Breastfeeding 1-2-3

Controversial Test for Alcohol in Breast Milk

by Angela White, J.D., breastfeeding counselor on December 30th, 2006

Can a nursing mother enjoy an alcoholic beverage to toast the New Year? If she has consumed a significant amount of alcohol, must she “pump and dump”? Is the new “Milkscreen” test for alcohol in breast milk a valuable tool for nursing mothers or a waste of money?

(Photo shown with permission by Larar)

The Womanly Art of Breastfeeding: 7th Revised Edition states:

The effects of alcohol on the breastfeeding baby are directly related to the amount the mother ingests. When the breastfeeding mother drinks occasionally or limits her consumption to one drink or less per day, the amount of alcohol her baby receives has not been proven to be harmful. If you enjoy an occasional glass of wine in the evening, or a cold beer on a hot summer day, there’s no reason to deprive yourself of this because you are breastfeeding.

p. 328. So, if a nursing mother sips a glass of champagne for a New Year’s toast, she need not worry about the level of alcohol in her breast milk.

But what if a mother consumes more than one drink–does she need to “pump and dump”? No, she simply needs to wait the requisite amount of time after drinking before nursing her baby (of course, if the mother begins to feel overly full or engorged during that time, by all means she should pump for her comfort). A mother does not need to pump to remove her milk, nor does pumping out the milk affect the rate at which alcohol leaves the mother’s system. The level of alcohol in the milk is the same as the mother’s blood alcohol level (you know, the one used to assess drunk driving). In Medications and Mothers’ Milk Thomas W. Hale, Ph.D. notes:

Adult metabolism of alcohol is approximately 1 oz in 3 hours, so mothers who ingest alcohol in moderate amounts can generally return to breastfeeding as soon as they feel neurologically normal.

p. 323. For more information, see this discussion.

Of course, some mothers may wish to abstain from drinking any alcohol while breastfeeding, or may wish to know that any alcohol has left their system entirely before breastfeeding again. That’s where the new Milkscreen test comes in. It’s a two-minute test for the detection of alcohol in breast milk. The nursing mother saturates a reactive pad with her milk, waits two minutes, and looks for a color change indicative of the presence of alcohol in the milk. The company sells the tests for $19.95 for a box of six test strips. It’s also available through other retailers.

What is controversial about the test? The worry is that the existence of this test might scare mothers into thinking that they should not enjoy an occasional drink while nursing (and that in turn might cause them to decide to wean). I think the test is fine for nursing mothers who would like that peace of mind before breastfeeding again. I do not think the test is generally necessary. Of course if a mother feels impaired, she should not breastfeed. If she does not feel impaired and she has waited 2-3 hours per drink consumed, she can rest assured that it is safe to nurse again.

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