Alcohol in breast milk may lead to lower cognition in kids, study finds

Children's exposure to alcohol through breast milk may cause a comparable drop in their cognitive abilities, accordin...

Posted: Jul 30, 2018 2:17 PM
Updated: Jul 30, 2018 2:17 PM

Children's exposure to alcohol through breast milk may cause a comparable drop in their cognitive abilities, according to a study published Monday in the journal Pediatrics.

"This is the first study in which associations between alcohol exposure through breast milk and cognition in children are examined," the researchers from Macquarie University in Australia wrote in the report.

5,107 Australian infants were followed for 11 years for the new study

Higher maternal consumption of alcohol aligned with lower nonverbal reasoning in 6-and 7-year-olds who had breastfed

The authors obtained data from a longitudinal study, a continuous study of data over a period of time, of 5,107 Australian infants who were recruited in 2004 and evaluated every two years until age 11. Their mothers were asked about their alcohol consumption from a modified questionnaire used by the World Health Organization. They were also asked about daily cigarette smoking during pregnancy and breastfeeding. The children were quizzed on their vocabulary, nonverbal reasoning and cognitive processes.

The researchers also found that an increased maternal consumption of alcohol aligned with lower nonverbal reasoning scores in 6- and 7-year-olds who had breastfed. The same was not found in those who had never breastfed after adjusting for factors such as prenatal alcohol consumption, gender, child and maternal age, breastfeeding duration and birth weight. This lowered cognitive ability was not maintained when the children were assessed at 10 and 11 years old, the authors discovered.

"If you have a small effect to begin with and it lasts to, say, age 6 or 7, chances are by the time the child gets older, other environmental factors will start to play a bigger role," said Dr. Melissa Bartick, an assistant professor of medicine at Cambridge Health Alliance and Harvard Medical School, who was not involved in the study.

The researchers hypothesized that increased education was a possible mediator for the decreased effects of age and alcohol. The size of the relationship between alcohol exposure in breast milk and cognition was small, and they suspected that clinical implications could be limited unless mothers drank a great deal.

Smoking while breastfeeding did not appear to have any effect on cognition, the study found. Women who were breastfeeding tended to smoke fewer cigarettes daily than those who were not: 1.06 cigarettes per day, compared with 2.84.

"Just because the authors didn't find an issue with smoking doesn't mean mothers should think it's OK to smoke while breastfeeding," Bartick wrote in an email. "Remember, the authors only looked at one thing, cognition, and there are lots of toxins in tobacco smoke, and smoking around children can cause them lots of harm and just having smoke on your clothes can be harmful to the health of others, as well as to the mother. Smoking is not good in any circumstance, for baby or mother."

Additionally, 91.7% of the children in the study had at some point been breastfed, but just 8.2% had not.

About 82.5% of children have ever breastfed in the United States, according to the US Centers for Disease Control and Prevention.

"It's a very different culture than the United States," said Dr. Diane Spatz, a professor at the University of Pennsylvania School of Nursing who did a visiting professorship in Australia in 2007 but who was not involved in the new study. "The breastfeeding rates are much higher in Australia than they are in the United States. Also I think alcohol consumption is different too, is what I observed while I was there."

About one in 10 pregnant women in the United States drinks alcohol, reports the CDC. One study reported that 40% to 80% of women in the UK, Australia and New Zealand drank alcohol while pregnant.

"I think we really need to emphasize to that when you are pregnant, you shouldn't be consuming alcohol," said Spatz, who is also director of the lactation program at the Children's Hospital of Philadelphia. "When you are breastfeeding, you shouldn't be consuming alcohol. If you want to have an occasional adult beverage, that's OK, but it shouldn't be a regular intake of alcohol."

The CDC states that not drinking alcohol is the safest option for breastfeeding mothers, but moderate alcohol consumption -- defined as up to one drink a day -- is not known to be harmful to infants, particularly if the mother waits at least two hours before nursing. Breast milk has the highest alcohol content about a half-hour or hour after the woman consumes a drink, and the alcohol is usually still detected for two to three hours after per drink.

"We tell moms, 'you know, If you are feeling tipsy, drunk, woozy, any effects of alcohol, you shouldn't be caring for your infant, nor should you be breastfeeding your infant,' " Spatz said. "That's when a mom will pump and discard her milk. But that's for getting rid of the milk for comfort's sake."

"Pumping and dumping" does not lessen the amount of alcohol in breast milk any faster, the CDC says. The alcohol in a mother's milk is basically what is in her bloodstream.

The new study is interesting but leaves questions unanswered because it does not detail the effect of just alcohol consumption in lactation, Spatz said. A high level of alcohol exposure in pregnancy could also affect a child's cognition. And there is no distinction made in whether mothers breastfed exclusively or whether there was any kind of supplementation.

Another limitation of the study was that individual people weren't studied, just a large population, Bartick said.

She noted that the researchers "had to do what's called imputation of the missing data, which means that whenever you have to [replace] missing data, it means it's going to be less accurate than if you had all the data there."

