After nearly 10 months of pregnancy, you’ve finally met your new baby. You’re settling into your new routines and schedules, figuring out what your new normal is.
Pregnancy can be difficult, and newborns are a handful. You may not have realized it, but breastfeeding can be hard, too.
Some people think it’ll be a piece of cake, since it’s “natural” or “instinctive” — but that can be far from the truth.
It should come as no surprise that many breastfeeding women are longing for a bit of normalcy in what can be a stressful few months.
Moms are often anxious to return back to their pre-pregnancy coffee intake to fight off that new-parent exhaustion, or relax with a glass of wine. But many aren’t sure if they’ll be passing caffeine, alcohol, or other substances to their baby through breast milk.
Fearing judgement, you may hold back from asking your doctor for advice when it comes to controversial things like alcohol and marijuana.
While there are do’s and don’ts while breastfeeding, once you’ve read this guide, you’ll likely go much easier on yourself (and your diet) than you have been up to this point.
How much of what you consume ends up in breast milk?
When you grab a snack or drink, traces of whatever you ingest end up in your milk.
It’s not a 1:1 trade, though. So, if you eat a candy bar, your baby isn’t going to get a candy bar’s worth of sugar in your milk.
The nutrients from your diet do enter your bloodstream and make it into your milk, but sometimes it’s not as big a deal as you might think.
For instance, there are no foods you should avoid in order to provide healthy milk for your baby. You can eat anything you want and your body will still make high-quality milk.
Of course, a healthy diet is important. But don’t feel like you need to skip the spicy chili or french fries because you’re breastfeeding. If, however, you notice patterns of the baby being more irritable or upset after eating certain things, you could reduce intake and see if the problem resolves.
Breastfeeding myths debunked
- There are no foods you should avoid unless your baby has a sensitivity.
- Your body will make healthy milk regardless of what you eat.
Caffeine: Yes, 2 to 3 cups a day is fine
If there’s one thing a new mom is probably anxious to add back into her diet post-baby, it’s coffee.
Late nights and little sleep are the hallmark of caring for a newborn, so the lure of a hot cup of coffee can be intense.
Lots of moms are hesitant to have a cup of joe though, because they don’t want their baby ingesting caffeine through breast milk. Besides worrying about long-term effects, a sleep disrupted infant is a nightmare scenario for an already sleep-deprived mom.
Here’s some great news: It’s ok to drink coffee while you’re breastfeeding.
Ali Anari, pediatrician and chief medical officer at Royal Blue MD, explains that caffeine does appear in breast milk quickly after ingestion. “Fussiness, jitteriness, and poor sleep patterns have been reported in the infants of mothers with very high caffeine intakes equivalent to about 10 or more cups of coffee daily.”
However, up to five cups of coffee per day resulted in no adverse effects in babies older than 3 weeks.
Anari cautions that preterm and very young newborns metabolize caffeine more slowly so mothers should drink less coffee in the early weeks.
And don’t forget: Caffeine is also found in drinks like soda, energy drinks, and yerba mate. Anari points out that drinking any beverage with caffeine will have similar dose-related effects on the breastfed infant.
Most experts agree that around 300 milligrams (mg) of caffeine is safe for a breastfeeding mom. But since caffeine concentration in coffee is variable depending on the type of coffee and how it’s brewed, many experts give a low-end estimate of 2 cups per day.
“Generally speaking, having the equivalent of two cups of coffee is considered fine for a lactating person,” says Leigh Anne O’Connor, New York City Le Leche League (LLL) leader and international board certified lactation consultant (IBCLC). “Depending on the person’s size, metabolism, and the age of the baby this can vary.”
Caffeine while breastfeeding
- Experts agree that 2 to 3 cups of coffee per day, or 300 mg of caffeine, is safe.
- Drink less caffeine when you have a very young newborn baby.
- Mom’s weight and metabolism can affect how much caffeine ends up in breast milk.
- These guidelines apply to all drinks with caffeine — soda and matcha included.
Alcohol: No need to pump and dump
Having a glass of wine or a beer can be a terrific way for a new mom to relax after a long day of caring for an infant. Likewise, getting out of the house for a date night or a mom’s night out might be just what a new mom needs to feel like she’s getting back to a sense of normal.
But many mothers are unsure about whether or not breastfeeding after drinking alcohol is safe for their baby.
The old myth that you should “pump and dump” if you have a drink is so unappealing for some moms, they may avoid drinking entirely.
No need to waste that precious milk. Pumping and dumping isn’t necessary!
Another myth that moms should be aware of is that beer or wine can help stimulate milk production. Anari cautions that this isn’t entirely true and may backfire.
“Alcohol decreases milk production, with 5 drinks or more decreasing milk letdown and disrupting nursing until maternal alcohol levels decrease,” she says.
