• Its not ideal to breastfeed and smoke, but its worse to smoke and not breastfeed!

We can’t say we think you should still smoke. Obviously the best thing for both you and your babys’ health is that you stop smoking, completely. After all, you’ve just given birth! Giving up smoking will be a comparative breeze! You can do it!

Why you should stop:

• Higher incidence of Sudden Infant Death

I hear you stubbing that last one out! Babies of smoking mothers and fathers have a seven times greater chance of dying from sudden infant death syndrome (SIDS).

• More infections

Babies and children who are exposed to cigarette smoke have a much higher incidence of pneumonia, asthma, ear infections, bronchitis, sinus infections, eye irritation, and croup.

• Higher incidence of colic

Colic occurs more often in babies whose mothers or fathers smoke or if a breastfeeding mother smokes. Researchers believe that not only does the nicotine transferred into mother's milk upset baby but the passive smoke in the home acts as an irritant.

• Tummy problems

Heavy smoking by breastfeeding moms occasionally causes symptoms in the breastfeeding baby such as nausea, vomiting, abdominal cramps and diarrhe

• CCardiac problems in later life

Children who are exposed to passive smoke in the home have lower blood levels of HDL, the good cholesterol that helps protect against coronary artery disease.

• Turning your kids into smokers

Children of smoking parents are more likely to become smokers themselves.

• Increasing your baby’s risk of lung cancer

National Smokers Quitline:

http://www.irishlinks.co.uk/national-smoking-quitline.htm

BUT IF YOU SIMPLY HAVE TO KEEP SMOKING……

Yes, you should still breastfeed your baby. In fact it’s the best thing you could possibly do if you are still smoking. Babies and children who are exposed to cigarette smoke have a much higher incidence of pneumonia, asthma, ear infections, bronchitis, sinus infections, eye irritation, and croup. Breastfeeding babies have much lower incidence of all of these. See 100 reasons! (link).

Breastfeeding is even thought to reduce the levels of nicotine in the baby.  

 http://www.ncbi.nlm.nih.gov/pubmed/17285322?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSu

Smoking during breastfeeding has been associated with:

• Lower levels of prolactin

• Lower milk production : Maternal smoking cuts breast milk production at two weeks postpartum from 514 milliliters per day to 406 milliliters per day

• Problems with milk let-down

• Earlier weaning

These problems may be psychosocial rather than physiological however, and are not significantly proven. Food for thought though…

But if you really really can’t stop ….

• Cut down. The less you smoke, the smaller the chance that difficulties will arise.
• Don't smoke immediately before or during breastfeeding. It will inhibit let-down and is dangerous to your baby.
• Smoke immediately after breastfeeding to cut down on the amount of nicotine in your milk during nursing. Wait as long as possible between smoking and nursing. Nicoteine has a half life of 90 mins.
• But please …
• Don’t smoke in the same room as your baby
• Don’t sleep and smoke in the same room
• Don’t allow your baby to sleep in a room where you smoke
• Ventilate you house frequently
• Smoke outside if possible
• Keep breastfeeding

References

www….

Great article on fast facts regarding feeding and smoking, including quitting resources online:

http://www.breastfeeding123.com/fast-facts-about-cigarette-smoking-and-breastfeeding/

http://www.llli.org/llleaderweb/LV/LVAugSep04p75.html

Nicotine replacement therapy and breastfeeding:

http://www.breastfeedingnetwork.org.uk/supporterline/nocotinereplacement.html

Pubmed articles

• Infantile colic, maternal smoking and infant feeding at 5 weeks of age. Scand J Public Health. 2008 May;36(3):284-91

• What do mothers think about concurrent breast-feeding and smoking Ambul Pediatr. 2008 May-Jun;8(3):200-4. Epub 2008 Apr 8.

• Breastfeeding and smoking: short-term effects on infant feeding and sleep.

        Pediatrics. 2007 Sep;120(3):497-502.

• Nicotine and cotinine in infants dying from sudden infant death syndrome.

        Int J Legal Med. 2008 Jan;122(1):23-8. Epub 2007 Feb 7

• Bedsharing and maternal smoking in a population-based survey of new mothers. Pediatrics. 2005 Oct;116(4):e530-42.

• Myr R. Promoting, protecting, and supporting breastfeeding in a community with a high rate of tobacco use. J Hum Lact. 2004 Nov;20(4):415-

• Shenassa ED, Brown MJ. Maternal smoking and infantile gastrointestinal dysregulation: the case of colic. Pediatrics. 2004 Oct;114(4):e497-505

• Dahlstrom A, Ebersjo C, Lundell B. Nicotine exposure in breastfed infants. Acta Paediatr. 2004 Jun;93(6):810-6.

