Expert: Sally Wendkos Olds - 4/26/2011

Question
I dont know why i started back up and im trying to quit but i smoke no more than 4 cigarettes a day. When I smoke I wear a robe outside so my clothes wont smell, wash my hands, face, and brush my teeth. I dont smoke within an 1hr 1/2 of pumping. I only pump and I place my bottles in the frig. So my question is this..... If there is nicotine in my milk when i pump and then placed in the frig for 6 hours before feed, is there still nicotine in the milk ? I ask because i know nicotine leaves the milk within hours in the body but does the same apply once the milk is expressed ?

Answer
Dear Gennine,

First, congratulations for giving your baby the best start in life by breastfeeding! Also, given the fact that you are smoking, it sounds as if you are taking good precautions to protect your baby from the nicotine.

Since you are only smoking 4 cigarettes per day, this should not pose a problem for your baby. Even non smokers will have nicotine from ambient exposure. The most important thing is that you are breastfeeding!

I am attaching an excerpt from my book (see below) about smoking, which you may find interesting.

Best regards,

Sally
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Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Olds & Marks, 4th edition, September 2010, published by Workman Publishing, and available in most public libraries, bookstores & La Leche League chapters.

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Tobacco
If you smoke, is breastfeeding still best for your baby? Yes. Would it be better for your baby if you did not smoke, or at least cut down while you’re nursing? The answer here is a more emphatic yes. It would also be better for you and everyone else in your household.
  Nicotine, the main substance released when you smoke a cigarette, passes through your milk to your baby, and most of it is altered in your baby’s liver and kidney. Since gastrointestinal absorption is slow, you would expect few if any severe toxic reactions in the nursing baby of a smoking mother.
  However, nicotine does interfere with milk production, and therefore babies of smoking mothers gain weight more slowly than do babies of nonsmokers. Nicotine also seems to make babies sleep less. Babies of smoking mothers spend less time sleeping during the hours immediately after their mothers smoked, compared to times when their mothers did not smoke. Some research also suggests that a mother’s smoking may have negative effects on her baby’s tooth development. And it’s possible that nicotine absorbed through breast milk can make babies fretful. The main reason given by mothers who discontinue breastfeeding is that they “don’t have enough milk,” or that their babies “don’t seem satisfied.” It may be possible to avoid both these problems by not smoking.
  Also, we know about the adverse effects of “passive smoking,” or “secondhand” smoke, that is, inhaling the smoke from other people’s cigarettes. Babies are susceptible to upper respiratory infections when the person closest to them is the one breathing smoke on them. This is true whether a baby is being fed by breast or bottle. One study found that babies of smoking mothers and fathers have higher rates of upper respiratory tract infections, but that breastfeeding protected them to some degree. These researchers concluded, “Smoking should not be permitted in households with infants.” One reason for this is “thirdhand” smoke, the tobacco toxins that remain in household dust, swirling in the air, and deposited on surfaces – contamination that remains after a cigarette is extinguished. Young children are especially vulnerable to thirdhand smoke exposure because they breathe near, crawl and play on, touch, and put their mouths on contaminated surfaces.
  If you’re pregnant now, you probably already know that smoking causes a variety of prenatal complications. The most well-documented finding related to smoking is the tendency of pregnant smokers to bear smaller babies, and it’s harder to establish breastfeeding with a premature or low-birthweight baby. The good news is that women who stop smoking by four months of pregnancy do not experience these complications.

Minimizing the Effect of Nicotine on Your Nursing Baby . If you feel that you can’t stop smoking even for the duration of pregnancy and lactation, it’s still better to smoke and breastfeed rather than smoke and formula feed. You can lessen the risk to your baby by taking these steps:
* Don’t smoke, and don’t let anyone else smoke, in the home or in any indoor space where your children are.
• Don’t smoke while nursing. Aside from the danger of the tobacco smoke, there’s the very real risk of dropping hot ashes on your baby.
• Cut down, smoking as little as possible, especially around your baby. The less you smoke, the less risk there is to your baby.
• Make special efforts to smoke in another room or outdoors.
• Do your smoking immediately after a feeding rather than shortly before one.
* If you must smoke, wait two hours before breastfeeding.