Tobacco smoke contains thousands of toxins, including dozens of chemical compounds that are known to cause cancer. Whether you are pregnant or not, smoking is a multi-pronged attack on multiple body systems. The components of tobacco travel everywhere –your lungs, heart, brain, liver, kidneys, and your uterus. And, if you’re pregnant, they travel through the placenta to the developing child. They also go to the glands in your breasts that secrete the milk. And so, if you do smoke toward the end of pregnancy and onward from giving birth, and if you breastfeed, your infant is smoking too, even if you don’t smoke anywhere near the baby.
As far as numbers go, they vary depending on what you read, but the scientific literature states the rate of pregnancy smoking at about 10 percent. That’s down from what it was a generation ago. However, it may be more than 10 percent, since people do not always respond truthfully to questions that imply that they may be doing something wrong. Moreover, there is a notoriously high rate of smoking relapse following delivery. Many women are able to quit for the 40 weeks but, then, light up almost as soon as the umbilical cord is cut, thinking that the baby will not be affected.
There are a several reasons why such an idea is bunk. First, new mothers are around their babies almost constantly, so the baby will inhale second hand smoke. Second, even if a mother manages to put distance, and several walls, between herself and the child while she smokes, the tobacco penetrates her clothing, producing volatile compounds that can enter the baby’s lungs (sometimes this is called ‘third hand’ smoke). Then, there is the matter of the breast-milk.
Your Breast is A Nicotine Delivery Device
If you are unable to kick the smoking habit, or if you relapse into smoking after giving birth, do NOT breastfeed.
Like jogging on the most polluted street of the most polluted city on Earth, you will be doing more harm than good. Over the years, there have been numerous studies, systematic reviews of those studies, and meta-analyses (statistical studies that combine data from numerous studies into one pool). The message from all of these studies is that the harmful compounds from tobacco get into the milk, and we’re not talking just trace amounts. One important example is nicotine —the highly addictive drug that is the main reason why it’s so hard for smokers to quit. Nicotine is present in breast-milk at a concentration three times higher compared with the mother’s blood. Thus, exposure to the drug is even worse through breast-milk than it is through the placenta during pregnancy. Essentially, the milk glands see the nicotine in the blood, draw it in, and concentrate it, turning your breast into a nicotine-delivery device.
And so, if a mother smokes, the exposure to nicotine is even higher for a breastfeeding infant than it is for a fetus inside the womb. This raises the stakes for you to go all out in getting treatment to end your smoking addiction, but with a very important caveat. If you end up using a nicotine patch, or nicotine chewing gum, that’s all well and good in terms of your long-term health, and by all means do it if it helps you to quit. But don’t breastfeed, since the nicotine (and its metabolite, cotinine) will get into the milk just as it gets in through smoking.
Babies must not be exposed to nicotine because it affects their muscle contraction and their brain and because it is highly addictive. But, what about smoking cessation medications, such as varenicline and buproprion? Well, varenicline is what’s called a nicotinic receptor partial agonist — it attaches to the same target in the body as nicotine does, though more weakly— which means that it too is off-limits during lactation. Buproprion works differently, but through multiple actions that are not totally understood, so that too is off the list.
Suffice it to say, if you are still smoking, or have returned to smoking, by the time that your baby is born, your options for quitting the tobacco habit are quite limited, if you are set on breast feeding. Most likely, you are going to be buying infant formula, and a lot of it. Perhaps, adding the price of infant formula to the price of cigarettes could be an incentive to quit, but there’s another option, if you are reading this early in your childbearing years. Quit now, before you get pregnant, before you are lactating. This way, you can avail yourself to smoking cessation medications.
Other Smoking and Breastfeeding Effects on Baby
On top of the mere presence of nicotine and other harmful substances in the milk, there are other issues pertinent to breast-feeding. Maternal smoking messes with infant sleep-wake cycles. Smoking also has been shown to alter the content of breast-milk, plus it reduces the duration of lactation, and the quantity of milk that comes out. This means that, if you smoke, you’ll have a hard time producing enough milk to nourish the child. But that could be a good thing because –as emphasized earlier in this post—if you do smoke, you should NOT breastfeed. Buy formula and keep your child safe from your unhealthy habit.