Moms Who Smoke after Delivery Breastfeed Less

By Charnicia E. Huggins

NEW YORK (Reuters Health) – Women who smoke more than 10 cigarettes a day after giving birth may wean their babies off breastmilk much more quickly than nonsmokers, study findings show.

“A lot of public health programs put lots of attention to smoking cessation during pregnancy, but they do not educate women about not smoking after delivery,” study author Dr. Jihong Liu, of the University of South Carolina, told Reuters Health.

For those who have a “misunderstanding that smoking postpartum is okay” for babies, Liu said the shortened breastfeeding duration among these women is “one adverse consequence.”

Liu conducted the research as a maternal and child health epidemiology fellow at the US Centers for Disease Control and Prevention in Atlanta, Georgia.

Little research has evaluated the association between women’s smoking patterns before, during, and after pregnancy and their duration of breastfeeding. To investigate, Liu and her colleagues analyzed data from more than 3,000 women who were involved in the 2000 and 2001 Oregon Pregnancy Risk Assessment Monitoring System, an ongoing surveillance system that collects information on the behavior and experiences of new mothers in that state.

The team found that while 91 percent of new mothers started breastfeeding, nearly 26 percent had stopped doing so by the time their infant was 10 weeks old.

This pattern was most common among mothers described as persistent smokers, who continued to smoke during and after pregnancy, and among those who smoked heavily – i.e. at least 10 cigarettes per day – after giving birth, study findings indicate.

In fact, both of these groups of mothers were more than twice as likely as nonsmokers to have stopped breastfeeding their infants before 10 weeks, Liu and her team report in the American Journal of Public Health.

The likelihood of early weaning among mothers who quit smoking while pregnant and either did not resume smoking or resumed smoking fewer than 10 cigarettes per day after delivery, was not significantly higher than among nonsmokers.

The shorter duration of breastfeeding among smokers may be partly due to hormonal factors such as lower prolactin levels and decreased breastmilk production among smokers, or to the lower fat content of smokers’ breastmilk, all of which has been shown in previous research.

Mothers who smoke may also stop breastfeeding because of concern about the toxic chemicals in cigarette smoke or because of their baby’s colic or excessive crying, which has been found to be more common among breastfed infants of smokers than among other infants.

Liu advised women who cannot maintain their nonsmoking status after giving birth to cut down on the number of cigarettes they smoke so that they can breastfeed longer.

“I’m still a believer that breastmilk is best for the infant,” Liu said.

She and her colleagues conclude that their “findings suggest that health care providers need to assist and help mothers who have previously smoked before and during (as well as after) their pregnancies to quit smoking during pregnancy and remain nonsmokers after delivery.”

SOURCE: American Journal of Public Health, February 2006.