Ask the Expert...Lactation, Tobacco Use and Meds to Quit Smoking

If you are a lactating person and use tobacco products, you may be thinking about quitting more than ever! Tobacco exposure not only negatively impacts your health but your baby’s as well. The more you smoke, the greater the risks so even cutting down will have beneficial effects for all! Let’s dive in and answer some common questions about smoking cessation during lactation.

Should a mother who smokes breastfeed?

Absolutely! Breastmilk is rich in protective factors that can help your baby fight illness and may counteract some of the negative effects of cigarette smoke. Of course, it’s better if you don’t smoke at all. But, if you are going to smoke, it’s healthier for your baby to breastfeed or consume breastmilk than formula feed.

How does smoking affect my baby?

Babies of mothers who smoke have more colic, asthma, respiratory infections and allergies. Babies of mothers who smoke are also seven times more likely to die of Sudden Infant Death Syndrome (SIDS).

How does smoking affect the lactation process?

Smoking contributes to lower prolactin levels, lower milk production, difficulty with letdown and earlier weaning.

Is Nicotine Replacement Therapy (patches, gum, lozenges, Rx nasal spray, Rx inhaler) safe during breastfeeding?

Yes! NRT is safe as long as you are not using other tobacco products and the nicotine level delivered is less than what you are currently exposed to from cigarettes or tobacco product. NRT is available over the counter and often covered by insurance (you may be required to obtain a prescription).

Is the oral quit smoking medication bupropion (Wellbutrin, Zyban) safe during breastfeeding?

Yes! Bupropion is available by prescription and does transfer into breastmilk in small amounts. but is not expected to cause side effects in most babies. Bupropion may reduce the amount of milk your body makes so this is something to be aware of and monitor. Remember to always look at the big picture when considering risk vs benefit of any medication. Continued smoking is likely to put you and your baby at much higher risk for health consequences than medications to help you quit. Learn more about buproprion for smoking cessation here. (CDC)

Isn’t bupropion expensive?

Cash pay price varies depending on the pharmacy but generally less than $25 for a one-month supply of twice daily dosing. If you have health insurance, it is generally covered and often covered at 100%! You can check GoodRx to see the pricing at pharmacies near you.

What about Chantix (varenicline)? Is it safe during breastfeeding?

There is not much research yet on varenicline in lactating people so it is not recommended until we know more about safety.

If I smoked during pregnancy, isn’t the damage already done?

Smoking during pregnancy increases risk of miscarriage, birth defects, low birth weight and premature birth. But once the baby is here, he or she will continue to have potential health consequences due to tobacco exposure. It’s never too late to quit!

What resources are available to help me quit?

✓ Phone support is available with a quit coach: Call 1-800-QUIT-NOW. FREE!

✓ Smokefree Texting Programs from Smokefree.gov. FREE!

✓ quitSTART App from the National Cancer Institute (Google Play and Apple). FREE!

✓ Web support and a wealth of information from smokefree.gov

Congratulations on learning more about tobacco use and cessation during lactation! We care about you and your baby and, when you’re ready to quit, I'm here to help!

✓ Medication counseling and recommendations

✓ Prescription for quit-smoking medication (usually covered by insurance!)

✓ Assistance to identify state programs if you do not have insurance

✓ Identification of resources for continued support

Contact me if you are interested in booking a smoking cessation visit!

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