No drinking warning ‘inflames and misleads’ breastfeeding mums

Hundreds of doctors want a coroner to retract a “misleading” warning to breastfeeding mothers never to drink alcohol.

Two-month-old baby Sapphire Rose died with six times the legal drink drive limit in her blood in the Far North on January 2, 2017.

Coroner Debra Bell found acute alcohol intoxication and a dangerous sleeping environment were significant contributors, but was unable to ascertain the direct cause of death in a report released on Friday.

Palmerston North obstetrics and gynaecology registrar Heather Johnston is training to be a lactation consultant after, like many women, having a complicated breastfeeding journey with her two children.
Despite toxicologist’s findings that the high alcohol reading was “difficult to explain”, Bell decided it was more likely than not the alcohol was passed to the baby through her mother’s breast.

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“I stress the importance to breastfeeding mothers not to consume alcohol at any stage,” she wrote.

About 500 medical professionals have banded together to dispute this blanket warning and the suggestion that breastfeeding from any mother who has consumed alcohol would be dangerous to their baby.

Palmerston North obstetrics and gynaecology registrar Dr Heather Johnston is organising a petition to the coroner asking the comment be retracted. She said she already had 500 signatures from medical practitioners including obstetricians, paediatricians, general practitioners and lactation consultants.

The advice was likely to confuse women, when studies suggested low-level drinking was unlikely to cause harm to babies, she said.

“We feel that this has the potential to inflame and mislead the public, and it removes focus from the other key issues which were identified in the coronial inquest … it could actually be quite harmful for breastfeeding.”

Studies suggested the amount of alcohol ingested to receive such a high blood alcohol reading in a baby would have to be astronomical, she said.

Otago University Department of Public Health senior research fellow Dr Amanda Kvalsvig said heavy-handed messaging regarding breastfeeding and alcohol risk was unhelpful.

“How we talk about risk in breastfeeding is tremendously important because we know that breastfeeding is protecting the health of both mothers and babies. So unless we’re very sure there’s a risk, it’s not in the best interest of babies or mothers to discourage mothers from breastfeeding.”

A July 2019 literature review found casual use of alcohol (such as 1 glass of wine or beer per day) was unlikely to cause problems in nursing infants. Frequent drinking can cause long-term harm to babies.

The Ministry of Health and the Health Promotion Agency advise avoiding alcohol during breastfeeding, but provide advice for those who do choose to drink. This includes to limit intake to one or two glasses once or twice a week, and avoid breastfeeding for two to three hours after every standard drink.

The inquest found conditions contributing to the death were acute alcohol intoxication, dangerous sleeping environment, prematurity, possible septicaemia, possible mechanical asphyxia, and asphyxia due to suffocation.

A Ministry of Justice spokesman said a coroner does not have the jurisdiction to reopen a case once it is closed. Should someone wish for a case to be reopened, they would need to apply to the solicitor-general.

Tips for breastfeeding mums

– Alcohol in breast milk peaks after 30 to 40 minutes, and should be avoided for two to three hours after drinking

– Apps like Feedsafe can help guide you on when it is safe to breastfeed while drinking

– If planning to ingest large quantities of alcohol, expressing milk in advance is a good idea

– Always have a sober adult caring for babies, whether breastfeeding or formula feeding

SOURCE: Health Navigator NZ 

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