Sorry but I completely disagree with kpzr's statement. The American Academy of Pediatrics is comparable to any U.S. institution and will discourage anything to cover themselves against a liability. The general trend in prescribing practices for lactating mothers is to avoid everything because if you "give an inch, they'll take a mile." The real research is to be found in european journals simply because they have much more liberal recommendations and therefore, a greater percentage of their breastfeeding mothers admit to imbibing.
Here is something from the National Institute on Alcohol Abuse and Alcoholism from the NIH. " In general, less than 2 percent of the alcohol dose consumed by the mother reaches her milk and blood. Alcohol is not stored in breast milk, however, but its level parallels that found in the maternal blood. That means that as long as the mother has substantial blood alcohol levels, the milk also will contain alcohol. Accordingly, the common practice of pumping the breasts and then discarding the milk immediately after drinking alcohol does not hasten the disappearance of alcohol from the milk as the newly produced milk still will contain alcohol as long as the mother has measurable blood alcohol levels. Peak alcohol levels both in the mother' s blood and in the milk occur approximately one-half hour to an hour after drinking and decrease thereafter, although there are considerable individual differences in the timing of peak levels and in alcohol elimination rates in both milk and blood (Lawton 1985; Mennella and Beauchamp 1991) ."
This country has a history of excessive caution when it comes to alcohol (prohibition). This paranoia has translated to advising against many many many medications that can make the patients' lives better without harming the infant (I can think of several off the top of my head) without ANY data. The trend is unfair to the patients who want to breastfeed but feel they can't because of their medications.
Another very useful equation to consider is this:
infant's dose (Dinfant) received via milk can be calculated using the maternal plasma concentration (Cmaternal), M/PAUC ratio and the volume of milk ingested by the infant (Vinfant):
Dinfant (mg/kg/day) = Cmaternal (mg/L) x M/PAUC x Vinfant (L/kg/day)
Do the math. Its only very lipid soluble medications that actually concentrate in breastmilk. And the concentration is still negligible.
I think its important to use clinical insight on a case per case basis rather than applying general recommendations to the entire patient population. "How Doctors Think" is a great book that covers this.
HAM's post brought to mind my pediatrician husbands comments about the American Acad of Pediatric's book on childcare (which I found mostly OK, but occasionally strange and way off track..."what do you expect, it's advice from a committee..."
IMHO the risks of drinking A LOT don't inform us at all about any risks of a very occasional drink. If you aren't getting adequate supply maybe it is worth a try once or twice...if you are really concerned I'd find a way to measure the alcohol content in the pumped milk (in all your spare time).
your child is very fortunate to be breastfeeding:)
I know this is off-track, but I wholeheartedly agree that the AAP is getting a little extreme with all of their recommendations (vaccines, sleep, alcohol...everything). And their book is awful. This sounds totally sexist, but every time I try to read their parenting book, I imagine some slacker dad (who was never the main caregiver) is trying to explain how to parent. And instead of explaining parenting, he put together a hodge-podge of research, internet findings and anecdotal suggestions.
But then again, pediatricians are trained to treat and prevent childhood disease, not to be parenting experts. I really don't think pediatricians (or their governing body) should pretend to do both.
Sorry about the rant. The more I look into these recommendations, the more I see they were not meant for individuals.
Someone should look into this further... (sorry, with one child suffering from a GI virus and the other with bilateral ear infections, I just don't have the time right now.) But I thought that I'd mention (and second nonny's 1st post above) that my son's pediatrician had recommended, when I was having great difficulty with adequate milk supply a couple of years ago, NON-ALCOHOLIC beer as a way to increase lactation. I wonder if there is any empirical evidence for its use...