Mothers and their healthcare providers often ask whether smoking can be responsible for a lower milk supply and if fewer women smokers are therefore breastfeeding. Dr. Lisa Amir, a medical doctor and lactation consultant, researched this very question and published it with the following conclusion:
Several studies have found a dose-response relationship between the number of cigarettes smoked each day and breastfeeding intention, initiation, and duration that persists after adjusting for confounding factors. In some population groups, a high proportion of smokers breastfeed successfully. The association between maternal smoking and lack of breastfeeding is consistent across different study designs in a range of countries. Given that women who smoke are less likely to intend to breastfeed, however, it cannot be assumed that the relationship between smoking and duration of breastfeeding is a physiological one. If smoking had a consistent negative physiological effect on lactation, one would not expect to see such wide variations in breastfeeding rates among women who smoke. Therefore, it is likely that psychosocial factors are largely responsible for the lower rates of breastfeeding found in women who smoke compared with those who do not.
Donath SM, Amir LH; ALSPAC Study Team. The relationship between maternal smoking and breastfeeding duration after adjustment for maternal infant feeding intention. Acta Paediatr. 2004 Nov;93(11):1514-8.
What do you find in your work? Do you notice that the mothers who smoke are less likely to initiate breastfeeding?
A sentiment expressed by Maureen Minchin, author of Breastfeeding Matters, is that there is more harm done to a child who is not breastfed by a mother who smokes than to be breastfed by that mother.
Do you discuss reducing smoke exposure to infants when you are aware one or both parents smoke? It's a good idea too - and can be done without making it sound judgemental, remembering that smoking in the household is one of the biggest risk factors for SIDS (formula feeding is another).
Suggestions could include:
- always smoke outside the home.
- never smoke inside the car or other enclosed space where a baby may be brought into.
- wear an outsize shirt over clothing and tie hair in a bandana or scarf while smoking. Remove these before returning inside.
- clean your teeth and wash your hands and face after smoking.
- smoke as soon after breastfeeding as possible, allowing the longest time before the baby will want to feed again to reduce the number of cigarette byproducts in the mother's bloodstream and her milk at the next feed.
Kathy Parkes, MSN-Ed, RN, IBCLC, FILCA
Professional Development Educator
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