Smoking Cigarettes While Breastfeeding: Is It Safe?

All moms know they shouldn't smoke while pregnant. But once the baby's out — and shrieking for hours straight — just about anyone might start itching for cigarette to calm her nerves. Still, if you're breastfeeding this presents problems. Even if you don't smoke in front of your infant and expose her to the fumes, that nicotine enters your bloodstream, and your breast milk to boot. Moms might feel forced to pick one or the other: smoking or breastfeeding. Yet experts say that the two aren't as mutually exclusive as we might think.

"While it is highly recommended for a mother to stop smoking while she is breastfeeding, it is not an absolute contraindication to NOT breast feed," says Melissa Goist, MD, an ob/gyn at the Ohio State University Wexner Medical Center. Or put in plain English, "Although smoking while breastfeeding is strongly discouraged, if you do smoke, we still highly encourage you to breastfeed."

In other words, the positive health perks of breast milk outweigh the negative impact of smoking. Still, the negatives are extensive. "Smoking has been shown to reduce the quantity and quality of breast milk, producing milk with lower fat content," Dr. Goist explains. Research also shows that mothers who expose their child to tobacco through breast milk increase the newborn's risk of respiratory issues, ear infections, diarrhea, colic, and — scariest of all — SIDS by seven-fold. Long-term concerns are increased risk of cavities, asthma and possibly cancer. And to top things off, "newborns of mothers who  smoke tend to sleep less compared to mothers who abstain," Dr. Goist adds.

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Yet for breastfeeding moms who just can't give up the smoking habit, experts do have some general guidelines to keep in mind. "Here’s what we know from research: If you smoke, try to limit yourself to three cigarettes per day," says Barb Dehn, RN, a practicing Women’s Health Nurse Practitioner and author of Nurse Barb's Personal Guide to Breastfeeding. This keeps the levels of nicotine, tobacco and other toxins in your bloodstream and breast milk to low levels. 

Also time your smoke breaks for right after you breastfeed, to give yourself time for these toxin levels to ebb. "It takes about 97 minutes for one half of the nicotine to leave your system," Dehn continues. "So wait as long as possible until after you breastfeed to smoke, at least 90 minutes."

As an added safety measure, wear a different shirt and cover your hair while smoking — far, far away from your baby. "After smoking, wash your face and hands and change your shirt to decrease the baby’s exposure to the chemicals in cigarette smoke," Dehn adds.

For moms who smoke a pack or more per day (20 cigarettes), it's recommended that they ask their health care provider about using a low-dose nicotine patch to curb their smoking and decrease the levels of nicotine in their breast milk.

Bottom line: While smoking and breastfeeding is hardly ideal, in the risk/reward balance, there is a way to do both that doesn't mean you've sentenced your baby to certain death. And hey, moms can't always be perfect, so there's no need to judge a breast-feeder who needs a puff or two to deal with a very hard day. 

Did you smoke while breastfeeding?

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