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Thursday, December 12, 2013
Smoking and low milk supply
I recently started smoking a couple cigeretts a day. It seems as though my milk supply isn`t the same as it used to be. How do I make more milk, besides the obvious, quitting smoking? Thank you
As you`ve stated, you already know the obvious. It sounds as if you gave cigarettes up while pregnant and first breastfeeding. That probably was hard but you did it day by day. I hope you will consider continuing to avoid smoking just one day at a time until you know you`ve quit for good. Whether breastfeeding or not, both you and your family will be healthier if you quit smoking even a couple of cigarettes a day.
Studies have shown that heavy smoking can decrease the amount of milk a mother makes and it also may interfere with the reflex that "lets down" the milk. Although "heavy smoking" usually refers to a woman that smokes 1/2 pack or more a day, some mothers find milk production is affected by fewer cigarettes. Individual differences and the timing of the introduction of cigarettes in relation to the baby`s birth may contribute to the effect the number of cigarettes has on lactation (milk production). Not surprisingly, weaning tends to occur earlier when mothers smoke.
Milk production also can be affected by a baby`s feeding routine. Most fully breastfed babies cue to breastfeed 8-12 times in 24 hours. However, babies go through several so-called "growth spurts` during which they breastfeed more frequently for several days in order to increase milk production. These spurts commonly occur at some point between 10-14 days, 4-6 weeks, 3-3 1/2 months, and at about 6 months. If a mother is trying to get baby on too tight of a "schedule," or she is unaware of the signs of a growth spurt and introduces a supplement because she thinks she doesn`t have enough milk, her body will not have the opportunity to increase production to meet the amount of breast milk her baby requires. To make more milk, a mother breastfeeds or pumps more often.
Whether or not smoking is the culprit affecting milk production, you should be aware of the other effects it can have when breastfeeding. Smoking may decrease the amount of fat in breast milk. The combination of lowered milk production and less fat means that some babies do not gain weight well. In addition, nicotine is suspected as having a role in a baby`s fussiness and with sleep difficulties. Heavy smoking is occasionally associated with severe symptoms in a breastfed baby, such as nausea, vomiting, cramping, diarrhea, rapid pulse, and other "circulatory disturbances." Smoking a cigarette or two a day when wearing a nicotine patch also has been associated with more severe symptoms.
Smoking an occasional cigarette usually has little effect on breast milk or on a baby. Yes, some nicotine does get into the milk after even one cigarette, but most of it is out of breast milk within 2-3 hours. So if a mother chooses to smoke a cigarette, it is better for her to do so immediately after a breastfeeding. Since most babies breastfeed at about 2-3 hour intervals, most of the nicotine will be out of the milk by the next feeding. (However, some babies would find it a hardship to wait this long between some or all feedings.) Also, less nicotine will be in the breast milk at 2-3 hours if the mother smoked a cigarette that is low in nicotine and if she puts the cigarette out without smoking the last ¬-1/3 of it.
The real danger of smoking even one cigarette is that one cigarette often leads to two, then three, and so on. The more a mother smokes, the more the quantity (amount) and the quality of her breast milk is affected. The more she smokes, the more likely her baby is going to be affected by nicotine and other substances in cigarettes that get into breast milk.
No matter how a baby is fed, if a parent smokes, that child is at much greater risk to suffer from respiratory illnesses, such as colds, bronchitis, pneumonia, SIDS, etc. Asthma also has been linked to parental smoking. (No one should smoke near a baby or in rooms where a baby/child spends time either. Smokers should be sent outdoors or to a well-ventilated, less-used room by an open window.) Plus, as a baby grows, he/she learns how to behave by watching parents. When either parent smokes, the child is more likely to become a smoker too.
All the best as you strive to do the best for your baby and yourself. References:
Hale T (1999). Medications and mothers` milk 1999 (8th ed.). Amarillo, TX: Pharmasoft Medical Publishing.
Lawrence RA & Lawrence RM (1999). Breastfeeding: A guide for the medical profession (5th ed.). St. Louis: CV Mosby.
Karen Kerkhoff Gromada, MSN, RN, IBCLC
Adjunct Clinical Instructor
College of Nursing
University of Cincinnati