Vivian's Point of View

Little, R. E., K. W. Anderson, et al. (1989).
"Maternal alcohol use during breast-feeding and infant
mental and motor development at one year." N Engl J Med 321(7): 425-30.
The detrimental effects of maternal drinking during pregnancy on
fetal health have been documented. The consequences for infants of
maternal drinking during breast-feeding are unknown, but research in
animals suggests that the infant could be affected by exposure to
alcohol through the mother's milk. In a study of 400 infants born
to members of a health maintenance organization, we investigated the
relation of the mother's use of alcohol during breast-feeding to the
infant's development at one year of age. Mental development, as measured
by the Bayley Mental Development Index (MDI), was unrelated to maternal
drinking during breast-feeding. However, motor development,
as measured by the Psychomotor Development Index (PDI), was
significantly lower in infants exposed regularly to alcohol in breast
milk (after alcohol exposure during gestation was controlled for),
with a dose-response relation (P for linear trend, 0.006). The infants
of breast-feeding mothers who had at least one drink daily had a mean
PDI score of 98, whereas the infants exposed to less alcohol in breast
milk had a mean PDI score of 103 (95 percent confidence interval for
the difference of the two means, 1.2 to 9.8). The effect was more
pronounced when mothers who supplemented breast-feeding with formula
were excluded from the analysis. The association persisted even after
we controlled for more than 100 potentially confounding variables,
including smoking and other drug use during pregnancy and in the
postpartum period. We conclude that ethanol ingested through breast
milk has a slight but significant detrimental effect on motor
development, but not mental development, in breast-fed infants.