The guidelines on what pregnant mothers should eat and drink are fairly clear-cut.
The Australian authorities recommend for example that as the effects of alcohol in pregnancy are not fully understood, the only truly safe advice is for pregnant women to abstain completely.
The health effects of taking illegal drugs, certain prescription medicines or smoking are also well documented and they are not advised if you want to live a healthy life.
When it comes to caffeine in pregnancy, current advice is that the upper limit for caffeine intake should be no more than 200mg per day, which equates to two cups of coffee.
But what about once the baby has been born? Many women are put off the idea of breastfeeding completely because they are under the misconception that the same “no alcohol” rule applies, but this is not necessarily the case, as long as a few healthy life key points are considered.
Alcohol passes into breastmilk as it does into the blood stream, so mothers who have a drink and then feed their baby will be passing some of the alcohol onto their child. However, it is possible to have a drink while breastfeeding if the mother is careful about timings.
The alcohol levels peak in breastmilk between 30 minutes and 1 hour after the drink is consumed, then gradually decline until the alcohol has disappeared from the system. This process takes between 2 and 3 hours, depending on the size of the drink and how quickly the mother metabolizes the alcohol.
For mothers whose babies are a little older and have fallen into a pattern of feeding every 3 to 4 hours, they can therefore have a glass of wine in the knowledge that by the time their baby next demands a feed, the alcohol will be out of their system. While drinking in moderation is safe, mothers should not drink to excess or get drunk, given that the alcohol will take longer to pass through the system.
Similar rules which apply to alcohol also apply to caffeine. The problem with caffeine is that it is not always easy to know how much caffeine you are taking in.
A typical can of cola will contain 45mg of caffeine, but a freshly made coffee from a coffee shop can range between 70mg and 375mg. Mothers who have abstained from caffeine completely during their pregnancies may find that their babies are more sensitive to caffeine intake than those mothers who drank a cup of coffee a day throughout.
It is also true that the younger the baby, the greater their sensitivity to caffeine. Caffeine is metabolized by the body in a similar way to alcohol and levels peak between 1 and 2 hours after the coffee or cola has been drunk. Timing that pick me up morning coffee around a baby’s feeds is therefore not impossible. Babies who are sensitive to caffeine may appear overly fussy, reluctant to sleep or appear very alert and active.
In the past, the advice given to mothers who wanted to have a glass of wine or some coffee was to pump and dump, that is to express their milk and dump it down the sink.
For mothers who are planning a big night out and who will be away from their babies for several hours, this is still good advice as pumping off milk will stimulate the body to keep up production and stop issues such as mastitis or engorgement from developing. For a mother who has a glass of wine with her meal or a coffee in the morning, this is not necessary.
The key to combining alcohol and caffeine with breastfeeding is a little forward planning, and having a rough idea of when your baby is likely to demand their next feed.
In the early days when breastfeeding is being established there is often no pattern to a baby’s feeding, and this is perfectly normal. Once breastfeeding is established, planning your baby’s feeds and a glass of wine is much easier.
Mothers who are planning a night out with friends or weekend away from the baby can use forward planning to build up a stock of expressed milk for the feeds when they are away, and can then use their pump to express milk in order to keep up their milk supply.
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