Pump & dump is a myth

If you’ve ever talked with a nursing mom, you’ve probably heard them speak with frustration about the return of alcohol into their lives.  Many moms excitedly look forward to the chance to enjoy a glass of wine, can of beer, or their favorite mixed drink after 9 months of sobriety.

Their friends soon remind them however, that with every drink comes the waste of precious breast milk AND precious time pumping the milk just to dump it down the drain.

 

I’d like to take you briefly through the biochemistry of this concept…for those that aren’t interested in it and just want the punchline (it’s okay to drink AND nurse!) just skip 4 paragraphs for the finale…..

Let’s look at the biochemistry behind “Pump and Dump”. Imagine two big containers of liquid next to each other when an opening between them. The container on the left is the bloodstream, and the one on the right is the breast milk. The opening between the two containers is semi-permeable: some things can pass through but others can’t (like a screen door – it lets fresh air in but keeps squirrels out). Alcohol does pass through this membrane and moves from the blood into breast milk.

Another important principle to understand is gradients. Whenever there is a difference of concentrations between two areas, a gradient exists. One area has a higher concentration, one has a lower. Substances move from areas of higher concentration to areas of lower concentration (imagine you are in a mob of people, claustrophobic you is going to move towards an area where there are fewer people!).

So, when alcohol is absorbed from the stomach into the blood stream, the concentration of alcohol is high in the blood compared to the breast milk, so alcohol molecules down their concentration gradient from the blood into the milk. They keep moving until there is no gradient – each has the same number of alcohol molecules. At this point, it seems like the alcohol molecules should be stuck in the milk and will make it to baby. Luckily, the blood breaks down alcohol molecules. Enzymes in the blood breakdown the alcohol (the reason you don’t stay tipsy forever!), making the concentration of alcohol less in the blood.

As the alcohol concentration level in the blood decreases, a gradient exists again between the blood and breast milk, but in the opposite way. Now, alcohol MOVES OUT of breast milk, back to the blood and is broken down by blood enzymes. This continues until all the alcohol is moved out of the breast milk and broken down in the blood. As you can imagine, by the end all the alcohol molecules are broken down in the blood and none are left in the blood or breast milk.  This whole process takes about an hour or two per drink depending on each woman’s genetic ability to clear alcohol.

Pump and dump verdict: WRONG.

 

You have enough things to worry about.  Your time is precious.  Breast milk is precious.  Your baby is precious….most of the time.   But probably not all the time…that’s why you’re reading a blog post (high likelihood that you are nursing as you read this) to get permission to have that margarita!

Alcohol gets out of breast milk quickly and so there is no need to “pump and dump” if mother limits her alcohol intake to one or two drinks and waits 1-2 hours per drink to breast feed or pump. The AAP agrees with my sentiment: modest alcohol intake does not preclude breast feeding and there should be as little inconvenience as possible to breast feeding mothers to encourage exclusive breast-feeding.

Bottom line: have a drink if you’d like, wait an hour or two, and feel no qualms about breast-feeding your little one.

 

More info: La leech league FAQ on alcohol and nursing

Who can you share this (and maybe a nice pinot or pilsner) with?
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