Alcotest for breast milk: I don't know whether to laugh or cry

http://www.milkscreen.com

Because every mom metabolizes alcohol differently, it is important to test your milk before feeding your baby if there is any question of the lingering presence of alcohol.

Can't they just use magnets like every other charlatan???

Oh, that's easy, Randy: just start laughing hysterically, realize that you can't seem to stop, and end up sobbing until you're exhausted

The only consolation is that this kind of foolishness is largely limited to first time moms---if a second kid comes along, they are generally over eing so paranoid and ridiculous.

Do you know what best practices are for mothers who breast feed their babies, Randy?

I've tried to make sense of this issue and have found lots of conflicting information: See for example:
See for example http://alcoholism.about.com/cs/preg/a/aa000801a.htm

Conflicting Advice

"There are a lot of breast milk and alcohol theories out there," writes Stephanie Ryan, RN, BSN, ICCE, IBCLC at the Childbirth.org web site. "Some health care providers feel it is best to avoid all alcohol while nursing. Some feel that occasional moderate drinking is okay and some feel that if any alcohol is consumed, you should pump and dump for 24 hours."

"Alcohol clears the breast milk in about the same amount of time it takes to clear the blood stream. If you are planning to drink heavily (more than 2 drinks), you may want to give it 6-8 hours to clear your system," Ryan says.

But Denise G Hewson, RN, IBCLC at the Breastfeeding.com web site has a different view. "By the time you are no longer feeling "tipsy" it is okay to feed your baby. Alcohol does not go into your milk and stay there. It goes in and comes out. If you feel ok, then most of the alcohol is out of your milk. If you have any doubt, pump and dump one time and that should be fine."

But the American Academy of Pediatricians has a still different view: While you are nursing, avoid drinking alcohol because it can pass through your milk to your baby. If you choose to drink alcohol, drink it just after you nurse rather than just before.

The above article concludes:

Moderation is Key

Although these experts disagree about the length of time between drinking and breastfeeding, one thing they all agree about is that mothers who drink while breastfeeding should only do so moderately and "moderate" means no more than two drinks per day.

Heavy drinkers or alcoholics who breastfeed should "abstain from drinking alcohol until their babies are weaned" the Recovery Emporium suggests. Alcohol readily enters breast milk and heavy alcohol consumption has been shown to reduce lactation.

The effects of alcohol on the breastfeeding baby are directly related to the amount the mother consumes, according to LaLeche League. A significant difference was detected, in a study by The National Institute of Child Health and Human Development, in motor development at one year of age in those babies subjected regularly to alcohol.

"Moderation is the key," says Pat Dwiggins, a nurse and International Board Certified Lactation Consultant in Pensacola, Fla. "Drinking large amounts of alcohol on a regular basis can inhibit let-down and even deplete milk supply, not to mention affect baby's development."

The prevalent assumption here seems to be that alcohol in a mother's milk can't harm a developing baby. Is that true?

Regards, Bob

I think it's really amazing that humans have survived as long as they have, really.

Must be that intelligent design thing I keep hearing about.

I think it's really amazing that humans have survived as long as they have, really.

Must be that intelligent design thing I keep hearing about.

Sometimes I feel like I need four more hands so that I could adequately supply all the people waiting in line to hold my hands.

I love the comment that mothers should wait until aftre they have breast fed before they drink wine. In my view, if a mother has to be told that bit of astounding news, that mother ought to have been forced to apply for a license to give birth, which isn't a bad idea in itself

I can't help but wonder how the hell my mother gave birth to ten of us without incident. On weekends she added a glass of wine for lunch to her daily dinner wine Jones.

Remember the good old days? My grandmother used to put whiskey on her babies' gums when they were teething.

Of course, 5 of her 8 children have been through rehab at some point...hmmm

Remember the good old days? My grandmother used to put whiskey on her babies' gums when they were teething.

Of course, 5 of her 8 children have been through rehab at some point...hmmm

And whiskey stopped being sold...and prescribed...as medicine only in the 1930s or 1940s, I believe.

