The Solution to the Smoking and Breastfeeding Controversy

By ACSH Staff — Apr 07, 2016
In an article published in Pediatrics, researchers found that an acute episode of smoking by lactating mothers altered infants’ sleep/wake patterning. This, combined with the adverse physiological effects nicotine-saturated breast milk has on babies, one would think bottle feeding would be recommended among this cohort. It's not.
shutterstock_69411319 Smoking and breastfeeding via Shutterstock

Fans were outraged after learning 24-year-old Jenelle Evans, star of MTV’s "Teen Mom 2," had resumed her smoking habit, despite still breastfeeding her two-month-old son.

Smoking is bad, smoking is dangerous, and the American Council on Science and Health has been in a war on smoking for 38 years, so it's good we have done our job so well that young people are outraged.

Yet we have also been on a mission to separate health threats from health scares, so a Yahoo article citing breastfeeding expert Dr. Ruth Lawrence, while provocative and therefore valuable for getting a dialogue going about breastfeeding and smoking, misses an obvious solution.

Lawrence, the director of the Breastfeeding and Human Lactation Study Center in Rochester, NY, obliquely defended the young mom by saying, “You weigh the benefit of breastfeeding against the risk of what the substance is,” because of the implication that breast milk has some mystical otherworldly power that offsets carcinogens.

The article then goes on to say that even with recovering heroin addicts who are taking methadone, it’s “better to keep breastfeeding even if you can’t totally give up the poison because of its valuable, brain-nourishing nutrients an infant gets from breast milk.”

Sorry, there is nothing magical about breast milk that outweighs smoking or heroin use. Instead, there is way to avoid the issue altogether. It's called infant formula.

Formula has been slighted in recent years, and the only reason seems to be a naturalistic fallacy. While it is acknowledged that, when possible, breastfeeding is fine, the recent cultural bullying of formula is really bullying working mothers, poor mothers and women who simply can't breastfeed. The implication is that they are "bad" moms if they don't breastfeed, and it has become so ingrained that we have rationalizations about how heroin addicts and smokers can avoid impacting infants in their breast milk.

So a mother who smokes or shoots heroin is less somehow bad if those carcinogens are linked to the "valuable, brain-nourishing nutrients an infant gets from breast milk."


A study in Pediatrics showed that an acute episode of smoking by lactating mothers “altered infants’ sleep/wake patterning." Babies spent significantly more time awake when they nursed from a smoking mother, as compared to when their mothers abstained.  Authors attributed this disruption to the bad taste of the cigarettes that seeped through into the breast milk. They also contend the altered sleep patterns were also due to the physiological disruptions that nicotine saturated breast milk is known to cause.

A study in the Journal of the American Association of Nurse Practitioners showed that infants of smoking mothers had a "significant change in respirations and oxygen saturations" while urine cotinine values from breastfed babies increased significantly with higher concentrations of cotinine in the mother's milk. Cotinine is a primary metabolite of nicotine and the high concentration could make infants more susceptible to a nicotine addiction later in life.

It's obvious from the literature that women who smoke and breastfeed pose a greater threat to their infant's health than women who smoke and use formula. Using formula, rather than coming up with pop culture guidelines for how heroin addicts and smokers should continue to breastfeed, seems obvious. Yet advocates against formula say there is a lack of long-term evidence regarding the possible "developmental and behavioral impairments" associated with smoking and breastfeeding.

Claiming that breastfeeding will help wash away the health sin of smoking around infants is ridiculous, especially when formula has been a healthy, nutritious and even life-saving alternative for generations.

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