Wednesday, September 5, 2007

Maybe breastfeeding isn't better

After all my ranting about breastfeeding yesterday, I see an article in Pediatrics today that caused me pause. Apparently, women who smoke and breastfeed are lacing their milk with nicotine, and it's having a negative effect.

Researchers in Pennsylvania studied 15 mother-infant pairs to better understand how nicotine affects infants in the short-term. Moms were asked to breastfeed their babies on two separate occasions. On one occasion, the moms dressed in disposable lab coats and gloves and entered a 700 square foot stainless steel chamber to smoke without their babies present. Then they removed their protective garb, washed their hands, provided a sample of breast milk, and breastfed their babies upon demand. The babies were then placed in a crib or on a carpeted floor to sleep. On the second occasion, the moms did not smoke before breastfeeding their babies and putting them down for a nap. On both occasions, researchers monitored the babies' sleep patterns and movement.

The first relevant finding in this study was that both nicotine and cotinine (a metabolite of nicotine) were present in the mothers' breast milk. The researchers estimated the infants received 4.3 times the amount of nicotine when moms smoked before breastfeeding, compared to when they did not.

The second relevant finding is that infants who fed after their mothers' smoked slept 36.7% less than when their mothers did not smoke beforehand. Further, there was a direct and negative relationship between nicotine exposure and sleep: the more nicotine the infants were exposed to, the less they slept. This is not wholly surprising - after all, nicotine is a stimulant.

The researchers suggest that although nicotine has been removed from the list of drugs contraindicated during lactation, nursing mothers who smoke still should consider the negative effects of nicotine on their infants. Since nicotine is not stored in breast milk, they suggest these mothers time their breastfeeding and avoid nursing 30 to 60 minutes after smoking, when nicotine levels peak. They also caution there may be other chemicals transferred in breast milk that we don't know about, and these unknown compounds may have negative health consequences.

What's the moral of this story? Quit if you smoke - it's better for you and your baby. If you don't quit, at least avoid nursing when nicotine levels are highest. You'll transfer less nicotine to your baby, and you both may get more sleep. And that's something everyone in the household can benefit from.

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