It was most certainly sold in great quantities during Prohibition, prescribed as medicine and sold in special paper cartons.

My mother commonly prescribed whiskey, lemon and honey for sore throats, as well as using the stuff for teething, K.

Remember the good old days? My grandmother used to put whiskey on her babies' gums when they were teething.

My mother commonly prescribed whiskey, lemon and honey for sore throats, as well as using the stuff for teething, K.

I got the "whiskey-on-the-gums" treatment while teething as well.

Guess I'll have to let you all decide how that's worked out.

Mike

Do you know what best practices are for mothers who breast feed their babies, Randy?

I've tried to make sense of this issue and have found lots of conflicting information: See for example:
See for example http://alcoholism.about.com/cs/preg/a/aa000801a.htm

The problem is that different women metabolize alcohol at vastly different rates. My wife and I (both scientists) researched this topic exhaustively during her pregnancy. There are well-documented (but rare) cases of Fetal Alcohol Syndrome resulting from a mother who never consumed more than a glass of wine a day, and there are also reports of mothers with much heavier alcohol consumption giving birth to children without appreciable FAS. The consensus view is that, for the vast majority of women, very moderate alcohol consumption, especially with meals, is unlikely to have any deleterious consequences -- but no medical professional is going to risk a malpractice suit by actually sanctioning a pregnant woman to drink.

The prevalent assumption here seems to be that alcohol in a mother's milk can't harm a developing baby. Is that true?

No, it's not. Minute quantities of alcohol in milk are unlikely to do harm to the child, but there are also documented cases of heavy drinking by a nursing mother resulting in permanent brain damage to the child.

The bottom line is that it's a very serious issue that concerns a lot of pregnant women. One thing that concerns me about the product Randy posted about is that they give no details about their methodolgy. It looks like a colorimetric assay for ethanol, but unlike the breathlyzer test (which I understand in detail) testing for ethanol in breastmilk (or cow's milk for that matter) is tough to do without a gas chromatograph handy. It's impossible for me to tell if it's bogus or not.

Mark Lipton

When my kids were nursing I couldn't find a definitive answer for this, so I limited alcohol intake to one glass of wine at a special event now and then... maybe three times a year.

I especially love the line "If you choose to drink alcohol, drink it just after you nurse rather than just before. " It seemed like my son was attached to me 24/7. There really wouldn't have been any "after" time that wasn't immediately preceding a "before" time!

And whiskey stopped being sold...and prescribed...as medicine only in the 1930s or 1940s, I believe.

I remember having a bottle in the ER for medicinal purposes in the 1980's.

Thanks, Mark. Very interesting and thoughtful response. Regards, Bob

As a young father with a wife that loves wine, we have thought about this a lot. Surely, moderation is always good advice. But at the end our reasoning was the following:

If a nursing wife drinks wine, the alcohol will get into her blood, so it will end up in the milk eventually. If we assume that the alcohol is not accumulated in the milk, the milk should not contain more alcohol than the blood. This means for moderate drinking something like 0,02% alcohol contents in the milk as consumed by the baby. If you compare this with the possible alcohol contents in e.g. apple juice (up to 1%) or sourdogh bread, i don't see a dramatic problem. Of course this very slightly alcoholic beverage for the baby is then metabolized and will probably have no effect on the blood alcohol level of the baby.

The situation is of course different for pregnant women, where the foetal organism is directly connected to the mothers blood circulation system and thus (simplified!) may have more or less the same blood alcohol level as the mother.


To sum it up - of course I don't advocate heeavy drinking but I don't have a problem if my nursing wife has a glass or two with dinner.
But what di I know - I am only a physicist and not a physician.

Regards, Robert

""Do" the expression "common sense" ring a bell?"

Thanks for clarifying your position, Randy. I wasn't sure from you original post why you didn't know whether to laugh or cry about the Alcotest.

If your position was alcohol or nurse, but not both, the Alcotest is unnecessary.

If your position was alcohol and nursing is ok, the Alcotest is also unnecessary.

I thought either position was possible as you worded your original post.

