It is provided as a guideline. No responsibility can be taken by the author or the Breastfeeding Network for the way in which the information is used. Clinical decisions remain the responsibility of medical and breastfeeding practitioners. The data presented here is intended to provide some immediate information but cannot replace input from professionals.
Smoking whilst breastfeeding is not advised. However the benefits of breastfeeding and smoking are still greater than formula feeding. Although there is some vapour release the risk would probably be less than with smoking. These suggestions are based on my experience of running a smoking cessation clinic as in independent prescribing pharmacist. This information can also be viewed as a PDF by clicking here The information provided is taken from various reference sources.
Smoking Whilst Breastfeeding Smoking whilst breastfeeding is not advised. Nicotine is found in breastmilk. The flavour of breastmilk collected minutes after smoking was identified as tasting more like cigarettes than samples taken at any other time. The levels of cotinine the chemical into which nicotine is changed in the body in the urine of breastfed babies whose mothers smoked were ten times higher than those of formula fed babies of smoking mothers.
It appears that this is due to passage through breastmilk and not through exposure to smoke in a room. Babies of mothers who smoke appear to be more likely to suffer from colic. Smoking appears to lower breastmilk production — more women who smoke believe that they have insufficient milk Mothers who smoke are likely to breastfeed for a shorter length of time Many women continue to smoke whilst breastfeeding perceiving that it is the only time that they have for themselves, to overcome tiredness or to reduce their appetite.
Passive smoking is related to early onset of wheezing — breastfeeding may reduce the severity of bronchial asthma. Research shows exposure to smoke increases the risk of cot death in babies. Smoking Cessation Whilst Breastfeeding It is safer to use nicotine replacement therapy whilst breastfeeding than to smoke.
NRT products are not licensed to be used by breastfeeding mothers. This means that the manufacturers have not included a statement on their use when they first made the product available.
It does not mean they are not safe. Babies will be exposed to less nicotine through NRT than through smoking. Mothers should not use NRT and continue to smoke Patches applied over a 24 hour period may produce vivid dreams in the mother; it might be advisable to remove the patch overnight so that the baby is exposed to less during night time feeds.
Breastmilk contains important factors to help babies fight illness. Breastfeeding helps protect the baby from these harmful effects of cigarette smoke. Of course, it is better if a breastfeeding mother does not smoke, but if she cannot stop or cut down, then it is better to smoke and breastfeed rather than smoke and formula feed.
Options and useful resources on quitting smoking can be found at www. Some people use nicotine patches to help them to quit smoking. This was compared to the use of a higher milligram 21 mg nicotine patch or continuing smoking. Donath SM, Amir LH, , The relationship between maternal smoking and breastfeeding duration after adjustment for maternal infant feeding intention, Acta Paediatr, 93 11 — Luck W, , Nicotine and cotinine concentrations in serum and milk of nursing smokers , British Journal of Clinical Pharmacology, 18 1 :9— While there might be certain health advantages to e-cigarettes, they deliver the same levels of nicotine to the smoker.
Thus, we must conclude that e-cigarettes carry many of the same risks associated with nicotine exposure as regular cigarettes and are not a better option for nursing mothers. According to the data provided by LactMed , a 21 mg transdermal nicotine patch delivers an amount of nicotine to the nursing baby via the breast milk which is equivalent to smoking 17 cigarettes per day.
Using lower patch strengths 7 or 14 mg results in proportionately lower amounts of nicotine delivered to the breastfed infant. We have no studies investigating the use of nicotine spray or gum in nursing mothers. Based on these findings, we would conclude that babies exposed to the nicotine delivered through a transdermal patch may face some of the same risks as babies exposed to nicotine through maternal smoking.
Varenicline is a partial nicotine agonist used for smoking cessation. Because there is no information regarding the use of varenicline in breastfeeding women and its impact on the nursing infant, we would typically avoid the use of this medication in this setting, if possible. There is Limited information regarding the use of bupropion in breastfeeding women; however, there are data to indicate that the levels of bupropion in the breast milk and in the nursing infant are low.
While the risk of adverse events appears to be low, there was one report of a possible seizure in a nursing infant whose mother was taking bupropion. If bupropion is required by a nursing mother for either smoking cessation or the treatment of depression, there is not significant evidence to recommend avoiding or discontinuing breastfeeding.
Our information on the use of medications for smoking cessation in nursing mothers is limited, and there may be factors at play which may make smoking cessation more difficult, or at least different, in postpartum women e. Based on the information we do have, it looks as if bupropion Wellbutrin is the option which has the most data to support its safety in breastfeeding women and their infants.
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