Albertsen K, Nybo Anderson AM, Olsen J, Gronbaek M Alcohol consumption during pregnancy and the risk of preterm delivery. Am J Epidemiol. 2004; 159:(2)155-61

Alcohol Action Ireland. Women are more at risk of harm from alcohol than men. 2009. (accessed 15 January 2015)

Alcohol Action Ireland. It is in a child's best interests for a prospective mother not to drink alcohol while pregnant. 2014. (accessed 12 January 2015)

The National Infant Feeding Survey 2008. 2009. (accessed 12 January 2015)

Bradley KA, Boyd-Wickizer J, Powell S, Burman ML Alcohol Screening Questionnaires in Women, A Critical Review. JAMA. 1998; 280:(2)166-71

Crozier SR, Robinson SM, Borland SE, Godfrey KM, Cooper C, Inskip HM Do women change their health behaviours in pregnancy? Findings from the Southampton Women's Survey. Paediatr Perinat Epidemiol. 2009; 23:(5)446-53

Daly SF, Kiely J, Clarke TA, Mattews TG Alcohol and cigarette use in a pregnant Irish population. Ir Med J. 1992; 85:(4)156-7

Department of Health and Children. Survey of Lifestyle, Attitudes and Nutrition in Ireland. 2008a. (accessed 12 January 2015)

Department of Health and Children. Minister Wallace renews advice not to drink alcohol in pregnancy. 2008b. (accessed 12 January 2015)

Eberhart JK, Harris RA Understanding variability in ethanol teratogenicity. Proc Natl Acad Sci USA. 2013; 110:(14)5285-6

Breastfeeding in Ireland 2012: Consequences and Policy Responses.Dublin: National Office of Health Promotion; 2012

Fitzpatrick CC, Fitzpatrick PE, Darling MRN Factors associated with the decision to breastfeed among Irish women. Ir Med J. 1994; 87:(5)145-6

Giglia R, Binns C, Alfonso H, Scott J, Oddy W The effect of alcohol intake on breastfeeding duration in Australian women. Acta Paeditrica. 2008; 97:(5)624-9

Giglia R Alcohol and lactation: An updated systematic review. J Acad Nutr Diet. 2010; 63:(2)103-16

Haastrup MB, Pottegard A, Damkier P Alcohol and breastfeeding. Basic and Clinical Pharmacology and Toxicology. 2014; 114:168-173

Haslam C, Lawrence W, Haefeli K Intention to breastfeed and other important health-related behaviour and beliefs during pregnancy. Fam Pract. 2003; 20:(5)528-30

Health Service Executive. Alcohol and pregnancy, a pocket guide. 2013. (accessed 15 January 2015)

Henderson J, Gray R, Brocklehurst P Systematic review of effects of low-moderate prenatal alcohol exposure on pregnancy outcome. BJOG. 2007; 114:(3)243-52

Koren G Drinking alcohol while breastfeeding. Will it harm my baby?. Can Fam Physician. 2002; 48:39-4

Kramer MS, Kakuma R Optimal duration of exclusive breastfeeding. Cochrane Database Syst Rev. 2012; 8

Llana R, Chertok A, Luo J, Culp S, Mullett M Intent to breastfeed: a population-based perspective. Breastfeeding Med. 2011; 6:(3)125-9

Maloney E, Hutchinson D, Burns L, Mattick R, Black E Prevalence and predictors of alcohol use in pregnancy and breastfeeding among Australian women. Birth. 2011; 38:(1)3-9

Mennella JA, Beauchamp GK The transfer of alcohol to human milk. Effects on flavour and infant's behaviours. N Engl J Med. 1991; 325:981-5

Mullally A, Cleary BJ, Barry J, Fahey TP, Murphy DJ Prevalence, predictors and perinatal outcomes of peri-conceptional alcohol exposure – retrospective cohort study in an urban obstetric population in Ireland. BMC Pregnancy and Childbirth. 2011; 11:(27)27-33

Murphy DJ, Mullally A, Cleary BJ, Fahey T, Barry J Behavioural change in relation to alcohol exposure in early pregnancy and impact on perinatal outcomes—a prospective cohort study. BMC Pregnancy Childbirth. 2013a; 13

Murphy DJ, Dunney C, Mullally A, Adnan N, Deane R Population-based study of smoking behaviour throughout pregnancy and adverse perinatal outcomes. Int J Environ Res. Public Health. 2013b; 10:3855-67

Murphy DJ, Dunney C, Mullally A, Adnan N, Fahey T, Barry J A prospective cohort study of alcohol exposure in early and late pregnancy within an urban population in Ireland. Int J Environ Res Public Health. 2014; 11:2049-63

