Breastfeeding offers many benefits for both mothers and their infants, providing essential nutrients and fostering a unique bond. However, when a mother smokes while breastfeeding, it raises health concerns for the infant. Understanding how cigarette substances affect a baby through breast milk and secondhand smoke is important for informed decisions about infant feeding and maternal health.
How Chemicals Enter Breast Milk
When a mother smokes, harmful chemicals from cigarette smoke, particularly nicotine, are absorbed into her bloodstream and then diffuse into breast milk. Nicotine’s concentration in breast milk can be twice that found in the mother’s blood.
Nicotine’s metabolite, cotinine, also transfers into breast milk and can be detected in the urine of breastfed infants whose mothers smoke. Cigarette smoke contains over 7,000 chemicals, including carbon monoxide, tar, arsenic, cadmium, mercury, and lead, many of which can also pass into breast milk. The levels of these substances depend on the number of cigarettes the mother smokes daily.
Effects on Infant Health
Exposure to cigarette smoke chemicals through breast milk and secondhand smoke can lead to various infant health concerns. A primary risk is an increased likelihood of Sudden Infant Death Syndrome (SIDS). Nicotine exposure through breast milk may affect a baby’s ability to rouse themselves during periods of low oxygen, contributing to SIDS.
Infants exposed to smoke are also more susceptible to respiratory problems, including asthma, bronchitis, and pneumonia, along with impaired lung function. Ear infections are more common in these infants. Some babies may experience symptoms due to nicotine acting as a stimulant, such as:
Colic
Increased fussiness
Vomiting
Diarrhea
Restlessness
A faster heartbeat
Nicotine can disrupt infant sleep patterns, leading to less time in active and quiet sleep, and shortening their longest sleep periods. Early nicotine exposure may also interfere with normal infant lung development and has been linked to neurological effects.
Effects on Breast Milk and Supply
Smoking can impact a mother’s breast milk and her ability to produce it. Nicotine reduces prolactin levels, a hormone essential for milk production, leading to decreased milk supply. Studies show smoking mothers may produce less milk, partly due to altered fat concentration in the milk.
Smoking can also interfere with the let-down reflex, making milk flow harder. Nicotine and other components of cigarette smoke can alter the taste and smell of breast milk. This change may affect the infant’s feeding behavior, causing them to refuse feeds or nurse for shorter periods, which can contribute to earlier weaning.
Minimizing Infant Exposure
For mothers who smoke but are breastfeeding and find it challenging to quit immediately, strategies can help reduce infant exposure to harmful chemicals. Timing breastfeeding sessions is one approach; nicotine levels in breast milk are highest during and immediately after smoking, decreasing by approximately half within 90 to 95 minutes. Smoking immediately after a feeding allows more time for nicotine levels to decline before the next feeding.
It is also important to create a smoke-free environment for the infant. This includes smoking outdoors or away from the baby and ensuring good ventilation in living spaces. To prevent thirdhand smoke exposure, which consists of residual chemicals on surfaces and clothing, mothers should change their clothes and wash their hands and face thoroughly after smoking and before handling the baby. Never smoking in a car, especially when children are present, is also advised.
Prioritizing Support for Cessation
Complete cessation of smoking offers the safest outcome for both mother and infant. Quitting smoking provides immediate and lasting health benefits, including improved maternal health and a reduced risk of health problems for the baby, such as SIDS, respiratory issues, and ear infections. It also helps improve breast milk supply and quality.
Mothers are encouraged to seek support for quitting, as resources are available to assist them. Healthcare providers can offer personalized advice and may recommend counseling, support groups, or smoking cessation programs. Nicotine replacement therapies (NRTs) like patches, gum, or lozenges can help manage withdrawal symptoms by delivering controlled doses of nicotine without the many harmful chemicals found in cigarettes. Consulting a doctor before using NRTs while breastfeeding is advisable. Despite the risks associated with smoking, breastfeeding still provides benefits to the infant, and mothers should be supported in their breastfeeding journey while also being encouraged to quit smoking.