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The Breastfeeding Baby and Smoking

I recently had a grandmother ask this question, "Unfortunately my daughter has smoked during her entire pregnancy. She wants to breastfeed and continue smoking. She will not quit spite the potential problems. How can you smoke and breastfeed safely?" 
This is a difficult issue and I thought it best to arm her with the facts.  There are many studies on nicotine in breast milk, but I am referring below two helpful articles.  The first shows that while nicotine is harmful, it may be less harmful to breastfeed and smoke than to bottle-feed and smoke since the baby will most likely be getting the passive second hand smoke.  The second shows the effects of sleep patterns on infants due to nicotine intake.  These babies have difficult sleep patterns and increase risk of respiratory infection.  The Nicotine patches are a much reduced risk to the baby, so I would encourage the mother in that direction.  Also, when dealing with someone who is self-involved, make it more about her benefit than the babies.  For example, tell the mother that she will get more sleep when her baby sleeps better.  Tell her that she will spend less money and time at the doctor when her baby does not have a respiratory infection.  Tell her that she will not have to buy or mix formula when her milk supply is not decreased by nicotine. 
If the mother continues to refuse to stop smoking, make her aware that the nicotine peaks at 60-90 minutes so avoiding nursing during that peak, will help somewhat.  As I said, this is a difficult issue when you care so much, but it is ultimately the mother who will have to come to terms with her decisions.
Best Wishes,



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