the doctors are in
Drinking and breastfeeding? PDF Print E-mail

Question : I am a L&D nurse and get asked about drinking and breastfeeding. Exactly how much alcohol is excreted in the breast milk? It seems that even if your blood alcohol is .1%, that not even that much would be in the milk. Is it possible for there to be enough alcohol in the breast milk to intoxicate a baby? And how fast is it metabolized out of the milk?

Answer : It appears likely that alcohol, using this term in the generic sense, does get into the breast milk. Alcohol, however, is not stored in the breast and therefore, dependent on normal alcohol catabolic pathways that govern alcohol metabolism in general and mirrors the blood alcohol content. The percent alcohol of the beverage consumed, rate at which it is consumed, other activities (dancing, e.g.) during consumption, body weight and body mass index, and whether food and which types of food are consumed all have a potential impact. The American Academy of Pediatrics categorizes alcohol as "usually compatible with breast feeding". Binge drinking, however, is never encouraged among lactating women but should not be considered sufficient deterrent to discourage all forms of consumption or abstinence. Studies of breast milk production appear to be consistent and refute folklore that suggests alcohol consumption increases breast milk supply. Most forms of alcohol transiently decrease milk volume. Interestingly, beer increases breast milk production and this is thought to be an effect of polysaccharides found in barley and hops. Furthermore, infants seem to enjoy the taste of alcohol in breast milk. We suppose that it is possible for an infant to get intoxicated on breast milk but this will never be studied. Maternal drinking one alcoholic beverage (4 fluid ounces of 12% wine; 12 fluid ounces of 4.5% beer; 1 fluid ounce of 100 proof whiskey) is unlikely to cause either short-term or long-term health problems in the nursing infant. Heavy maternal drinking may cause sedation, fluid retention, and hormonal imbalances in breastfed infants. Although the risks of drinking alcohol while breast-feeding have not been well-defined, data seems to support that common sense and moderation can prevail.

How Much Can I Drink? PDF Print E-mail

Question : How Much Can I Drink?

Answer : At my annual exam with my doctor today, I asked how much red wine was OK to drink daily considering the latest research on alcohol and breast cancer. I read that women should drink no more than 5 ounces per day. I am 61 and healthy. -CS, Palo Alto Dear CS, We invite you to read our hot topics article on alcohol and breast cancer. The answer to your question is complex. The definition of “what is a drink” is not standardized among published studies, although the FDA nutritional guidelines define a glass of wine, whether white or red as 5 ounces and 12% alcohol (There are not many California wines that fulfill this 12% criteria and most actually exceed this percentage.). The nutritional guidelines state that one drink/day for women (This assumes that a woman consumer is of average size, 5ft. 4 inches and 125 lbs.) and up to 2 drinks/day for men may be protective against the most common cause of death: heart disease. It also seems to decrease all-cause mortality. Although the data is provocative, it is not definitive. Nonetheless, let’s proceed with an example: A 5-ounce pour of 2005 Martinelli JackAss Zinfandel at 17.5% alcohol. That’s 20.8 grams of alcohol compared to the FDA example at 13.6 grams. Not only does this reflect the failure to update information based on “hotter”, higher alcohol wines, but the difficulty of standardizing information. Published studies linking alcohol to postmenopausal breast cancer are epidemiologic and observational and therefore subject to biases. As an example, similar study designs concluded that menopausal estrogen therapy decreased the risk of coronary heart disease. Subsequent prospective randomized studies showed that menopausal estrogen therapy actually increased the risk of heart attacks, strokes, and blood clots in postmenopausal women. Unfortunately, there are no prospective, randomized human trials that address alcohol as a risk factor for breast cancer and this question remains unanswered. It is important to note that approximately 30% of women may encounter cardiovascular events in their lives while only 11% may encounter breast cancer. Data suggests, however, that women disproportionately express their concerns about this cancer risk by up to 8 fold over vascular events. You must, remember that these are generalized statements and cannot replace the individual advice that only your personal physician can provide. We hope this gives you something to ponder and maybe discuss over your next glass of wine…

What is resveratrol? PDF Print E-mail

Question : What is resveratrol?

Answer : Resveratrol is a polyphenol and phytoestrogen found in grapes, mulberries, and peanuts. It has been shown to have anti-inflammatory, antioxidant, antitumor, neuroprotective, and immunomodulatory activities in in vitro studies and some animal models. Although there has been a lot of media attention about the health benefits of resveratrol and there are even resveratrol tablets on the market (unregulated by the FDA), there are no well-designed human trials showing benefit in decreasing risk of cardiovascular disease and mortality.

Are wine headaches caused by sulfites? PDF Print E-mail

Question : Are wine headaches caused by sulfites?

Answer : The answer is controversial. Many wine components including histamine, tyramine and sulfites have been implicated in headaches. Some of the strongest data in the neurology literature seems to rest in tyramine, a by-product of the wine protein tyrosine which may be present in wines based on various wine production techniques. Fining proteins in wine may leave the final product with less tyrosine than the preliminary product and everyone many have different capacities to break down residual tyrosine in their bodies, depending on various enzyme levels. Very recently, scientists at the University of California at Berkeley have discovered and refined a device that measures the tyramine content in wine. Their hope is that this may be useful for the consumer.

What is the French Paradox? PDF Print E-mail

Question : What is the French Paradox?

Answer : The French Paradox was a theory postulated by Dr. Renaud from France. We know that a high intake of saturated fat is positively related to high mortality from coronary heart disease (CHD). However, in France, there is high intake of saturated fat but low mortality from CHD. “The French paradox for CHD may be due to high consumption of wine.” This theory has been debated ever since it was popularized on "60 Minutes". S Renaud, M deLorgeril. Wine, alcohol, platelets, and the French paradox for coronary heart disease. Lancet,1992;339:1523-6.

Nov 1, 2007


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