Does Maternal Smoking Have a Negative Physiological Effect on Breastfeeding? The Epidemiological Evidence

Abstract

The association between maternal smoking and lack of breastfeeding is consistent across different study designs in a range of countries. Given that women who smoke are less likely to intend to breastfeed, however, it cannot be assumed that the relationship between smoking and duration of breastfeeding is a physiological one. If smoking had a consistent negative physiological effect on lactation, one would not expect to see such wide variations in breastfeeding rates among women who smoke. Therefore, it is likely that psychosocial factors are largely responsible for the lower rates of breastfeeding found in women who smoke compared with those who do not.

Secondhand and Prenatal Tobacco Smoke Exposure

“…§ Bans on smoking at workplaces, restaurants, child care settings, public parks, and beaches and in other public venues have been extremely successful in decreasing and, in some cases, eliminating SHS exposure. 113 Other positive effects of bans are increases in quitting attempts and successes, 96,[114][115][116][117] increased prevalence of smoke-free homes and cars in the surrounding community, 61,118,119 improved air quality and health outcomes for employees [120][121][122] and children, 123 and decreased social acceptability of tobacco use. 58,124,125 Studies of restaurants and bars that compared income before and after a ban have shown no adverse effect on the economics of the hospitality industry.…”

“…• Decreased initiation and duration of breastfeeding [119][120][121][122][123][124][125] • Decreased iodine levels in human milk 126…”

Aboriginal mothers, breastfeeding and smoking

“…This theory is supported by a review of studies investigating an association between maternal smoking and breastfeeding. 11 In this review, studies of breastfeeding intention and initiation did not support an equal desire to breastfeed among smokers and non-smokers.…”

“…10 In addition to these direct risks to infant and child health, maternal smoking has been shown in numerous epidemiological studies to be negatively associated with both the initiation and duration of breastfeeding. 11 In general, women who smoke are less likely to initiate breastfeeding 12,13 and to breastfeed for shorter periods. [13][14][15] Thus, the infants of mothers who smoke may be deprived of, or have reduced exposure to, the known health benefits of breastfeeding.…”

Fatores associados à duração do aleitamento materno em três municípios na região do Alto Jequitinhonha, Minas Gerais, Brasil

“…O número de cigarros consumidos diariamente por mães tabagistas e sua relação com o período de amamentação não foram pesquisados, limitando, portanto, maiores conclusões. Poderia haver também a possibilidade de que o mecanismo de interrupção precoce do aleitamento materno seja psicológico, devido à menor intenção de mães fumantes em amamentar seus filhos, e não fisiológico, o que foi sugerido por Amir & Donath 18 . Nesse caso, os efeitos negativos do tabagismo materno sobre a duração da amamentação poderiam ser menores em alguns grupos populacionais.…”