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

Abstract

OBJECTIVE-The present experimental study was designed to determine how breast-feeding from a mother who smokes affects infants in the short-term. METHODS-Fifteenmother-infant dyads were tested on 2 days separated by 1 week. Mothers smoked (not in the presence of their infants) on one test day and refrained from smoking on the other. For the next 3.5 hours, infants breastfed on demand. Sleep and activity patterns were monitored by placing an actigraph on the infants' leg, and milk intake was determined by weighing the infants before and after each feeding. The nicotine content of the milk was measured to determine the dose of nicotine delivered to the infants. RESULTS-Althoughthere was no significant difference in breast milk intake, despite the taste changes in the milk, infants spent significantly less time sleeping during the hours immediately after their mothers smoked (53.4 minutes), compared with the session when their mothers abstained from smoking (84.5 minutes). This reduction was attributable to shortening of the longest sleep bout and reductions in the amounts of time spent in both active sleep and quiet sleep. With greater doses of nicotine delivered to the infant, less time was spent in active sleep.CONCLUSIONS-An acute episode of smoking by lactating mothers altered infants' sleep/wake patterning. Perhaps concerns that their milk would taste like cigarettes and their infants' sleep patterning would be disrupted would motivate lactating mothers to abstain from smoking and to breastfeed longer. Keywords breastfeeding; maternal smoking; nicotine; sleep More than 250 million women throughout the world inhale one of the most strongly addicting drugs. 1 Those who smoke tobacco while pregnant present a serious threat to their own health and their children's health. 2 These health threats continue after birth when infants are exposed passively to nicotine and other toxic constituents of cigarette smoke in ambient air, breast milk, or both. 2,3Although the amount of nicotine transferred into breast milk is more than double that transferred to maternal serum, 4 there is evidence that breastfeeding offers protection; the incidence of acute respiratory illness among infants whose mothers smoked was diminished for those who were breastfed, compared with formula fed. 5 Because the benefits of breastfeeding outweigh the risks of nicotine exposure, nicotine is no longer listed as a drug that is contraindicated during breastfeeding. 6 Although lactating women who smoke are

Mütterliches Rauchen in der Schwangerschaft und Schlafstörungen bei 2 Monate alten Säuglingen

“…One possible explanation may be an overwhelmingly adverse effect of antenatal tobacco exposure compared with the effects of an infant's postnatal passive smoking. Meanwhile, this does not exclude the deleterious influence of maternal smoking after birth, and previous studies indicated that acute episodes of smoking by lactating mothers could alter infants' sleep-wake patterning [26].…”

“…Cigarette smoking is known to be associated with sleep difficulties in adults [39], and animal experimental studies suggest that the nicotine contained in cigarette smoke may predispose human infants to SIDS by interfering with the normal maturation of sleep and wake patterns [13]. Although maternal smoking in pregnancy did not appear to alter infant neonatal electroencephalogram [7] and infant sleep architecture [17], recent reports provided highly indicative evidence that sleep disturbances were common in the newborns of mothers who had been heavy smokers during pregnancy [32] and that breastfed infants of smoking mothers spent significantly less time sleeping during the hours immediately after their mothers smoked, compared with the session when their mothers abstained from smoking [26].…”

Secondhand and Prenatal Tobacco Smoke Exposure

“…• Allergic sensitization 111, • Poor sleep, in breastfed infants 153 • Lower respiratory disease, including…”

Tobacco Metabolites and Caffeine in Human Milk Purchased via the Internet

“…Few of the advertisements associated with these samples reported the use of caffeine, and none reported tobacco use. Outcomes in infants of mothers who smoke have been shown to be cardiovascular dysregulation, 35 altered sleep/wake patterns, 36 stunted growth, 37,38 and an increase in respiratory ailments. 38 Caffeine is rapidly transferred into human milk and has been shown to cause irritability and poor sleeping patterns in infants of women who have ingested large amounts.…”