In general, it is best if mothers can stop smoking, or at least reduce smoking as much as possible while pregnant and breastfeeding. The less cigarettes a nursing mother smokes, the better for her baby.

However, for those who can not or will not stop smoking, studies show that breastfeeding and smoking is still a healthier choice than formula feeding and smoking. Here's how the effects of smoking can be minimized on the baby:

• Smoke right after breastfeeding – this leaves time for the nicotine to peak and move back out of the milk before the next feed. Smoking right before breastfeeding can increase the amount of nicotine to the baby 10 times according to one study!

• Smoke in a different room than the baby – regardless of how the baby is fed, and who in the household is smoking, the effects of secondhand smoke can be reduced to the baby by not smoking in the same room or in any room where the baby plays or sleeps, or even better, outside. Having a "smoking shirt" to put on and remove when back with the baby will reduce the baby inhaling smoke from clothes when held or carried.

• Reduce smoking as much as possible – If you can't quit, EACH less cigarette smoked is better for the baby

Mothers who do quit smoking during pregnancy are more likely to continue this if they breastfeed, which adds not only the benefit of breastfeeding but adds elimination of cigarette exposure to the child – a win-win!

Smoking can affect a mother's milk supply, so it's important to ensure baby is getting enough milk and growing properly (see my articles "Is My Newborn Getting Enough?" and "Do I Need to Increase My Milk Supply?" in related links below).

It's also worth noting that although breastfeeding is known to reduce a baby's chance of dying of SIDS (Sudden Infant Death Syndrome, known sometimes as crib death), this is only true for non-smokers – smoking negates that protective effect. Only the elimination of smoking, along with breastfeeding, can offer that particular protection.

Trying to quit with the nicotine patch or nicotine gum while nursing is a tricky thing and should be used with caution. The smoke factor is eliminated, which is great. The level of nicotine in the patch is constant in the milk, but less than that from smoking. But using the patch or gum while continuing to smoke as well (even reduced numbers of cigarettes) may actually give the baby *more* nicotine.

Nicotine gum provides 30-60% of the nicotine in cigarettes and the level rises and falls in the milk like cigarettes do. So nicotine gum would be used similarly to cigarettes themselves, chewing just after nursing so levels drop again before the next breastfeed. Again, using *BOTH* nicotine gum and cigarettes for any period is actually worse, increasing overall nicotine levels.

Obviously, quitting smoking is best for both mother and baby during pregnancy or breastfeeding. However, the main points to remember are that breastfeeding and smoking is still better than not breastfeeding and smoking and that timing smoking for after a feed with a long span (2-3 hours or more) of time before the next feed has the best chance of reducing nicotine to the baby.

Reference: The Breastfeeding Answer Book, 3rd Revised Edition

For those trying to quit or reduce smoking, this book may be helpful. Be sure to discuss any plan to quit smoking with your doctor, obstetrician, midwife or other appropriate health professional. Remember that the use of any nicotine replacement product while still also smoking any amount of cigarettes can be dangerous.




Disclaimer: All material on the BellaOnline.com Breastfeeding website is provided for educational purposes only and does not constitute medical advice. Although every effort is made to provide accurate and up-to-date information as of the date of publication, the author is neither a medical doctor, health practitioner, nor a Certified Lactation Consultant. If you are concerned about your health, or that of your child, consult with your health care provider regarding the advisability of any opinions or recommendations with respect to your individual situation. Information obtained from the Internet can never take the place of a personal consultation with a licensed health care provider, and neither the author nor BellaOnline.com assume any legal responsibility to update the information contained on this site or for any inaccurate or incorrect information contained on this site, and do not accept any responsibility for any decisions you may make as a result of the information contained on this site or in any referenced or linked materials written by others.