• Laurberg P, Nohr SB, Pedersen KM, Fuglsang E. Iodine nutrition in breast-fed infants is impaired by maternal smoking. J Clin Endocrinol Metab. 2004 Jan;89(1):181-

• Ilett KF, Hale TW, Page-Sharp M, Kristensen JH, Kohan R, Hackett LP. Use of nicotine patches in breast-feeding mothers: transfer of nicotine and cotinine into human milk. Clin Pharmacol Ther. 2003 Dec;74(6):516-24.
• Agostoni C, Marangoni F, Grandi F, Lammardo AM, Giovannini M, Riva E, Galli C. Earlier smoking habits are associated with higher serum lipids and lower milk fat and polyunsaturated fatty acid content in the first 6 months of lactation. Eur J Clin Nutr. 2003 Nov;57(11):1466-72.
• Amir LH, Donath SM. Does maternal smoking have a negative physiological effect on breastfeeding? The epidemiological evidence. Breastfeed Rev. 2003 Jul;11(2):19-29.
• Batstra L, Neeleman J, Hadders-Algra M. Can breast feeding modify the adverse effects of smoking during pregnancy on the child's cognitive development? J Epidemiol Community Health 2003 Jun;57(6):403-4.
• Mohrbacher N, Stock J. The Breastfeeding Answer Book, Third Revised Edition. Schaumburg, Illinois: La Leche League International, 2003.
• Letson GW, Rosenberg KD, Wu L. Association between smoking during pregnancy and breastfeeding at about 2 weeks of age. J Hum Lact. 2002 Nov;18(4):368-72.
• Hale TW. Medications and Mothers Milk, Tenth Edition. Amarillo, Texas: Pharmasoft Publishing, 2002.
• Amir LH, Donath SM. Does maternal smoking have a negative physiological effect on breastfeeding? The epidemiological evidence. Birth. 2002 Jun;29(2):112-23.
• American Academy of Pediatrics Committee on Drugs. The Transfer of Drugs and Other Chemicals Into Human Milk (Policy Statement). Pediatrics. 2001 Sep;108(3):776-89.
• Amir LH. Maternal smoking and reduced duration of breastfeeding: a review of possible mechanisms. Early Hum Dev. 2001 Aug;64(1):45-67.
• American Academy of Pediatrics. Task Force on Infant Sleep Position and Sudden Infant Death Syndrome. Changing Concepts of Sudden Infant Death Syndrome: Implications for Infant Sleeping Environment and Sleep Position (Policy Statement). Pediatrics. 2000 Mar;105(3 Pt 1):650-6.
• Najdawi F, Faouri M. Maternal smoking and breastfeeding. East Mediterr Health J. 1999 May;5(3):450-6.
• Mennella JA, Beauchamp GK. Smoking and the Flavor of Breast Milk. N Engl J Med. 1998 Nov 19;339(21):1559-60.
• Ortega RM, Lopez-Sobaler AM, Martinez RM, Andres P, Quintas ME. Influence of smoking on vitamin E status during the third trimester of pregnancy and on breast-milk tocopherol concentrations in Spanish women. Am J Clin Nutr. 1998 Sep;68(3):662-7.
• Mascola MA, Van Vunakis H, Tager IB, Speizer FE, Hanrahan JP. Exposure of Young Infants to Environmental Tobacco Smoke: Breast-Feeding among Smoking Mothers. Am J Public Health. 1998 Jun;88(6):893-6.
• Alm B, et al. A case-control study of smoking and sudden infant death syndrome in the Scandinavian countries, 1992 to 1995. The Nordic Epidemiological SIDS Study. Arch Dis Child. 1998 Apr;78(4):329-34.
• Boshuizen HC, et al. Maternal smoking during lactation: relation to growth during the first year of life in a Dutch birth cohort. Am J Epidemiol. 1998 Jan 15;147(2):117-26.
• Schafer T, Dirschedl P, Kunz B, Ring J, Uberla K. Maternal smoking during pregnancy and lactation increases the risk for atopic eczema in the offspring. J Am Acad Dermatol. 1997 Apr;36(4):550-6.
• American Academy of Pediatrics Committee on Environmental Health. Environmental Tobacco Smoke: A Hazard to Children (Policy Statement). Pediatrics. 1997 Apr;99(4):639-42.
• Blair PS, et al. Smoking and the sudden infant death syndrome: results from 1993-5 case-control study for confidential inquiry into stillbirths and deaths in infancy. BMJ. 1996 Jul 27;313(7051):195-8.
• Klonoff-Cohen HS, Edelstein SL, Lefkowitz ES, Srinivasan IP, Kaegi D, Chang JC, Wiley KJ. The effect of passive smoking and tobacco exposure through breast milk on sudden infant death syndrome. JAMA. 1995 Mar 8;273(10):795-8.
• Little RE, Lambert MD 3rd, Worthington-Roberts B, Ervin CH. Maternal smoking during lactation: relation to infant size at one year of age. Am J Epidemiol. 1994 Sep 15;140(6):544-54.
• Stepans MB, Wilkerson N. Physiologic effects of maternal smoking on breast-feeding infants. J Am Acad Nurse Pract. 1993 May-Jun;5(3):105-13.
• Hopkinson JM, Schanler RJ, Fraley JK, Garza C. Milk production by mothers of premature infants: influence of cigarette smoking. Pediatrics. 1992 Dec;90(6):934-8.
• Schulte-Hobein B, Schwartz-Bickenbach D, Abt S, Plum C, Nau H. Cigarette smoke exposure and development of infants throughout the first year of life: influence of passive smoking and nursing on cotinine levels in breast milk and infant's urine. Acta Paediatr. 1992 Jun-Jul;81(6-7):550-7.
• Dahlstrom A, Lundell B, Curvall M, Thapper L. Nicotine and cotinine concentrations in the nursing mother and her infant. Acta Paediatr Scand. 1990 Feb;79(2):142-7.
• Luck W, Nau H. Nicotine and cotinine concentrations in the milk of smoking mothers: influence of cigarette consumption and diurnal variation. Eur J Pediatr. 1987 Jan;146(1):21-6.
• Luck W, Nau H. Nicotine and cotinine concentrations in serum and urine of infants exposed via passive smoking or milk from smoking mothers. J Pediatr. 1985 Nov;107(5):816-20
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