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Drinking and Breastfeeding

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Last winter I was still breastfeeding our younger son. So when New Year’s eve rolled around, I started to wonder about alcohol and breastfeeding. Just how much can a mom drink when she’s breastfeeding? I wasn’t planning to hit the bottle to ring in the New Year …I’m a bit of a light-weight…but still, I was curious.
This year of course, even though the babe is off the boob, we’re planning a married-with-kids version of hitting the town. One bottle of champagne and a living room window with a view of the New York City fireworks, and even a distant Times Square. Very glamorous.
Anyway…here’s the main information about drinking and breastfeeding from last year’s post:
After a bit of research, I’ve found that as with anything mommy related, there are differing, and sometimes conflicting, opinions about alcohol and breastfeeding.
But from numerous reputable sources, it seems that bottom line, alcohol in small amounts is ok. One to two drinks per week is fine. You might want to feed your baby before you have a drink, and then wait 2 to 3 hours after drinking before feeding again. Also, there’s no need to “pump and dump.” As the alcohol leaves your bloodstream, it also leaves your breast milk. So sober up, and your boobs will be set to go. If it makes you feel better, give your baby a bottle of expressed milk in the meantime.
Here’s a bit of information from
In general, if you are sober enough to drive, you are sober enough to breastfeed. Less than 2% of the alcohol consumed by the mother reaches her blood and milk. Alcohol peaks in mom’s blood and milk approximately 1/2-1 hour after drinking (but there is considerable variation from person to person, depending upon how much food was eaten in the same time period, mom’s body weight and percentage of body fat, etc.). Alcohol does not accumulate in breastmilk, but leaves the milk as it leaves the blood; so when your blood alcohol levels are back down, so are your milk alcohol levels.
Always keep in mind the baby’s age when considering the effect of alcohol. A newborn has a very immature liver, so minute amounts of alcohol would be more of a burden. Up until around 3 months of age, infants detoxify alcohol at around half the rate of an adult. An older baby or toddler can metabolize the alcohol more quickly.

La Leche League also says that the occasional drink is ok, but excessive drinking is not.
Alcohol abuse (excessive drinking) by the mother can result in slow weight gain or failure to thrive in her baby. The let-down of a mother who abuses alcohol may be affected by her alcohol consumption, and she may not breastfeed enough. The baby may sleep through breastfeedings, or may not suck effectively leading to decreased milk intake. The baby may even suffer from delayed motor development. If you are concerned that you or someone you know is drinking alcohol excessively, call your doctor.
At least one organization, the March of Dimes says you should avoid alcohol while breast feeding.
Small amounts of alcohol do get into breast milk and are passed on to the baby. One study found that the breastfed babies of women who had one or more drinks a day were a little slower in acquiring motor skills (such as crawling and walking) than babies who had not been exposed to alcohol. Large amounts of alcohol may also interfere with ejection of milk from the breast. For these reasons, the March of Dimes recommends that women abstain from alcohol while they are nursing.
So, what’s a mom to do? Use caution if you plan to get your party on this New Year’s Eve. If you want a drink or two, it seems you can go for it. You deserve to celebrate your parenting successes of the past year. Just remember, you may still have to get up in the middle of the night to feed your baby. So make sure you’ll be sober enough to safely care for her. And don’t forget, if you have an early bird, she’s not going to give you the day off from work.

