Real Talk: Can You Drink While Breastfeeding Or What?

On an old but iconic episode of Kourtney & Kim Take Miami, Kourtney Kardashian came home from a night of drinking with Khloé, and had to use special strips to detect whether there was still alcohol in her breastmilk. "They test the alcohol, to see if there's alcohol, so I know if I need to save this breastmilk or throw it away," she slurs.

The strips indicate that there is in fact alcohol in the breastmilk, and Kourtney threatens to pour the useless, booze-laced breastmilk over her adult sister's head. But would that wanton waste of so-called "liquid gold" be warranted? What IS the deal with drinking and breastfeeding?

You can do it, but you have to proceed with caution, according to the American Academy of Pediatrics. "Their policy is usually no more than a single drink, which would be a can or bottle of beer, four ounces of wine, or two ounces of alcohol, consumed within two hours of breastfeeding, for a 120-pound woman," says Blair Hammond, MD, assistant professor of paediatrics, Mount Sinai Paediatrics. "So basically, if you are going to have a drink, you would have it soon after you finish breastfeeding, and at least two hours before you breastfeed again," Dr. Hammond says.

There are a few reasons why these guidelines are so rigid, the most important being that alcohol can get into your breastmilk. Breastmilk is really made up of a few "ingredients," including blood and water, that are synthesised into milk in the mammary gland, Katie Hinde, PhD, associate professor at the School of Human Evolution and Social Change and the Center for Evolution and Medicine at Arizona State University told Refinery29. And if there is some alcohol in your blood, that could get secreted in your breastmilk, Dr. Hammond says.

But it's not like your baby is going to suck a glass of straight pinot grigio out of your breast, because the alcohol that you consume is also metabolised in your liver. "Everyone has a different ability to metabolise alcohol, and some things can help," Dr. Hammond says. For example, if you're someone who considers yourself a lightweight, you might want to eat a little bit before drinking, or wait a little longer before breastfeeding again. "Peak alcohol concentration in milk is 30 to 90 minutes after a beverage is consumed," she says. "So avoid breastfeeding during that time."

Drinking alcohol can affect your ability to breastfeed optimally, too. "There are some studies showing breastmilk can change in flavour by alcohol," which can make your baby less inclined to drink up. And alcohol can also make you dehydrated, which can affect your milk supply. Some people say that drinking beer can actually make breastfeeding easier, because it increases prolactin, which is a hormone that helps make milk, but Dr. Hammond says that's not really true. "Beer actually decreases a hormone called oxytocin, which helps with the milk being released from the breast," she says.

In some cases, a few drinks could impair a person's ability to care for their baby. "I get most concerned about drinking with a newborn during the first few months of life, when things like SIDS are most common," she says. She also worries that parents may end up co-sleeping when drunk, which "has been absolutely shown to not be safe in parents who have had alcohol." And furthermore, alcohol in breastmilk can lead to long-term developmental issues.

It's understandable why new parents would be nervous around alcohol. But it's fine to have a drink now and then, if you time it right. If you're going to an event where you know you'll be drinking more than just a glass of wine, you might want to consider pumping and dumping, or just being strategic about when you pump, she says. You might want to consider using a testing strip, like Kourtney did, to see if there is alcohol in the milk, and then not give it to your baby. "Some people choose to pump in advance, and give the baby breastmilk from before and not [breast]feed them," she says. "Other people choose to give formula for the feed that they would have possibly given breastmilk with alcohol."

While it's totally okay to drink, Dr. Hammond says making it a daily habit can lead to more serious effects. "There have been studies showing that people who drank everyday and breastfed during the first year of life were seeing lower scores on fine motor and some developmental outcomes after a year," she says. If you're in the mood, having a glass of wine or beer might be better than something with hard alcohol, because it can be difficult to know exactly how much liquor is in a mixed drink, she says. In other words, you are A-okay to crack open one cold one, and watch a few more episodes of Kourtney & Kim Take Miami before your next feed.