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Can I Smoke While Breastfeeding?

Medically Reviewed by Michelle Roth, BA, IBCLC
While the nicotine in your breastmilk may affect your baby directly, it’s not the only way that smoking can cause problems.

Did you quit smoking during pregnancy, but find yourself craving cigarettes now that baby is born? Are you breastfeeding and concerned about the potential side effects of smoking on your child?

Studies have shown almost half of women who give up their habit during pregnancy return to smoking within six months of giving birth (1). But what effects does smoking actually have on you, your breast milk, and your baby?

Does Smoking Affect Your Breast Milk?

The short answer is yes. There’s strong evidence showing a nursing mother passes nicotine to her child through her breast milk (2). What’s more, while breast milk doesn’t transmit every chemical found in cigarettes, the amount of nicotine transferred through nursing is twice as much as the amount transferred through the placenta (3).

We hear you — it’s one thing to look at statistics — but what do all these facts mean for mother and baby?

How Smoking Can Affect Mother

Smoking may affect a nursing mother in the following ways:

  • Changing the taste of breast milk.
  • Causing her to produce a smaller overall breast milk supply.
  • Reducing her motivation to breastfeed, sometimes resulting in early weaning.

How Smoking Can Affect Baby

Smoking may affect a breastfeeding baby in the following ways:

  • Altering baby’s regular sleep patterns — sleeping for shorter periods of time.
  • Making baby more susceptible to Sudden Infant Death Syndrome, also known as SIDS (4).
  • Changing baby’s behavioral patterns, such as making them more prone to colic.

In addition to the above effects, researchers have found traces of nicotine babies’ blood and urine (5). This means a smoking mother is passing on chemical substances through breast milk to her child. And that child’s immature bodily systems (such as the liver and lungs) aren’t as efficient at removing those toxins.

The case seems to be open and shut — but it isn’t. You might be surprised to learn experts like the American Academy of Pediatrics still believe the benefits of breastfeeding a child outweigh the potential negative side effects despite the mother smoking.

Second- and Third-hand Smoke

While the nicotine in your breastmilk may affect your baby directly, it’s not the only way that smoking can cause problems.

Second-hand smoke is created by the burning cigarette itself and is also the smoke that is exhaled by the person smoking. This creates an environment when non-smokers are exposed to harmful chemicals.

When a baby is exposed to second-hand smoke, their SIDS risk is increased. Babies developing lungs and circulatory system are especially sensitive to exposure.

Third-hand smoke is the residue remaining on your skin, hair, and clothes, as well as throughout your environment (such as on the couch cushions, walls, carpets, seats in the car, etc.). The American Academy of Pediatrics considers this exposure dangerous to the health of children and babies, as well (6).

What About Other Kinds Of Smoke?

So maybe you don’t smoke cigarettes, but participate in other kinds of recreational smoking. In the past few years, especially in the United States and Canada, the legalization of marijuana has been on the rise. So has the sale and use of e-cigarettes, also known as vaping.

While the stigma for both of these substances is generally dissipating, the effects they have on health apply to absolutely everyone — that includes you and your baby. How do these other substances affect breastfeeding?

Smoking Marijuana While Breastfeeding

THC (tetrahydrocannabinol — yeah, it’s a mouthful) is the substance in marijuana that produces mind-altering side effects in the brain. Once it goes into your bloodstream, it will concentrate in breast milk.

Take Note

Just like with alcohol, you can’t “pump and dump” THC out of your system (7).

Some babies exposed to THC through breast milk have been shown to feed less frequently, for shorter periods of time (8).

What’s more, some research has shown that THC can create delayed motor development by the time your baby hits its first birthday. Meanwhile, other research says there are no effects.

While there need to be more studies done on the effects of marijuana and breastfeeding, early evidence points to the fact it could have substantial repercussions for baby’s developing brain.

Mothers seeking medical marijuana for pain or anxiety could consider seeking counseling from a doctor for other solutions.

Vaping While Breastfeeding

E-cigarettes are smoking alternatives, and often contain a mix of nicotine and other chemicals. Because they are relatively new on the market, the jury’s still out on whether or not they are actually safer.

E-cigs use chemical cartridges that contain nicotine and other toxic substances — it’s not risk-free. However, one study did state that e-cigarettes are approximately 95 percent less harmful to your health than cigarettes, and can help people kick their smoking habit altogether when coupled with a program to quit (9).

There’s just not enough evidence, though, to say this is safe when breastfeeding. So while vaping might be safer overall, keep in mind it is still filtering nicotine and chemicals into your system and baby’s food.

To Quit Or Not To Quit?

The fact is, the only way to make sure your baby isn’t at risk of exposure to any kind of smoke through breast milk is to quit smoking. If you are having issues quitting, don’t be discouraged or be tempted to give up breastfeeding! Don’t wean your baby too early because of nicotine use.

Remember, overall, the consensus is that the benefits of breastfeeding outweigh the risks of smoking.

However, it is a good idea to cut back if you can’t quit. The fewer cigarettes you smoke, the better it is for you and your little one.

One study tested the breast milk of smoking women for cotinine, a substance found in tobacco, and discovered the amount detected in the milk was directly linked to the number of cigarettes being smoked. Smoking five or fewer cigarettes will have far fewer side effects than smoking 20 or 30 of them!

If You Can't Quit

One way to curb the amount of nicotine your baby receives is to breastfeed them and then smoke afterward. Leave as much time between smoking and nursing as possible. Your body will process the nicotine in approximately 90 minutes, and you will be clear for the next feeding.

If you’re cutting back and ready to take the next step and quit, read on.

Safe Ways To Quit Smoking

1. The Cold Turkey Method

This method involves tossing your cigarettes and give them up entirely. That’s it. Simple right?

Going cold turkey might be tough, but it has a surprisingly high success rate—in fact, in recent studies, it’s the most effective method to use when quitting.

2. The Baby Steps Method

If going completely off cigarettes right off the bat sounds intense, you can try slowly reducing the number of cigarettes you smoke over days or weeks. This may help the symptoms of nicotine withdrawal, especially if you are a heavy smoker.

3. The Substitute Method

Nicotine Replacement Therapy, also known as NRT, uses nicotine gum, lozenges, patches, or other nicotine to curb cravings. It’s important to consult with a doctor before starting any kind of NRT program. This method can improve your chances from one in 20 to one in 10.

The amount of nicotine your baby would get through your breastmilk with this method is much less than with smoking.
Headshot of Michelle Roth, BA, IBCLC

Editor's Note:

Michelle Roth, BA, IBCLC

4. Counseling

This system is great because it can be combined with any of the above treatments. Having someone to vent your frustrations to can be immensely helpful, and can boost your chances of quitting for good by half.

5. The Other Ways

There are many other ways to quit smoking. Some people will turn to hypnosis. You have to decide which method might work best for you!

The Bottom Line

Smoking or not smoking while breastfeeding is a personal decision. While the best solution for healthy milk production, mother, and baby, is to cut down or quit smoking any substance — that’s not always the immediate and realistic solution.

Just remember — experts believe even breast milk containing traces of nicotine and other chemicals from smoking is healthier for a newborn than no breast milk at all. It’s ultimately up to you to decide for yourself what will keep you and baby happy and healthy.

Headshot of Michelle Roth, BA, IBCLC

Medically Reviewed by

Michelle Roth, BA, IBCLC

Michelle Roth, BA, IBCLC is a writer, editor, and board-certified lactation consultant for two busy pediatric practices. She is a former La Leche League Leader, Lamaze Certified Childbirth Educator, and Certified Infant Massage Instructor.