Breastfeeding: Tobacco, Alcohol, and Drugs

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Topic Overview

If you are breastfeeding, many substances that you eat, drink, inhale, or inject end up in your breast milk and may harm your baby.

  • Smoking cigarettes or chewing tobacco may reduce your milk production and inhibit the let-down reflex. It also may make your baby fussy or irritable. Babies who are exposed to secondhand smoke are at increased risk for many problems, including ear infections, asthma, and sudden infant death syndrome (SIDS). You should not smoke or be around those who do while you are pregnant or breastfeeding. If you smoke, do so as little as possible. Smoke outside and right after you have breastfed, to give your baby the least exposure to the harmful chemicals.
  • When a breastfeeding woman drinks alcohol heavily, it can cause a lack of energy and other health problems for her baby. It can also get in the way of a mom's ability to feed the baby when the baby is hungry or to care for the child in other ways. There isn't a lot of research about exactly how much alcohol can harm a baby. Having no alcohol is the safest choice for your baby. If you choose to have a drink now and then, have only one drink, and limit the number of occasions that you have a drink. Avoid breastfeeding or pumping milk right after you have had a drink. Your body needs time to clear some of the alcohol from your system. You may want to pump or express milk before you drink any alcohol. Then you can use that milk to feed your baby after you have had a drink.
  • Illegal drugs can be passed to a baby in some amount through the breast milk. Drug use can cause poor milk let-down in the mother and a lack of energy, intoxication, hyperactivity, addiction, or other health problems in the infant. Drugs can also get in the way of a mom's ability to care for her child.

Other Places To Get Help


La Leche League International
U.S. Department of Health and Human Services: Women's Health


Other Works Consulted

  • Briggs GG, et al. (2011). Ethanol. Drugs in Pregnancy and Lactation, 9th ed., pp. 526–532. Philadelphia: Lippincott Williams and Wilkins.


ByHealthwise Staff
Primary Medical ReviewerSarah Marshall, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Adam Husney, MD - Family Medicine
Specialist Medical ReviewerKirtly Jones, MD - Obstetrics and Gynecology

Current as ofMay 30, 2016