Nicotine in breast milk and passive smoking can give your baby chest infections, vomiting, diarrhoea and irritability. Avoid smoking for half an hour before you breastfeed. If you are using nicotine gum, breastfeed first then chew the gum after so there is less nicotine in your breast milk. Cigarette smoke can make your newborn baby sick. In addition, because smoking is associated with sleep disturbances in adolescents and adults, researchers have begun to look at the sleeping patterns of babies breastfed by mothers who smoke.
They found that the infants of mothers who smoke just before nursing have shorter sleep times and altered sleep architecture. Most studies focus only on the effects of nicotine on the nursing infant; we have little information on how the breastfeeding infant may be affected by the other toxic chemicals in found in the breast milk of women who smoke, including arsenic, cyanide, formaldehyde, and lead.
Less understood are the risks of thirdhand smoke , the residual nicotine and potentially toxic tobacco-derived chemicals left behind by tobacco smoke on surfaces including hair, skin, clothes, furniture, carpets, and walls.
Electronic or e-cigarettes are relatively new, so we do not have a lot of long-term data on its health effects. One thing that concerns me is that people often assume that e-cigarettes are safer than smoking regular cigarettes. While there might be certain health advantages to e-cigarettes, they deliver the same levels of nicotine to the smoker. Thus, we must conclude that e-cigarettes carry many of the same risks as regular cigarettes and are not a better option for nursing mothers.
Breastfeeding and smoking: short-term effects on infant feeding and sleep. Effects of maternal nicotine on breastfeeding infants. To receive email updates about this topic, enter your email address.
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It is known that, in a aqueous solution, nicotine is widely metabolized by the liver before reaching systemic circulation 18 , which, besides causing concern, deserves further studies 14 , When investigating urinary cotinine levels in infants of smoking mothers and the contribution of breastfeeding to these values, researchers found that breastfeeding increases considerably the exposure to tobacco products, especially nicotine.
This same study states that it is possible that the adverse effects of smoking on children, attributed only to environmental exposure to tobacco smoke by inhalation, are greatly influenced by breastfeeding, i. Studies indicate that the amount of nicotine found in breast milk is 2. Urinary cotinine levels in infants breastfed by smoking mothers is similar to those found in adult smokers As for the OBJECTIVE of this review, it was observed that the effects of maternal nicotine on infants are multiple, such as changes in sleep and wake patterns; reduction of iodine supply to the infant through breast milk, leading to an increased risk of deficiency of iodine and thyroid stimulating hormone TSH ; damage to the liver and lung, besides showing significantly higher levels of superoxide dismutase SOD , minor catalase CAT and malondialdehyde MDA ; reduction of pancreatic b cells responsible for insulin production and thus decrease in glucose tolerance; high body weight after weaning; hyperleptinemia; lower amount of type-1 deiodinase in the liver.
Generally speaking, articles recommend breastfeeding mothers to quit smoking. As for changes in sleep and wake patterns 13 , a considerable change was observed in sleep and wake patterns when children were breastfed immediately after their mother smoked, with a variation from The authors attribute the reduction of the amount of time spent in active and quiet sleep to an acute episode of smoking by mothers.
The study indicates that an acute episode of smoking significantly alters the sleep and wake patterns of breastfed infants.
Corroborating these findings, another study observed that infants of smoking mothers have sleeping disorders It is also known that the inhaled nicotine causes problems for the infant, speculating that it could lead to irritability, excessive crying, lassitude, colic and pallor 5 , 7 - As for iodine supply through breast milk 14 , it was described that breast milk iodine content was reduced in smoking mothers Cotinine is the most precise indicator of smoking status half-life of approximately 20 hours.
For the authors, this reduction of breast milk iodine content exposes the infant to an increased risk of iodine deficiency and may lead to physiological disorders in the child, since, during the period of breastfeeding, thyroid function of the infant depends on iodine in maternal milk. Another finding was that smoking mothers had significantly higher serum levels of thiocyanate, which may competitively inhibit the sodium-iodide symporter secondary active transport, when two substances are transported in the same direction responsible for iodide transport in the lactating mammary gland.
A study in rats 17 found that maternal nicotine exposure imprints a neonatal thyroid dysfunction and possible secondary hypothyroidism in adulthood. This hypofunction was confirmed by the lower liver deiodinase 1 or iodine peroxidase activity in offspring exposed to nicotine at 15 and days of life, since this enzyme activity is considered a marker of thyroid status, which is decreased in hypothyroidism and increased in hyperthyroidism.
It was also observed that maternal nicotine exposure did not alter offspring body weight gain during lactation. However, after weaning, offspring exposed to nicotine showed higher body weight compared with the control offspring. The treatment with nicotine also caused hyperleptinemia at all ages tested 15, 21, 90 and days , with significant increase at days of life, i.
In addition, it presented increased total body protein and visceral fat compared with controls. Lipid profile was not changed in adulthood. Corroborating the results of both articles that addressed the negative effects of nicotine, with reduction of iodine supply to the infant through breast milk 14 , 17 , another research indicates decreased iodine supply in breast milk as a problem arising from smoking 9.
As for increase in body weight after maternal nicotine exposure 17 , the authors state that maternal smoking during lactation is a risk factor for obesity, because it contributes to the possibility of developing hypothyroidism.
Epidemiological studies also indicate that maternal smoking may be related to childhood obesity, but all the related factors have not been elucidated yet 22 , As for hyperleptinemia, a significant increase was observed in adulthood, as well as a decrease in thyroid hormones Confirming these findings, a study describes that leptin is responsible for regulating food intake, increase in energy expenditure, neuroendocrine function and for helping in glucose and fat metabolism, besides reporting that the decrease in thyroid hormones leads to an increase in leptin levels When investigating the effects of maternal nicotine during lactation of rat pups 15 , experts observed histopathological changes in the liver of the nicotine-exposed group, with portal inflammatory infiltrate, degeneration of hepatocytes, and focal necrosis in the parenchyma.
Thickening of alveolar walls because of interstitial inflammation was noted in the lungs. In the experimental group, SOD levels were significantly lower compared with the control group smokers: These results indicate that nicotine maternal exposure induces oxidative stress and causes histopathological impairment in the lung and liver of lactating offspring, since enzymes such as SOD and CAT, which act by sweeping away free radicals, are found at decreased levels; MDA, an important parameter of intracellular oxidative stress, is found to be high.
As for glucose homeostasis, the group exposed to nicotine during pregnancy and lactation had a greater response to the administered glucose load than the control group, showing decreased glucose tolerance at 26 weeks of age.
This result is comparable to type-2 diabetes model in humans. According to the authors, it is essential to consider the developmental differences between species, because in rats pancreatic development occurs both prenatally and postnatally, whereas, in humans, the majority of development is completed before term birth. These authors reaffirm the importance of quitting smoking during pregnancy and lactation as a way of preventing permanent damage that is likely to occur as a consequence of this habit.
Generally speaking, studies recommend that mothers should be informed about harmful chemicals contained in cigarettes that can be secreted into breast milk and should be strongly encouraged to stop smoking during pregnancy and lactation.
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