubmed/1886634
  71. http://www.nejm.org/doi/pdf/10.1056/NEJM199110033251401
  72. http://www.ncbi.nlm.nih.gov/pubmed/2761576
  73. http://www.ncbi.nlm.nih.gov/pubmed/3862407
  74. http://www.ncbi.nlm.nih.gov/pubmed/722441
  75. http://www.ncbi.nlm.nih.gov/pubmed/4688584

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