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Newborn and Infant Care

Smoking and breast feeding

01/26/1999

Question:

I'm a smoker, and I quit when I was pregnant, now I'm breast feeding, but then one day I smoked half a stick but that was it, will it affect my breast milk, shall I wait for the next day to feed the baby again?

Answer:

Occasionally smoking one cigarette is unlikely to have much effect on milk supply or on a baby. Some nicotine does get into the milk, however, so it is a good idea to wait 2-3 hours to breastfeed after smoking. It is better to smoke a cigarette that is low in nicotine, so less nicotine will be in the milk at 2-3 hours. Also, smoking immediately after a breastfeeding is better since it usually will be 2-3 hours before a baby wants to feed again and most of the nicotine will be out of the milk by then. (However, waiting this long is a hardship for some babies.)

Most mothers probably know that 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 breastmilk is affected. The more a mother smokes, the more her baby is likely to be affected by nicotine and other substances in cigarettes that get into the milk.

Studies show that heavy smoking (1/2 pack or more a day*) can decrease the amount of milk a mother makes. It also may decrease the amount of fat in milk. Less milk and less fat mean that babies may not gain weight well. Babies often are fussier when their mothers smoke.

(*A half pack/10 cigarettes is an average number. Some babies or the milk of some mothers may be affected by less than 1/2 pack. It may take more than 1/2 pack to affect other babies or mothers' milk.)

The nicotine also is suspected as having a role in a baby's fussiness and sleep difficulties. Occasionally, a mother's heavy smoking has been associated with severe symptoms in a breastfed baby, such as nausea, vomiting, cramping, diarrhea, rapid pulse, and other "circulatory disturbances." Not surprisingly, weaning tends to occur earlier when mothers smoke.

This would be a great time to quit smoking for good. 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. (Even if you do not smoke near the baby, don't let others smoke in rooms where your 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. If a parent smokes, the child is more likely to become a smoker too.

If additional information is needed or any part of this response needs to be clarified response, don't hesitate to write again. All the best for you and your new baby...

Karen Kerkhoff Gromada, MSN, RN, IBCLC

*Editor's note: Sorry for the delay in posting this response. We had a problem with our new software.

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Response by:

Karen Kerkhoff Gromada, MSN, RN, IBCLC
Adjunct Clinical Instructor
College of Nursing
University of Cincinnati