What to know
Using tobacco or electronic cigarettes (e-cigarettes) while breastfeeding can allow harmful chemicals to pass from the mother to the infant through breast milk or secondhand smoke exposure. Mothers who use tobacco or e-cigarettes should be encouraged to quit. If a mother is unable to quit, breastfeeding still provides numerous health benefits, and breast milk remains the recommended food for an infant.
Risks for infants
Nicotine and other harmful chemicals are found in cigarettes, cigars, pipe tobacco, and chewing tobacco.
Whether the mother breastfeeds or uses infant formula, secondhand smoke exposure puts infants at risk of:
- Sudden Infant Death Syndrome (SIDS).
- Lower respiratory illnesses, such as bronchitis and pneumonia.
- Ear infections.
- Impaired lung function.
In addition, chemicals in tobacco, including nicotine, can be passed from a breastfeeding mother who uses tobacco to her infant through breast milk. Smoking also decreases maternal milk supply, likely through the effect of nicotine, which lowers levels of the hormone that stimulates breast milk production (prolactin).
E-cigarettes and other vaping devices are battery-powered devices that typically deliver nicotine, flavorings, and other additives through an inhaled aerosol. Little is known about the effects of e-cigarette use by the mother on the infant’s health. E-cigarette aerosol can contain harmful and potentially harmful chemicals, including nicotine and other toxic agents, flavorings, and solvents.
Resources to help quit smoking
Quit Smoking - CDC
Smokefree Women - National Cancer Institute
Safety of breastfeeding
Mothers who use tobacco or e-cigarettes can breastfeed their infants but should be encouraged to quit. If they are unable to quit, breastfeeding still provides numerous health benefits, and breast milk remains the recommended food for an infant.
The American College of Obstetricians and Gynecologists and the American Academy of Pediatrics recognize pregnancy and breastfeeding as two ideal times to promote tobacco and smoking cessation.
To minimize exposure to the infant, mothers, and others who smoke should:
- Not smoke near the infant.
- Smoke outside.
- Have smoke-free rules for the car and home.
- Change clothes and wash hands after smoking and before handling the infant.
Resources
Tobacco Use and Pregnancy—CDC.
Drugs and Lactation Database (LactMed®)—National Library of Medicine
Surgeon General Reports:
- Smoking Cessation, 2020
- E-Cigarette Use Among Youth and Young Adults, 2016
- The Health Consequences of Smoking-50 Years of Progress, 2014
The Transfer of Drugs and Therapeutics into Human Breast Milk: An Update on Selected Topics—American Academy of Pediatrics (AAP).
Policy Statement: Breastfeeding and the Use of Human Milk—AAP.
Tobacco and Nicotine Cessation During Pregnancy—American College of Obstetricians and Gynecologists.
Clinical Protocol #21: Guidelines for Breastfeeding and Substance Use or Substance Use Disorder—Academy of Breastfeeding Medicine.