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Smoking While Breastfeeding: What to Know

Reviewed by Dan Brennan, MD on March 09, 2021

When you're pregnant, everything you do can potentially affect your baby. Take cigarettes or vaping devices like e-cigarettes, for example. If you're a smoker, you may have stopped while you were pregnant. But what happens after your baby is born?

You may not smoke or vape anywhere near your baby, but nicotine and other harmful toxins can accumulate in the air, in your body, and in your breast milk. It's called passive exposure, and it puts your baby at a higher risk of developing health problems, like ear infections, bronchitis, and pneumonia. Maternal smoking is even linked to impaired lung function and sudden infant death syndrome (SIDS)

How Smoking Affects Breast Milk

Breastfeeding is one the best things you can do for your child. Breast milk provides babies with antioxidants, digestive enzymes, live antibodies, and other essential nutrients. Breastfeeding is soothing for infants and can help them sleep. 

Babies who are breastfed have: 

Postpartum smoking is a big concern — not just because it exposes your child to secondhand smoke, but also because nicotine and chemicals like lead, arsenic, and formaldehyde end up in breast milk, which is passed on to your baby. There is evidence that nicotine changes the composition of your breast milk and can even decrease the amount your body makes. 

The amount of nicotine in your breastmilk varies depending on how much you smoke. Some evidence suggests babies of women who smoked five or more cigarettes a day had problems sleeping and were more like to cry or fuss for longer periods of time. 

The Risks of Smoking During Breastfeeding

If you smoke while breastfeeding, your baby may:

  • Develop chronic respiratory problems like asthma or allergies
  • Have trouble sleeping or sleep less 
  • Catch common childhood illnesses more easily, like colds and ear infections
  • Struggle with digestive problems
  • Develop behavioral problems and cry more often
  • Have a higher risk of dying from SIDS

Nicotine doesn't just stay in your lungs. Smoke and chemicals from cigarettes or e-cigarettes end up on your skin, hair, clothing, furniture, carpets, and the walls of your home. It's called thirdhand exposure. 

What to Do if You're a Smoker

Doctors agree the best way to protect your baby from the effects of nicotine is to quit. But even if you do smoke, it doesn't mean you have to stop breastfeeding. Breast milk is still best, and breastfeeding typically outweighs the risks of nicotine exposure. Breast milk protects your baby from infections and provides nutrients that aren't found in formula. 

If you smoke, consider taking these steps to protect your child:

  • Don't smoke near your baby.
  • Keep cigarettes, pipes, cigars, and vaping devices outside.
  • Create a smoke-free environment in your car and home.
  • Change your clothes and wash your hands after smoking.

If you or your partner smoke, don't co-sleep or share a bed with your baby. This can increase the risks of SIDS.

Other Considerations

If you're breastfeeding and trying to quit smoking, talk to your doctor. They may suggest in-person or phone counseling, or health resources like smartphone apps, support groups in your area, and online programs designed to help you quit. Pregnant women and new mothers who get support from people around them have a higher likelihood of being able to quit.  

Nicotine replacement therapy (NRT) is also an option. Quitting without medication is best, but if you're struggling, there are solutions like nicotine patches or prescription pills that can help. Talk to your doctor before using any smoking cessation products. 

Show Sources

SOURCES: 

American College of Obstetricians and Gynecologists: "Tobacco and Nicotine Cessation During Pregnancy." 

Centers for Disease Control and Prevention: "Tobacco and E-Cigarettes: What effects can tobacco or e-cigarette exposure have on infants?" 

Cleveland Clinic: "The Benefits of Breastfeeding for Baby & for Mom." 

MGH Center for Women's Mental Health: "You Asked: Is Smoking While Breastfeeding Safe?" 

NHS: "Breastfeeding and smoking." 

Pediatrics: "Breastfeeding and Smoking: Short-term Effects on Infant Feeding and Sleep." 

Smokefree Women: "Quit For Two." 

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