One Mom’s Story– Trouble Conceiving, And Then Trouble Breastfeeding

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Pregnancy and breastfeeding are hard enough when everything goes according to plan. Sometimes, nature defies us and makes it even tougher. Mel, the blogger, behind Stirrup Queens, sent me this story about the trouble she had conceiving and breastfeeding. Here’s her story.
Maybe I couldn’t conceive on my own and maybe I couldn’t get to term, but come hell or high water, I was going to breastfeed. When the babies were born, I wanted to get to the NICU immediately, not just to check out their adorable punim (Yiddish for cutie faces!), but because I needed to get them on my breasts. Everyone knows that early breast milk is crucial for a full-term baby so imagine what I had convinced myself in my anxious little head in regards to my premature, underweight, IUGR (Intrauterine Growth Restriction) babies. It was like my breasts were literally leaking the medication that would get them home and I wanted to shove my boob straight into their mouth AS SOON AS POSSIBLE.
Except that my breasts weren’t really leaking anything. Strangely, I hadn’t had any breast changes during the pregnancy. No sensitivity, no big boobage. My size C’s stayed firmly size C’s. I commented to my OB about this and he brushed it aside saying that many women experienced no breast changes. Which is probably true.
But then my milk didn’t come in. My boobs never became “engorged.” In fact, it was sort of like my boobs hadn’t gotten the message at all that I was pregnant nor had given birth. I thought of my boobs like teenagers glued to a Sony Playstation who have blankly turned towards my voice with a glazed over expression. “What? You were pregnant? Dude…that is nasty.”
But the breastfeeding consultants and books didn’t find this a problem. Rest more! Pump more! Eat more! Drink more! This was the advice that kept coming around every time I set up a session with a consultant and mentioned that eight full pumpings as well as several sessions directly on the breast every day yielded at most one ounce–altogether. In other words, I could squeeze out a few cc’s each session and if you poured all of them together into a vial, you could sometimes eek out an ounce that would go to one baby for one feed.
Books promised me that if I followed their instructions, I would easily be producing four ounces or more per feed. And I believed it because I wanted to believe it. Even though everything felt wrong just as it had with conception. I knew long before that first year was up that something felt “off” and I knew long before the blood work yielded no prolactin in my body that something just didn’t feel right with breastfeeding. Beyond quantity, my breast milk didn’t really even look like the breast milk the other NICU mothers were proudly placing in their child’s bottle. One triplet mum confided in me that she had so much of this creamy goodness stored in the refrigerator that the nurses were telling her to pump and dump. The babies just couldn’t keep up with her overachieving breasts.
But I really wanted to breastfeed, so I kept with it for weeks, drinking the water, popping the Reglan they promised would increase milk production, pumping with one of the twin’s dirty spit cloths under my nose to stimulate the brain. I was literally willing to try anything.
Breastfeeding for me was very similar to trying to conceive. The initial message when I expressed my fear that something was wrong, conceptionwise, was that I needed to give it time. I was told I needed to relax. I was told that a good vacation would bring me a baby. Then the blood work was taken and diagnoses were doled out. Suddenly, there were identifiable problems and doctors stopped telling me to relax and started addressing the situation as if they had believed me all along when I said, “something just doesn’t seem right.”
Which made me realize that some breastfeeding consultants are a lot like pilates instructors. They have a focused agenda. Pilates instructors are going to push a pilates routine with exercise being of utmost importance. They believe that almost everyone can do pilates as long as you really want to do it and you commit yourself to the exercises. If you’re going to take a half-assed approach, you’re going to get half-assed results. But if you make the commitment to doing pilates every single day and doing the exercises correctly, you are going to succeed and feel good and be aligned and whatever else you gain from pilates. Pilates instructors are never going to nod their head in agreement and say, “sedentary living and forgoing exercise to drink a latte and read a book is just as good as pilates.”
Therefore, I cannot blame breastfeeding consultants when they have an agenda. Breastfeeding consultants do not believe that formula is just as good as breast milk, therefore, I can hardly blame them when I went to them for instruction and had them berate me for giving my children formula (we had a breastfeeding consultant tell us we made a terrible choice by taking our children off IVs and giving them formula through an nasogastric tube. She told us that this proved that we weren’t committed to breastfeeding).
But I can blame them for telling me continuously that my lack of breast milk was my own doing and that all women can breastfeed if they wish. Turns out, if you don’t produce any prolactin, you can’t. But no one told me to have blood work taken. Instead, it was something I had to push for with my OB at my 6 week appointment. And with the results, there was no apology at pushing my body and self-esteem through hell. There was simply a shrugging of the shoulders and a comment that this “sometimes happens to women who use Follistim during fertility treatments.”
Which is a long-winded way to say to breast feeding consultants, help your clients get a diagnosis. New mothers are insecure mothers, desperate to succeed at what we’re told is the most natural thing in the world. When you see issues cropping up—breasts that are never engorged, breasts that remain indifferent whether the mother is pumping or not, or simply the mother who says, “something isn’t right”—start with removing the blame from the woman and instead suggest some simple blood work to check prolactin levels prior to prescribing medication or superhuman pumping schedules. Be boob investigators. True breast advocates. And if everything checks out and no problem can be identified, run down the list of suggestions to increase supply: eat more/eat less/drink more/sleep more/stop exercising/relax.
The best day of my foray into breastfeeding came when I received my diagnosis at the endocrinologist. I walked out of her office crying, mourning that there was yet another womanly trait I couldn’t master. But also relieved that stopping the madness was the right decision. I was never going to be able to make breast milk and all of the suggestions consultants threw at me—from the 2 liters of daily water intake to the Reglan—were like drawing blood from a stone.
Most new mothers who start out trying to breastfeed truly want to succeed. Instead of admonishing those who quit, try sending the message that breastfeeding doesn’t work for everyone. We all have to make decisions that work best for our family and ourselves. And sometimes very real problems exist and the message that “breast is best” cannot trump the more useful adage: take care of yourself. Positive interactions could be the difference between the mother who tries again with her second child and the mother who swears off breast feeding forever.
For myself, I’m not giving up on the idea of somehow producing prolactin if I ever get pregnant again. Boobs, beware! I’ve conquered my ovaries and I’ve conquered my uterus. I’m coming for you next. I mean…after I get knocked up…

