If you’ve ever been around a breast-feeding mom, you’ve probably heard the term “pump and dump”.
Essentially, it is the practice of pumping and dumping breast milk after having an alcoholic beverage. The thought is that the alcohol gets into the breast milk so to prevent the baby from sharing mom’s margarita, you “waste” the milk by pumping it and tossing it out.
In theory, this makes sense — whatever you eat or drink, baby eats or drinks (babies are notorious for not appreciating the flavor of garlic or other spicy foods). Obviously there must be something more to the story if I’m devoting a blog post (and a landmark post at that) to the topic.
Let’s look at the science and biochemistry behind the theory and see how it holds up. To think about the interaction between what’s in the blood, and what’s in the breast milk, imagine two big containers of liquid next to each other when an opening between them. The container on the left is the bloodstream, and the one on the right is the breast milk. The opening between the two containers is semi-permeable, meaning that some things can pass through but others can’t (like a screen door – it lets fresh air in but keeps squirrels out). Alcohol does pass through this membrane, so alcohol molecules do get into breast milk.
Another important principle to understand is gradients. Whenever there is a difference of concentrations between two areas, a concentration gradient exists. One area has a higher concentration, one has a lower.
Substances move from areas of higher concentration to areas of lower concentration (imagine you are in a mob of people and claustrophobic — you’re going to move towards an area where there are fewer people!).
So, when alcohol is absorbed from the stomach into the blood stream, the concentration of alcohol is high in the blood compared to the breast milk, so alcohol molecules down their concentration gradient from the blood into the milk. They keep moving until there is no gradient – each has the same number of alcohol molecules. At this point, it seems like the alcohol molecules should be stuck in the milk and will make it to baby. Luckily, the blood breaks down alcohol molecules. Enzymes in the blood breakdown the alcohol, making the concentration of alcohol less in the blood.
As the alcohol concentration level in the blood decreases, a gradient exists again between the blood and breast milk, but in the opposite way. Now, the breast milk is the area of high concentration and the blood is lower area so alcohol MOVES OUT of breast milk, back to the blood and is broken down by blood enzymes. This continues until all the alcohol is moved out of the breast milk and broken down in the blood. As you can imagine, by the end all the alcohol molecules are broken down in the blood and none are left in the blood or breast milk.
You’re saying, “I just wanted a yay or nay on ‘pump and dump’ and I get a lesson in pharmacodynamics!
How about a hand-drawn diagram of how this works?”
So, now that we understand the dynamic movement of alcohol in and out of breast milk, what’s the verdict on “pump and dump”? As illustrated above, alcohol gets out of breast milk quickly and so there is no need to “pump and dump” if momma limits her alcohol intake to one or two drinks and waits 1 to 2 hours per drink to breast feed or pump.
The American Academy of Pediatrics agrees with my sentiment: modest alcohol intake does not preclude breast feeding and there should be as little inconvenience as possible to breast feeding mothers to encourage exclusive breast-feeding.
Bottom line: have a drink if you’d like, wait an hour or two, and feel no qualms about breast-feeding your little one.
Next time you’re out throwing back a cold one with your breast-feeding mom friend and she tells you she is going to pump and dump: grab a cocktail napkin, draw your version of the above diagram, and save that milk!
For more on La Leche League’s infomation on alcohol and breastfeeding, click here.
Dr. Phil Boucher, a father and a pediatrics resident physician in Omaha, wrote this guest blog. He blogs at www.thedoctordad.com and frequently tweets about pediatrics and parenting topics at @Phil_BoucherMD You can read him here on momaha.com
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