In a nutshell: Using e-cigarettes won't affect your ability to breastfeed but it will almost certainly have some effect on your breastmilk. But experts agree that, if you vape, it's better for your baby that you continue breastfeeding than stop breastfeeding.

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How does vaping affect breastmilk?

There haven't been any studies on the long-term effects on a breastfeeding baby of a mother who vapes. But we do know that there's nicotine in almost all e-cigs, which will be absorbed into your bloodstream when you vape, and we also know from studies on regular cigarette smoking¹ that absorbed nicotine is present in breastmilk and can affect your baby – by disrupting their sleep patterns, for example.

Nicotine in your bloodstream is also known to affect both the supply and the composition of your breastmilk².

And nicotine is not the only potential issue: e-cigs also contain ingredients like glycerol, propylene gylcol and flavourings, all which can pass into your bloodstream when inhaled. There have been studies³ that suggest that, once in your bloodstream, many of these flavourings may trigger an inflammatory response in your white blood cells. But we really can't say for sure yet whether or not the flavourings have any specific impact on breastmilk.

Despite all of this, it's important to know that current NHS advice is that, if you do choose to use an e-cigarette to help you quit smoking, it's still better to carry on breastfeeding as it's thought that the overall benefits to your baby of breastfeeding outweigh any potential harm from vaping4.

Is vaping better than smoking if you're breastfeeding?

Yes – if vaping is helping you quit smoking.

It is a better option than smoking but, as we've seen, vaping is still not a safe or healthy lifestyle choice – because e-cigs still contain nicotine, and their liquid and vapour can contain toxic chemicals.

If you're looking to give up smoking, the NHS currently advises new parents to use nicotine replacement patches or gums (NRT), rather than vapes. That's because we currently know more about the safety and risks of NRT, while as yet there are many unanswered questions about the safety of e-cigarettes.

If I do vape, what can I do to minimise the risk to my baby?

If you are going to vape when breastfeeding, do make sure you vape after you've done a feed, so you can leave a big gap between your last vape and your next breastfeed. This will help you ensure that there's the least possible amount of nicotine in your breastmilk by the time your baby needs to feed.

It’s also wise to make sure you vape outdoors, and away from your baby. Although you only exhale tiny amounts of nicotine and other toxins when you vape, we don't know enough yet about the long-term effect on babies of passive vaping.

Dr Philippa also offers the reminder that, when it comes to pregnancy, "vaping is still not considered safe; quitting entirely is still the best option". So if you are hoping / planning to have another child, you should aim to give up completely before you get pregnant again if you can.

Getting help to quit vaping

It goes without saying that the best thing to do for both you and your baby is to try and quit nicotine, and give up vaping altogether– especially if you are hoping to have another child, as there's no evidence that vaping in pregnancy is safe.

Your GP surgery may have smoking cessation advice. If you're in England, you may also find it useful to call the National Smokefree helpline on 0300 123 1044; in Scotland, call Smokeline on 0800 848484; in Wales, call Help Me Quite Wales on 0800 0852219. The Northern Irish helpline has closed but you can find support at StopSmokingNI.. You can also visit the NHS Smokefree Facebook page

Pics: Getty

References

1. Breastfeeding and Smoking: Short-term Effects on Infant Feeding and Sleep. Menella et al, Pediatrics 2007 Sep; 120)(3): 497-502.
2. Tobacco smoking and breastfeeding: effect on the lactation process, breast milk composition and infant development. A critical review. Napierala et al. Environmental Research 2016;151;321 to 338.
3. Inflammatory and Oxidative Responses Induced by Exposure to Commonly Used e-Cigarette Flavoring Chemicals and Flavored e-Liquids without Nicotine, Thivanka Muthumalage et al, Front. Physiol., 11 January 2018. DOI: 10.3389/fphys.2017.01130
4. Breastfeeding and Smoking. NHS Online

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Authors

Dr Philippa Kaye works as a GP in both NHS and private practice. She attended Downing College, Cambridge, then took medical studies at Guy’s, King’s and St Thomas’s medical schools in London, training in paediatrics, gynaecology, care of the elderly, acute medicine, psychiatry and general practice.

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