Breastfeeding and maternal alcohol use: Prevalence and effects on child outcomes and fetal alcohol spectrum disorders

•90% of mothers breastfed for an average of 19.9 months.•71% of mothers who breastfed used alcohol simultaneously.•42 to 48% of mothers of normal controls drank and breastfed.•Maternal drinking while breastfeeding limits physical and neurobehavioral outcomes.•Alcohol use during the breastfeeding period is not recommended.

ObjectiveDetermine any effects that maternal alcohol consumption during the breastfeeding period has on child outcomes.MethodsPopulation-based samples of children with fetal alcohol spectrum disorders (FASD), normally-developing children, and their mothers were analyzed for differences in child outcomes.ResultsNinety percent (90%) of mothers breastfed for an average of 19.9 months. Of mothers who drank postpartum and breastfed (MDPB), 47% breastfed for 12 months or more. In case control analyses, children of MDPB were significantly lighter, had lower verbal IQ scores, and more anomalies in comparisons controlling for prenatal alcohol exposure and final FASD diagnosis. Utilizing a stepwise logistic regression model adjusting for nine confounders of prenatal drinking and other maternal risks, MDPB were 6.4 times more likely to have a child with FASD than breastfeeding mothers who abstained from alcohol while breastfeeding.ConclusionsAlcohol use during the period of breastfeeding was found to significantly compromise a child's development.