Ironically, if a nursing mother needs determine a "sensible" amount of alcohol to ingest, the Alcotest might actually be helpful -- assuming it works of course.

In any event, given the wide range of opinions expressed in this thread, "common sense" doesn't seem to give very clear guidance.

Regards, Bob

"If you compare this with the possible alcohol contents in e.g. apple juice (up to 1%) or sourdogh bread, i don't see a dramatic problem."

Robert, do I understand correctly that Austrian apple juice has up to 1% alcohol? That would be very unusual here -- and apple cider would normally be over 5% alcohol.

Yeasts do produce both carbon dioxide and a bit of ethanol, but I've understood that the quantities are tiny any almost all the ethanol is destroyed during the baking process.

Regards, Bob

"Do" the expression "common sense" ring a bell?

How about Cynthia's answer? Do we need tests and paragraphs of discussion on such a simple thing? A serious mother would just reduce consumption to a minimum sensible level and not philosophize for hours about it or buy testing kits. Wanting to drink the absolute maximum without hurting the baby? How about moderation or less during such a critical period, even if you're convinced there's no harm at all.

I understand where you're coming from, Randy, but "common sense" is elusive in this case. What you're advocating is making a decision about what threshold of alcohol intake will be harmless to an infant who has no say in that decision. The risk is, at worst, permanent and irreversible harm to that infant. So it's all about risk management. The device in question, if it does what it purports to do, would permit parents to rapidly work out some rules of thumb about alcohol and nursing. It seems a bit OTT to me, but I can understand the motivations of people who do buy it. As a parent, how could I ever make it up to a child who'd suffered permanent brain damage because of alcohol consumption by a nursing mother? If this device helps prevent that scenario, is it not worth whatever expense they charge for it?

Not too long ago, I read an article (maybe in the NYT) about the growing awareness of Fetal Alcohol Syndrome in France. It appears that, after years of downplaying the risks, even in France there is discussion about what constitutes a sensible limit for alcohol consumption by pregnant and nursing women. It is a very sensitive topic.

Mark Lipton

There was a recent conference on the general subject Mark, which urged a warning in the UK. The concern seems to have been heightened by the growing popularity of binge drinking among young women.

One report:

Bottles and cans of alcohol should carry health warnings aimed at pregnant women, similar to those seen on tobacco products, campaigners said yesterday.

Wine, beer and spirits should carry words and pictures to warn expectant mothers of the risk they run of damaging their unborn child even if they drink only occasionally, the National Organisation on Fetal Alcohol Syndrome said.

Campaigners said that drinking during pregnancy could leave children mentally impaired, cause serious physical disabilities and even heart problems.

Despite the risks, nearly two thirds of women (61 per cent) drink at some stage during their pregnancy, according to the charity.

It believes that there should be a "zero tolerance" approach towards drinking while pregnant because of the magnitude of the risks.

Its warning comes amid widespread concern about the growing culture of binge-drinking among many young women.

The organisation, which held its annual conference in London yesterday, said that drink labelling with warnings aimed at women was already available in America, France and Finland.

Susan Fleisher, the charity's executive director, said last night: "We want to give people information. I can show you beer cans made by British companies that go to America warning women not to drink during pregnancy.

"We have beer cans with that information missing in this country."

Lord Mitchell, the Labour peer, introduced a private member's Bill last week which seeks labelling on all alcohol, warning of the dangers of drinking during pregnancy.

Telegraph.com.

I haven't seen anything about a health warning label in France, although this article says there is one. A very useful overview of the wide discrepancies between countries on the subject appears at International Center for Alcohol Policies site, which doesn't list a French warning label, current through February 2007.

Regards, Bob

Bob, I checked my facts and stand corrected:

From Wikipedia:

Bread: up to 0,3 %
Apple Juice: up to 0,4 %
Sauerkraut: 0,5 %
Grape Juice: up to 0,6 %
ripe Banana: up to 1 % (on average 3 ml)

Still my argument holds.

Regards, Robert

Thanks, Robert. Regards, Bob