Smoking and Breastfeeding

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"Parenting isn't a practice.  It's a daily learning experience."

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I was lucky enough to be a part of the generation who was consistently told from day one that “smoking is bad for you.” I consider myself lucky because I always had the confidence to say “no” and I never felt the desire to even try a cigarette. Despite this, it would be foolish to believe that no one of my generation, or those in child-bearing ages, do not smoke currently. We know the health risks, we know we shouldn’t, but many still do and it has great impacts on not only their health but the health of their children.

You might ask how this relates to breastfeeding? Well, many women believe that because they smoke, they cannot also breastfeed. While it is strongly encouraged that women quit once they become pregnant, we must live within some people’s realities. If a woman smoked during her entire pregnancy and then gives birth, we cannot expect her to magically not be addicted on the day of delivery. So, what are the impacts of smoking on breastfeeding and lactation?

Research has found that smoking mothers are less likely to continue breastfeeding. This may be because of a lower motivation to continue, as well as the perception of harmful effects on the quality and quantity of their breast milk.

Nicotine, from smoking, does transfer into a mother’s milk. Smoking 20 cigarettes daily increases the nicotine in a mother’s milk to harmful doses and may cause nausea and vomiting in the infant. Other possible side-effects in infants include fussiness, shock, rapid heart rate and restlessness.

The American Academy of Pediatrics (AAP) states that maternal smoking is not absolutely contraindicated but is strongly discouraged (AAP, 2013). Concerns cited within this policy also cause some anxiety in pregnant and breastfeeding mothers, which cause them to choose not to breastfeed. Those listed are concerns with: respiratory infections, sudden infant death syndrome, low milk production, and low weight gain.

So, what do you do if you smoke? Understand your options.

• You should attempt to quit smoking before you give birth
• Find a smoking cessation program before and during pregnancy, and continue while breastfeeding
• Talk with you obstetrician and your baby’s pediatrician about it

What is important is the management of smoking, if you continue, during pregnancy and after baby is born. Second-hand smoke is linked to many issues with children, and therefore smoking around your child is strongly discouraged. Nicotine intake from second hand smoke is much greater than nicotine intake from breastfeeding.
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Children who are exposed to smoke within the home may have:

• Higher risk of respiratory infections and illness
• Higher risk of asthma
• Higher risk of neurobehavioral problems
• Decreased performance in school
• Higher risk of ear infections
• Higher risk of sudden infant death syndrome

If you continue to smoke after birth, do not do it inside of the home, in the car, or anywhere that may confine your child to be exposed to the smoke. Go outside, wear a “smoking jacket” or change your clothing after you smoke, and wash your hands thoroughly before interacting with your baby again. Also, try to time out your smoking with feedings. Feed your baby before you have a cigarette and then perform all the previously stated to even further decrease your child’s exposure.

Mothers who continue to smoke during pregnancy and breastfeeding often feel guilty. The best thing is to understand that you are not alone and to make the best decisions that fit the needs of both yourself and your baby. It is better for a baby of a smoking mother, or a baby who is exposed to second hand smoke, to be breastfed as they receive protection from breastfeeding that they would otherwise not get. We are all trying to do our best as parents, and we must work within our own realities. You got this mama.

Source Credit: Lauwers, J., & Swisher, A. (2016). Counseling the nursing mother: a lactation consultants guide. Burlington, MA: Jones & Bartlett Learning.