smoking and breastfeeding
Babies of mothers who smoke are more in need of breast milk than other babies. If she smokes right after the feed, and of course not near the baby, by the next feed, the nicotine would have left her milk. Here is a quote form the literature: Steldinger, R. and Luck, W. Half lives of nicotine in milk of smoking mothers: implications for nursing. J Perinatal Med 1988; 16:261-62 (This sounds like a good one because it acknowledges the MDs honest concerns about smoking but then continues on to discuss how nursing can work.) ´The Breastfeeding Answer Book´, LLLI - Revised Jan./97: states that the 1/2 life of nicotine is 95 minutes (Steldinger and Luck 1988) and therefore recommends, that if unable or unwilling to quit, that the breastfeeding mother be encouraged to not smoke before or during breastfeeding but rather to smoke immediately after breastfeeding to reduce the nicotine level in her breastmilk during feeds. Smoking linked to fussiness (Matheson and Rivrud 1989), lower prolactin levels, lower milk production (Hopkinson 1992) and interferes with milk ejection reflex (Lawrence 1994). Heavy smoking linked to the following symptoms in the breastfed infant: nausea, vomiting, abdominal cramp, and diarrhea. (Vorherr 1974). Quote: "Some mothers smoke and breastfeed with no apparent problem, yet other mothers and babies do not do well." - ´The Breastfeeding Answer Book´, LLLI, Revised Edition 03/97. Some smoking things on 2-26-98 in archives (smoking and smoking and BF) There are also a number of articles out there on nicotine/cotinine etc in milk, breast milk volume R/T smoking (less volume), colic etc. One that looks interesting is JAANP, 5(3), May-June 1993, 105-113. Gives some specific rec of how mom can reduce exposure to baby if she does smoke (smoke right after feeding or 1 1/2 hours before feeding, Never in same room with baby, air circulation in home with window open a crack helps. The theory is all babies are exposed to smoke in the home and have measurable levels of cotinine and nicotine. Babies with smoking mom have higher levels, but at same time receive immunities from mom´s milk that protects them. Bottle fed babies in smoking home do not get this advantage.