If you’re struggling with your milk supply it might be best to avoid alcohol until you feel like your supply meets your baby’s demand.
But if your supply of milk is fine, “casual use of alcohol (such as one glass of wine or beer per day) is unlikely to cause either short- or long-term problems in the nursing infant, especially if the mother waits 2 to 2.5 hours per drink.”
According to Anari: “Breast-milk alcohol levels closely parallel blood alcohol levels. The highest alcohol levels in milk occur 30 to 60 minutes after an alcoholic beverage, but food delays the time of peak milk alcohol levels.”
It’s long-term or high-quantity drinking that can cause problems.
“The long-term effects of daily use of alcohol on the infant are unclear. Some evidence indicates that infant growth and motor function may be negatively affected by 1 drink or more daily,” explains Anari, “but other studies have not confirmed these findings. Heavy maternal use may cause excessive sedation, fluid retention, and hormone imbalances in breastfed infants.”
All that said, a night out every once in a while, or a glass of wine after a particularly hard day will not harm your baby. If you’re concerned, there are breast milk test strips available in most stores that test milk for alcohol.
Occasional drinking won’t harm your baby! A glass of wine or a beer is perfectly safe and might be just what the doctor ordered after a long day at home with an infant.
However, excess intake should be avoided, as this can get in the way of making good decisions and your ability to care for your infant.
Alcohol while breastfeeding
- It’s okay to have 1 drink a day, but long-term or heavy drinking can impact your baby.
- Wait 2 to 2.5 hours after each drink before breastfeeding.
- Don’t breastfeed 30 to 60 minutes after an alcoholic beverage, as that’s when the highest alcohol levels in milk occur.
- Keep in mind that food delays the time of peak milk alcohol levels.
- There’s no need to pump and dump.
- Alcohol may decrease your milk supply.
Cannabis with THC: Use caution
Now that it’s somewhat legal (recreationally or medically) in more than half of U.S. states, the safety of cannabis consumption while breastfeeding is being explored more closely.
Until recently there was very little scientifically-backed information about how THC (tetrahydrocannabinol) — the psychoactive compound found in the marijuana plant — interacts with breast milk.
However, a recent small scale study showed that when smoked, THC showed up in small amounts in breast milk. The researchers urge moms who smoke to use caution since it’s not known what long-term neurobehavioral effects from exposure might be.
Some much older research from 1990 did show that THC could impair motor development in infants who were exposed. Further research is still needed.
Since use of high-THC cannabis is becoming more mainstream, people are using it in ways other than smoking the flower of the plant, too. Edibles, vaping, concentrates like wax and shatter, and infused foods and drinks are increasingly common. But the studies just haven’t been done yet to determine how much THC enters milk if it’s eaten versus vaping or smoking.
While the science catches up with use, breastfeeding moms should use caution and abstain from THC while breastfeeding.
THC while breastfeeding
- Small amounts of THC do make it into breast milk, a small study showed.
- We don’t know the full impact on babies who are exposed to THC, though older studies show potential harm exists.
- There haven’t been enough studies done, so to be safe, avoid using high-THC cannabis while breastfeeding.
Cannabis with CBD: Talk to your doctor
Another cannabis-derived compound is having its day in the sun.
Like THC, the research just hasn’t been done yet to determine how CBD affects breastfed infants. While some folks say it’s most likely safe since it isn’t psychoactive, there are no studies to back that up.
If your doctor or healthcare professional prescribes CBD, you should mention to them that you’re breastfeeding before beginning treatment.
CBD while breastfeeding
- CBD use during breastfeeding isn’t proven to be safe, but like THC, more studies are needed to know what risks are possible.
- It’s best to talk to your healthcare provider before deciding.
Prescription pain meds: Use caution
Many new mothers are prescribed drugs like oxycodone for pain following caesarean deliveries or vaginal births with significant trauma.
Studies have shown that levels of opioids do show up in breast milk, and infants can be at risk for “sedation, poor attachment, gastrointestinal symptoms, and respiratory depression.”
These effects are much more likely with mothers who experience chronic pain, due to repeated, extended dosing.
Opioid use should definitely be discussed with your healthcare provider to determine risk to the baby versus benefit to the mother.
Pain pills while breastfeeding
- Opioids taken by a mom show up in breast milk.
- It’s still unclear whether or not it’s safe to take certain levels of opioids while breastfeeding.
- Talk to your doctor to help make a decision.
You have so much to worry about when establishing a breastfeeding relationship with your baby, it’s important to have clear information on what’s safe and what isn’t.
While the health of your baby is mostly top of your mind, seeing the myths around breastfeeding exposed should ease your worry about indulging in the things that make you feel better during a tough time.
Kristi is a freelance writer and mother who spends most of her time caring for people other than herself. She’s frequently exhausted and compensates with an intense caffeine addiction. Find her on Twitter.