National Health and Medical Research Council. Australian Guidelines to Reduce Health Risks from Drinking Alcohol 2009, Australia. 2009. (accessed 12 January 2014)

London: NICE; 2014

NHS Choices. Low-level drinking in early pregnancy ‘harms baby’. 2014. (accessed 12 January 2014)

Nykjaer C, Alwan NA, Greenwood DC Maternal alcohol intake prior to and during pregnancy and risk of adverse birth outcomes: evidence from a British cohort. J Epidemiol Community Health. 2014; 68:542-7

O'Keeffe LM, Kearney PM, Greene RA Surveillance during pregnancy: methods and response rates from a hospital based pilot study of the pregnancy risk assessment monitoring system in Ireland. BMC Pregnancy Childbirth. 2013; 13

O'Leary CM, Nassar N, Kurinczuk JJ, Bower C The effect of maternal alcohol consumption on fetal growth and preterm birth. BJOG. 2009; 116:(3)390-400

Patra J, Bakker R, Irving H, Jaddoe VWV, Malini S, Rehm J Dose-response relationship between alcohol consumption before and during pregnancy and the risks of low birth weight, preterm birth and small-size-for-gestational age—A systematic review and meta-analyses. BJOG. 2011; 118:(12)1411-21

Powers JR, McDermott LJ, Loxton DJ, Chojenta CL A prospective study of prevalence and predictors of concurrent alcohol and tobacco use during pregnancy. Matern Child Health J. 2012; 17:(1)76-84

Tarrant RC, Younger KM, Sheridan M, Kearney J Maternal health behaviours during pregnancy in an Irish obstetric population and their associations with socio-demographic and infant characteristics. Eur J Clin Nutr. 2011; 65:(4)470-9

US Department of Health and Human Sciences. US Surgeon General Releases Advisory on Alcohol use in Pregnancy. 2005. (accessed 12 January 2015)

Wen LM, Baur LA, Rissel C, Alperstein G, Simpson JM Intention to breastfeed and awareness of health recommendations: findings from first-time mothers in southwest Sydney. Australia Int Breastfeed J. 2009; 4–9

: The 54th World Health Assembly Geneva; 2001

World Health Organization. Exclusive breastfeeding for six months best for babies everywhere. 2011. (accessed 15 January 2015)

Alcohol consumption in pregnancy and its implications for breastfeeding

02 February 2015
Volume 23 · Issue 2



Current advice to women in Ireland is to abstain from alcohol when pregnant or breastfeeding. This study aims to establish whether women embrace this advice when pregnant and if there is a need for additional midwifery-led education in relation to alcohol consumption and breastfeeding.


A cohort study of 907 women who booked for antenatal care and to give birth in a large maternity hospital in Dublin, was undertaken from 2010–2011. Eligible women completed an interview at the first visit, a postal questionnaire during the third trimester of pregnancy, and were followed-up until the birth and discharge.


During pregnancy women who planned to exclusively breastfeed continued to consume alcohol at a rate similar to those who did not plan to breastfeed (30.2% compared with 27.5%; (OR 1.13; 95% CI; 0.84–1.53). Consuming alcohol was associated with older maternal age, Irish nationality and private health care. Intention to exclusively breastfeed was associated with socioeconomic group, non-Irish nationality and private health care. The findings at follow-up were similar to the first set of results with almost a third of women who consumed alcohol in pregnancy exclusively breastfeeding at the time of hospital discharge; (OR 1.28; 95% CI, 0.95–1.73)


Many women who plan to breastfeed continue to consume alcohol in pregnancy despite national and international guidelines that recommend abstention. There may be opportunities in the antenatal period to influence behavioural change in relation to breastfeeding and alcohol consumption.

Lifestyle choices before and during pregnancy can have a significant impact on the health and wellbeing of both a woman and her unborn child (O'Keeffe et al, 2013). Women are often advised by health professionals to make positive lifestyle modifications during the peri-conceptional, antenatal and postnatal period. These healthy lifestyle choices are encouraged to optimise infant health outcomes and to enhance the health of the new mother (Tarrant et al, 2011; Murphy et al, 2014). Health promotion is one of a midwife's key roles. As health professionals, midwives are in a powerful position to influence women's lifestyle behaviours and infant feeding decision making during pregnancy. Unfortunately, lifestyle choices such as alcohol consumption are often only addressed at the initial booking visit and at no further time point during pregnancy, despite the implications for breastfeeding.

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month