Breastfeeding and Cigarette Smoking

CigaretteMoms who smoke cigarettes often express uncertainty about the safety of smoking while breastfeeding. A common misconception is that chemicals found in cigarette smoke will be fully transferred through mom’s milk and make breastfeeding unsafe. While it is best for the health of your entire family for you to quit smoking, if you cannot quit, it is safer to smoke cigarettes and breastfeed than it is to smoke and formula feed.  In fact, studies have found that breastfeeding provides protection against many of the negative health effects of second-hand smoke.

Babies who are exposed to cigarette smoke in the home are at increased risk of:

  • colic
  • respiratory infections
  • bronchitis
  • ear infections
  • asthma
  • sudden infant death syndrome (SIDS)

Parents who smoke cigarettes can limit their baby’s exposure to second hand smoke:

  • Avoid smoking while holding your baby. Smoke outside or in a separate room away from your baby.
  • Avoid smoking where your baby sleeps.
  • Avoid smoking in the car with your baby. Opening windows does not lessen the risk of secondhand smoke.
  • After smoking, wash your hands and face and change your clothes before holding your baby. Some parents wear one over shirt or jacket for smoking, and leave it hanging by the door for easy access. You can also cover your head with a scarf to reduce smoke particles in the hair.
  • Ask visitors, family, and friends not to smoke in your home. In some Native cultures asking a guest not to smoke in your home is considered rude. One suggestion is to ask a respected relative to talk to visitors about not smoking inside and explain why it is important for your family’s health. They can make it clear that you do not wish to offend and the request is not personal.  A no smoking sign on your door can help you avoid uncomfortable conversations, as well. Offering a cozy outside smoking space for visitors may help them feel more welcome.

While nicotine (the addictive substance in cigarettes) does pass into breastmilk, it does so at lower quantities than are in the mother’s blood. To minimize your baby’s nicotine exposure while breastfeeding:

  • Cut down on the number of cigarettes you smoke per day. Limit your smoking as much as possible. The less you smoke, the less nicotine in your milk. Less smoking is also better for your health.
  • Smoke after breastfeeding instead of before. When you smoke, the nicotine levels in your blood and milk rise then fall over time.  About 90 minutes after smoking, the level of nicotine in your blood decreases by half. Smoking after breastfeeding reduces exposure to nicotine because the levels in your milk will be lower by the time baby is ready to nurse again.
  • Consider using a “stop smoking aid” like nicotine patches or gum instead of smoking. Nicotine levels in the blood are much lower with these products than with cigarettes.  Never smoke and use an aid at the same time, as this practice can lead to high amounts of nicotine in the blood. Talk to your health-care provider about your options for assistance with quitting smoking.
  • Watch for extraordinary fussiness, restlessness, vomiting, or diarrhea in your baby as these symptoms may be related to nicotine exposure. If any of these symptoms occur, further reduce your cigarette smoking as well as your baby’s exposure to second-hand smoke. The effects of nicotine exposure are cumulative (meaning the more exposure, even by second-hand smoke, the more nicotine in baby’s body).  Always talk to your baby’s health-care provider when you are concerned about your baby’s health or behavior.

Please note that some mothers who smoke cigarettes heavily experience a delay in let-down (milk ejection reflex) or a reduced let-down response.  If this occurs, assure that you avoid smoking close to feedings, try further cutting back on your smoking, and talk to your lactation specialist or health-care provider.

Some of the positive effects of quitting smoking are:

  • Your baby will be healthier because he won’t be exposed to second hand smoke.
  • You will be healthier.  You will have lower blood pressure, improved circulation, and improved lung function. Your risk of diseases caused by smoking (such as heart disease and lung cancer) will drop. Your odds of living a long and healthy life will increase dramatically.
  • Your sense of taste and smell will improve.
  • Your hair and clothes will not smell of cigarette smoke.
  • You will save money! Not only will you save money immediately by not buying cigarettes and lighters, but also you will reduce your and your family’s long term health-care costs.


Please note that in this article we are discussing cigarette smoking, not the traditional use of tobacco. Tobacco is used ceremoniously in smaller quantities, and the frequency of the exposure is far less than that of cigarette smoking. If you have questions about the use of ceremonial tobacco while breastfeeding, please talk to your traditional healer. For general information about the use of traditional tobacco please see: Facts on Traditional Tobacco


More information:

Key Facts About Smoking Among American Indians and Alaska Natives
How to quit smoking
Nicotine Addiction


The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General, U.S. Department of Health and Human Services

Mohrbacher, N (2010) Breastfeeding Answers Made Simple: A Guide for Helping Mothers Amarillo, Texas. Hale Publishing, L.P.

Hale, T. (2010) Medications and Mothers’ Milk Amarillo, Texas. Hale Publishing, L.P.

Ladomenou, F. et al (2009) Environmental tobacco smoke exposure as a risk factor for infections in infancy. Acta Paediatrica, 98(7) 1137-1141

Shenassa ED, Brown MJ. (2004) Maternal smoking and infantile gastrointestinal dysregulation: the case of colic. Pediatrics 114(4):e497-505.

Ilett KF, Hale TW et al (2003) Use of nicotine patches in breast-feeding mothers: transfer of nicotine and cotinine into human milk. Clinical Pharmacology and Therapeutics 74(6):516-24.

Fisher, D. (2006)  Social Drugs and Breastfeeding, handling an issue that isn’t black and white

© Native Mothering–All Rights Reserved


Revised 4/21/13

This entry was posted in Breastfeeding and tagged , , , . Bookmark the permalink.

2 Responses to Breastfeeding and Cigarette Smoking

  1. Pingback: I’m a Pregnant Teenager and I’m Thinking about Breastfeeding My Baby | Native Mothering

  2. Pingback: What’s in Breastmilk? | Native Mothering

Leave a Reply

Your email address will not be published. Required fields are marked *