Notes from Andi: I inserted the links to other sites in this post. Additionally, the book “Medications and Mothers’ Milk (Thomas W. Hale, Ph.D.) has this to say about Follicle Stimulating Hormones, such as Follistim: “FSH…is very unlikely to enter milk or be orally bioavailable to an infant. However, it is not known if the administration of FSH, and the subsequent maternal changes in estrogen and progesterone, would alter the production of milk. It is likely, since the onset of pregnancy is commonly followed by a decrease in milk production in most mothers.” (page 379).
If you want information about different medications and breastfeeding, check out Dr. Thomas Hale’s book and website. Also, check out ToxNet/LactMed.
Finally, a final note about Reglan– it can cause depression, so be sure to talk to your doctor if you have a history or depression or experience any feelings of depression.
And for more information on increasing your milk supply, check out this post from lactation consultation Melissa Nagin on

Answering Your Breastfeeding Questions

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I’ve been doing some guest writing on The Nest Baby, a cool site for new moms. Readers have been submitting questions about breastfeeding and I’ve been answering them. You can check out all of the answers on this link. You can also jump right to the specific questions from these links:
Breastfeeding Positions
Breast Lumps and Nursing
Dealing with Thrush
Inverted Nippes
Milk Blisters
Newborn Eating Enough?
Getting Help At Home
Prepping to Nurse?
Prepping to Pump?
Pumping and Work
Pumping Problems
Storing Breastmilk
Travel while Nursing
Weaning and Milk Supply
Pumping Extra Milk
If you have a specific question, feel free to email me any time at

A BreastFeeding Holiday Poem

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Our neighbors have a wreath on their door. So of course, The Bortsky (age three) wanted to know what it was. “Why don’t we have a wreath?” he asked. “Well,” I paused, choosing my words carefully, “Sarah celebrates Christmas and she has a wreath and a tree. We celebrate Chanukah and we have a menorah.” “Why?” he asked. I gave him a basic “we’re Jewish” answer, and fortunately that sufficed.
I’ll admit that even though Christmas isn’t our thing, I like the lights and decorations at this time of year. Everything seems transformed. I liked watching the Christmas shows when I was a kid and I’m a sucker for a little Holiday lore. Hence, my own version of the traditional poem, “A Visit From St. Nicholas.” I wrote this last year, and thought the newcomers to this site might appreciate it.
So back by popular demand…I bring you, once again…
By Andi Silverman,

‘Twas a holiday eve and the babe was asleep,
Swaddled tight in his crib he made not a peep.
My boobs were depleted from feeding all day.
“Please don’t wake. Sleep all night,” to the babe I did pray.
But his lips, how they moved, as he lay in his bed.
Visions of milky breasts danced in his head.
Dad in his boxers and I in my sweats,
Could we get some shuteye? Go ahead, place your bets.
The moon on the breast of my t-shirt did glow,
Gave a luster to leaking spots set to grow.
My nursing pads were soaked, they fell out of place.
My bra had unsnapped. How I missed sexy lace.
For months I’d been feeding our babe everywhere.
Coffee shop, park bench, museum, movie chair.
All my modesty gone, nothing shy anymore.
If the kiddo was crying, I knew how to score.
And now with the holidays, things often got dire.
While out buying gifts, I sometimes drew ire.
I breastfed in clothing stores. Changing rooms rock.
I breastfed in bookstores. To the stacks I did flock.
When from the babe’s room there arose such a clatter.
We sprang from our bed to see what was the matter.
Away to his room we flew with a flash,
Threw open the door, in the dark I did crash.
What a klutz I can be, ‘twas those bags made me fall.
Sacks for our trip, all arranged in the hall.
We were going to Grandma’s, a five hour drive.
Holiday time—Will I make it alive?
One big huge duffle held all the babe’s stuff.
Diapers, wipes, onesies. Did I bring enough?
Now don’t forget burp cloths, crib sheets and toys.
Books and Bjorn, we’ll exhibit such poise.
On breast pump, on bottles, on stroller and boppy.
On car seat, on cradle, on blanket and binky.
Fill the back of the car, fill the trunk with our haul.
And we’ll drive away, drive away, drive away all.
Now don’t forget stopping to feed long the way.
Gas stations, McDonalds and rest stops, oy vey.
Of course there’ll be lots of those diapers to do.
Get out the Purell, you’ll be covered in poo.
When we finally arrive, now what will await?
Lots of food and embraces, it’ll be really great.
No, no one will not fight. I will not shed a tear.
Ok, a white lie— but rejoice in who’s here.
And what about wine or a champagne or two?
Will it make my milk bad? Old wives tale or true?
And will anyone say, “Can he now take a bottle?”
“How long will you breastfeed?” How these questions can throttle.
Now back to that “clatter,” the babe and that noise.
We had rushed right on in, leaping over the toys.
When what to our wondering eyes did appear,
Our babe still asleep, oh how sweet, oh how dear.
His cheeks, how they glistened, his hair soft and furry.
And I smiled when I saw him, despite all my worry.
How delicious, his belly, moving in and then out.
How precious, his lips in a sweet little pout.
He had not woken up! He did not need to eat.
He had had quite enough, his day quite complete.
And so back to our bed we did quietly crawl.
Happy Holidays to one, happy sleeping to all.
© 2006, Andi Silverman,
The guide to Urban Legends linked to this poem.