"I think the study is helpful, but it doesn't definitely answer the question. The question is, how much, if any, alcohol is safe during lactation?" Bartick said. "I would advise mothers to avoid alcohol and not to use alcohol, not to use beer to try to increase their milk supply. I think that's safe to advise."

Dr. Lauren M. Jansson, director of pediatrics at the Center for Addiction and Pregnancy and an associate professor of pediatrics at the Johns Hopkins University School of Medicine, wrote in a commentary published with the study, "Previous recommendations that reveal limited alcohol consumption to be compatible with breastfeeding during critical periods of development, such as the first months of life, may need to be reconsidered in light of this combined evidence."

More research is needed to fully understand the effects of maternal consumption of alcohol and other substances like marijuana on breastfed children, Jansson said. A deeper dive into specific psychosocial risks for breastfeeding and non-breastfeeding mothers who use various substances is also suggested.

But the study serves as an "an important step in our understanding of the complex neurobiological and developmental vulnerability of the substance-exposed child," she added.

Indiana Coronavirus Cases

Data is updated nightly.

Confirmed Cases: 164581

Reported Deaths: 4143
CountyConfirmedDeaths
Marion26055792
Lake14436358
St. Joseph9606168
Elkhart9271138
Allen8647231
Hamilton6400115
Vanderburgh617162
Tippecanoe396715
Porter347550
Hendricks3418134
Monroe335638
Johnson3286130
Delaware311575
Clark306263
Vigo275340
Madison250896
LaPorte239261
Cass229724
Warrick205065
Kosciusko201127
Floyd187468
Howard169466
Bartholomew147958
Marshall147428
Dubois146426
Wayne142031
Grant133539
Henry133030
Boone129150
Hancock124744
Noble122935
Jackson121018
Dearborn103128
Morgan100340
Lawrence96838
Gibson94412
Clinton92416
Daviess92334
Shelby90632
LaGrange82815
Knox81810
Harrison81024
Posey7767
Putnam77616
Fayette76719
DeKalb76011
Jasper6885
Miami6715
Steuben6608
Montgomery63122
White62316
Greene57838
Adams5607
Scott55413
Decatur52839
Ripley4838
Whitley4836
Clay4617
Sullivan45714
Wells45611
Huntington4455
Starke4438
Wabash4439
Orange42425
Spencer4176
Randolph39210
Jennings38713
Washington3873
Franklin38325
Fulton3785
Perry36914
Jefferson3655
Pike35718
Carroll34313
Jay3386
Fountain3293
Tipton28423
Vermillion2721
Parke2564
Rush2464
Blackford2394
Newton23711
Owen2151
Martin2050
Pulaski1783
Crawford1631
Brown1473
Ohio1337
Union1140
Benton1130
Switzerland980
Warren911
Unassigned0236

Ohio Coronavirus Cases

Data is updated nightly.

Confirmed Cases: 200231

Reported Deaths: 5217
CountyConfirmedDeaths
Franklin32468642
Cuyahoga20452685
Hamilton17564344
Montgomery10959190
Butler8727131
Lucas8549375
Summit6978269
Warren446566
Stark4045182
Mahoning3863287
Marion345650
Pickaway309246
Delaware299728
Lorain286289
Fairfield284257
Licking274367
Clark263157
Clermont262238
Wood262082
Greene249942
Trumbull2380134
Allen228974
Columbiana218588
Miami213258
Lake206959
Medina197242
Portage172468
Mercer159629
Wayne155871
Ross148939
Richland143024
Tuscarawas138627
Athens12812
Erie119454
Darke119051
Hancock113327
Putnam112527
Auglaize110618
Madison108115
Lawrence98525
Shelby96414
Muskingum9534
Scioto9219
Geauga89850
Belmont81127
Union7993
Ashtabula76048
Sandusky74022
Huron72915
Holmes71611
Preble67718
Seneca63614
Ottawa61030
Fulton57115
Henry53117
Crawford5268
Clinton50613
Defiance50513
Jefferson4994
Jackson4928
Highland4756
Fayette46110
Logan4573
Ashland4359
Knox42516
Champaign4233
Brown4103
Morrow3872
Perry38511
Washington38124
Hardin36713
Williams3664
Guernsey3658
Coshocton34412
Pike3340
Gallia30613
Wyandot30313
Van Wert2905
Paulding2392
Adams2266
Carroll2217
Meigs21412
Hocking2129
Monroe17818
Noble1660
Vinton1093
Harrison863
Morgan830
Unassigned00
Fort Wayne
Overcast
43° wxIcon
Hi: 52° Lo: 41°
Feels Like: 39°
Angola
41° wxIcon
Hi: 50° Lo: 38°
Feels Like: 38°
Huntington
Overcast
42° wxIcon
Hi: 52° Lo: 41°
Feels Like: 38°
Decatur
Overcast
43° wxIcon
Hi: 53° Lo: 41°
Feels Like: 43°
Van Wert
Overcast
43° wxIcon
Hi: 53° Lo: 41°
Feels Like: 43°
Sunny Wednesday
WFFT Radar
WFFT Temperatures
WFFT National

Community Events