Breastfeeding your baby is still the best choice you can make, even if you can’t stop smoking.
Breastfeeding provides significant health benefits for mothers and babies. For babies, it reduces their risk of diabetes, certain cancers, respiratory infections, diarrhoea, and many other health problems. For mothers, it protects against breast cancer, helps with postnatal weight loss, and encourages a unique mother-child bond that can’t be duplicated.
Breastfeeding is just as beneficial for the smoking mother and her baby as it is for the non-smoking mother and her baby. Research has shown that babies of smokers are at increased risk of colic, respiratory infections, and SIDS (Sudden Infant Death Syndrome or cot death).
But breastfed babies are at lower risk for these diseases compared to artificially fed ones, even when their mothers continue to smoke. And breastfeeding helps to protect babies from the potential risks of cigarette smoke. Breastfeeding and smoking may well be less harmful to the child than bottle feeding and smoking.
Fewer cigarettes smoked means less smoke in the air, lower levels of nicotine in your milk, better health for everyone, and more time with your baby. Smoke as far away from your baby as possible To prevent exposing your baby to smoke and particles small enough to inhale, any smoker in your household should smoke outside or at least in another room, away from your baby. Some health professionals suggest that family members who smoke should always wash their hands after smoking and before touching the baby. A smoker can also wear a jacket or other outer garment while smoking to protect clothing from smoke particles. This garment can then be removed before any contact with the baby so that the baby will be exposed to fewer smoke particles.
When a breastfeeding mother smokes, the nicotine levels in her blood and milk rise, and then fall over time. So, smoking straight after breastfeeding minimizes the amount of nicotine in your milk. About 95 minutes after smoking, the level of nicotine in a mother’s blood and milk has fallen by about half. Your baby will probably want to nurse frequently in the early weeks, so you won’t always be able to wait that long between smoking and the next feed. Frequent breastfeeding is good for your milk production and ensures that your baby gets enough to eat. Medications and Mothers’ Milk by Thomas Hale, 2012, states “Mothers should be advised to limit smoking as much as possible and to smoke only after they have fed their infant, or to switch to the use of nicotine patches.”
Some research suggests that smoking affects a baby’s weight gain, while other research shows no difference between babies of smoking and non-smoking mothers. So, monitor your baby’s weight regularly and talk to an LLL Leader or your health visitor about any concerns. There are simple ways to increase your milk production.
Smoking increases the likelihood of your baby suffering Sudden Infant Death Syndrome (SIDS), also known as cot death. Sharing a room with your baby for at least the first 6 months helps to protect against SIDS and also helps with night-time breastfeeding. If you or your partner smoke, you should make sure that you never fall asleep with your baby in bed. Your baby’s risk of SIDS is increased if he sleeps in a bed with a smoker. You should never sleep with your baby on a sofa or armchair, whether you are a smoker or not (UNICEF 2011). See our page on Safe Sleep & the Breastfed Baby.
Smoking is a stress-relieving mechanism for many people. Finding other ways of relaxing can help you cope with nicotine withdrawal:
- Enjoy cuddling and playing with your baby.
- Go for a walk, get some fresh air, visit the park and feed the ducks. Take him swimming.
- Get some rest. Use the relaxation exercises taught in pregnancy. Or have a shower or bath.
- Read a book or magazine; chat to other mums on social media, find LLLGB Facebook groups and pages . Crafts like knitting can occupy your hands.
- Take advantage of non smoking public places to avoid temptation.
- Meet up with other mothers, including at LLL meetings.
Commercial products may help you to give up smoking and their use protects your whole family from carbon monoxide and respiratory irritants in the air. It is worth asking a health professional about the most appropriate therapy and dosage to meet your needs. Use nicotine gum, lozenges, microtabs or nasal spray immediately after a breastfeed so that blood levels of nicotine have time to fall before the next feed. This may be 2 to 3 hours for nicotine gum. Nicotine patches provide a steady level of nicotine in your blood and milk. That level can be lower than the level of nicotine when smoking—use a patch with the lowest level of nicotine possible to satisfy your cravings. Remove the patch at night to reduce levels of nicotine during night-time feeds. Research has shown that use of nicotine patches is a safer option than continuing to smoke.
Hale 2012 states: “The risk of using nicotine patches while breastfeeding is much less than the risk of formula feeding.” Nicotine inhalers give lower blood levels of nicotine than cigarettes, and levels of nicotine are probably too low to affect a breastfeeding baby (Hale 2012).
Electronic cigarettes have not been well studied and are not recommended. NEVER smoke cigarettes when using nicotine replacement products. Smoking while using replacement products may produce dangerous levels of nicotine in your blood and milk
There is no need to stop breastfeeding because you are smoking. Remember that breastfeeding offers your baby protection from the very respiratory diseases you may be worried about.
There are plenty of reasons to stop smoking, both for you and your baby. You’ve probably heard about many of them already. Decide what is realistic for you to do, based on your own circumstances. You could stop smoking during pregnancy and while you are breastfeeding. Otherwise try to minimize the effects by smoking away from your baby, allowing as much time as possible between smoking a cigarette and the next breastfeed, and by keeping the number of cigarettes smoked per day as low as possible.
Less smoking in your household will be good for your whole family’s health, not just your baby’s. Stop or cut down if you possibly can, but remember that even if you can’t, breastfeeding still provides significant health benefits for both you and your baby. If you would like to discuss this with an LLL Leader you can call our Helpline. A Leader will also be able to give you information about LLL meetings where you can chat with other breastfeeding mothers.
Adapted by Karen Butler and mothers of LLLGB from an original text by LLLI with thanks to Amy Conway and Kathy Koch, IBCLC for their help with compiling the original information.
Inclusion of pictures does not imply that the mothers smoke.
The Womanly Art of Breastfeeding. LLLI. London: Pinter & Martin, 2010.
Breastfeeding Today articles
NHS information on giving up smoking Website: www.smokefree.nhs.uk
NHS free smoking helpline: 0800 022 4332
UNICEF: Caring for your baby at night – information for parents and health professionals
Breastfeeding Answers Made Simple. Mohrbacher, N. Amarillo, TX: Hale Publishing, 2010.
Medications and Mothers’ Milk. Hale, T. Amarillo, TX: Hale Publishing, 2012.
Amir, L.H. Maternal smoking and reduced duration of breastfeeding: a review of possible mechanisms.
Early Hum Dev 2001; 64(1):45-67. Haug, K. et al.
Secular trends in breastfeeding and parental smoking. Acta Paediatr 1998; 187(10):1023-27. Ilett, K.F. et al.
Use of nicotine patches in breastfeeding mothers: Transfer of nicotine and cotinine into human milk. Clin Pharmacol Ther 2003; 74(6):516-24. Mennella, J.A. et al.
Breastfeeding and Smoking short-term effects on infant feeding and sleep. Pediatrics, 2007; 120:497-502. Nafstad, P. et al.
Breastfeeding, maternal smoking and lower respiratory tract infections. Eur Respir J 1996; 9:2623-29. Ratner, P. et al.
Smoking relapse and early weaning among postpartum women: is there an association? Birth 1999; 26(1):76-82. Steldinger, R. and Luck, W.
Half lives of nicotine in milk of smoking mothers: implications for nursing. J Perinat Med 1988; 16:261-62. Woodward, A. et al.
Acute respiratory illness in Adelaide children: breastfeeding modifies the effect of passive smoking. J Epidemiol Community Health 1990; 44:224-230.
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Copyright LLLGB 2016