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Breast Feeding

Smoking while breastfeeding



My daughter-in-law resumed her smoking the same day she gave birth to her baby girl. She claims that different nurses in the hospital told her it would not affect the breast milk and therefore would not affect the baby. I realize that this is a powerful addiction, but I cannot believe that it isn`t harmful to the baby. Please let me know the truth, so I can pass it on to her or stop worrying about it. Thanks!


Both active and passive smoke inhalation are harmful to health. In addition, nicotine and its metabolite both cross into breast milk.

Levels are 10 fold higher in breast fed than bottles fed infants of smoking mothers.

The nicotine milk to plasma ratio is 2.9, meaning there is almost 3 times as much nicotine in the milk as in the mother’s plasma.

Nicotine also suppresses the production of prolactin and hence the amount of milk produced for the infant.

Nicotine patch users have lower (less than half) the amount of nicotine in their blood than smokers.

When patches are used while smoking, the nicotine levels are extremely high and the amount in milk could harm the infant.

Having said this, if a mother MUST smoke, then breastfeeding is all the more important.

This is true because infants of smoking mothers have a higher incidence of SIDS and of respiratory infections and asthma.

Breastfeeding protects the infant from these complications to a significant degree; therefore, I would not advise her to stop breastfeeding because she smokes, but rather ask her to limit the amount of smoking as much as possible and to smoke only after she has fed the baby.

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Response by:

Jeanne L Ballard, MD, FAAP, FABM Jeanne L Ballard, MD, FAAP, FABM
Professor Emeritus, Pediatrics, Obstetrics and Gynecology
College of Medicine
University of Cincinnati