Breast Feeding on The Tyra Banks Show

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If only all talk shows would do segments like this one….
Watch Tyra Banks get a lesson in breastfeeding. Click here to watch the video from one of her shows.
And thank you, Black Breastfeeding Blog, for bringing this to my attention.

A Breastfeeding Blogging Bonanza

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Moms love to tell their stories about childbirth. There’s the “I pushed for 14 hours” story. The “you would not believe what happened to me…” story. The “I went all natural” or the “I begged for drugs” stories. And even the “I thought I was going to strangle (insert name)” story.
Now, it seems the story to tell is the breastfeeding tale. That’s what happened today on the new collective blog, New York City Moms. The NY Moms blog is part of a larger blogging network that has sites focused on Silicon Valley, Chicago and Washington, DC. And today, in each region, the focus was on breastfeeding…the ups and downs of boobs, bottles and babes.
I’m new to blogging for NY Moms, and I was thrilled that they asked me to write the introductory post to today’s entries. Click here for a full list of all of the entries from the day. The site administrators got so many requests from bloggers and readers to include their stories, that they ended up opening an entry where anyone can contribute. Click here if you have a tale to tell.

My Rookie Mistakes

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In my brief, 3 year career as a mom, I’ve made some mistakes. Nothing earth-shattering, thank god. Just some good old fashioned stupid blunders. One of my all time best ones…taking a toddler into one of New York City’s busiest supermarkets the day before Thanksgiving. Sheer stupidity. Actually, it’s right up there with trying to push a stroller down the crowded sidewalk to see the balloons being blown up for the Macy’s Thanksgiving Day Parade. For the record, these examples are from a couple of years ago.
If you want to read more about the error of my ways, check out my recent post over at the New York City Moms Blog. Tomorrow is the official launch of this site. So be sure to check there for some other good posts. There’s actually a great one right now about giving birth and becoming a mom.
Once you’ve read my Top Ten Rookie Mistakes, I’d love to hear what you’ve done. Maybe we can all learn from each other’s mishaps.

Need to Make Holiday Cards?

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Personally, I don’t send out holiday cards. Too much work given my administrative laziness. I can’t figure out how to do envelopes on my printer. My handwriting gets bad fast. And most importanly, I don’t keep an address book.
But if you are one of those super-organized people who does do holiday cards, I have two options for you.
The first option is to try CluuCards by Cindy Luu. Cindy is the illustrator of my book, Mama Knows Breast. CluuCards feature Cindy’s cool illustrations and can be personalized with your own message and photographs. Best of all, the cards are magnetic so they can stick to the frig. Cindy does cards for birth announcements, baby showers, bridal showers, save the date cards and of course the holidays.
The second option is to get a family photograph taken by Mercedes McAndrew. Mercedes is a Brooklyn based photographer who did the photograph I use on my blog. She also did family photos for us in Central Park this fall. This pictures of the kids are stunning, and I used them to make a 2008 calendar that I’m giving all the grandparents as gifts. Mercedes often travels outside of New York for work, so it’s worth contacting her even if you aren’t in NYC. Here’s the latest deal she’s offering.
$475 includes:
- An hour and 15 minutes of shooting time
- UNLIMITED color digital shots
- 2 rolls of film (color and/or black and white)
- Web contact sheet of all images
- CD of entire shoot
- (1) 4×6 and (1) 5×7 prints
$400 includes:
- An hour of shooting time
- UNLIMITED color digital shots
- Web contact sheet of all images
- CD of entire shoot
I realize it’s sort of last minute, and this may information me be a little too late for you. But you see what I mean…if I had my clerical act together, I would have done this post a few months ago. Oh well.