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Substance Use: Pregnancy and Breastfeeding

Frequently Asked Questions

​How do drugs, alcohol and tobacco affect my baby during pregnancy?

During pregnancy, alcohol, tobacco and tobacco-like products, cannabis, and other drugs pass through the placenta to your growing baby. Your baby is still developing so they can’t break down these substances as easily as you can. These substances could lead to harmful effects on your baby’s health, brain development and growth during pregnancy. They can also cause long-term problems after your baby is born or later in life.

Is it okay to drink beer or wine, if I don’t drink hard liquor?

No. A bottle of beer, a glass of wine, and a shot of hard liquor all have the same amount of alcohol. This means they all have the same effect and can harm your baby. Avoid drinking alcohol while you’re pregnant or thinking about becoming pregnant.

My friend drank alcohol during her pregnancy and her baby seems fine. Is it okay for me to drink?

Alcohol affects each pregnant woman and her baby differently. Drinking alcohol can affect your baby’s health and organs at any stage of your pregnancy. Once your baby’s developing brain or other organs are damaged, they can’t be fixed. The effects can be different at different stages of your pregnancy. You can see some of the effects when your baby is born, but other effects may not show up until your child is older. It's safest not to drink alcohol while you're pregnant.

Is it more harmful to my baby if I keep using alcohol and drugs or if I stop using them and go through withdrawal during pregnancy?

The effects of alcohol and each type of drug is different. It’s important to talk with your healthcare provider about whether it’s more harmful for you to keep using or stop using alcohol and drugs during pregnancy.

What if I drank alcohol or used drugs before I knew I was pregnant?

The effects of alcohol and drugs on your baby will depend on many things. Talk to your healthcare provider if you drank alcohol or used drugs before you knew you were pregnant so they can better understand what the risks are for you and your baby.

Someone told me you shouldn’t drink alcohol in the first 3 months of pregnancy, but after that it’s okay. Is this true?

No. Using alcohol and other drugs can be harmful to your baby during your whole pregnancy. There are different effects that can happen at different stages of pregnancy. Talk to your healthcare provider if you have questions about alcohol or drug during your pregnancy.

Since cannabis (marijuana, hashish, hash oil) is legal in Canada, does that mean it’s safe to use during pregnancy?

No, it is not safe to use cannabis when you are pregnant. Your baby’s health can be affected by using any type of cannabis product. Babies exposed to cannabis are more likely to have:

  • a low birth weight
  • problems with sleep and self-soothing (being able to calm themselves down)
  • abnormal brain development
  • slower growth
  • disabilities
  • problems with behaviour

Until more is known about the short- and long-term effects of cannabis on babies, it’s safest to not use cannabis while pregnant. Talk with your healthcare provider about cutting down and quitting cannabis. If you use cannabis for medical reasons, talk with your health care provider about finding a safer option while you’re pregnant.

Is it too stressful to quit smoking during my pregnancy?

Smoking, vaping and using tobacco products put your unborn baby at risk for problems as they develop and grow. Smoking during pregnancy can also lead to your baby having a low birth weight and heart defects.

It can be hard to stop using tobacco. Many people have to try many times before they can quit. But each time you try, you’ll learn new things to help you quit. You may find it helps to learn what triggers make you want to smoke, vape or use other tobacco products. If you can’t stop using tobacco, try cutting down on the amount you use in a day.

Talk with your healthcare provider about quitting using tobacco or if you’re worried about quitting. For information on ways to quit, go to Alberta Quits.

If smoking can cause a low birth weight, does that mean I’ll have an easier birth if I smoke?

No. A smaller baby does not mean an easier labour and birth. Smaller babies are more likely to have health issues and may have to stay in the hospital longer.

Is it dangerous for me and my baby to be around second-hand smoke or vapour?

Yes. When others smoke or vape around you and your baby, you are both exposed to second-hand smoke or vapour.

Second-hand smoke is the smoke that’s breathed out or that comes from the burning end of a cigarette or other tobacco product. Second-hand smoke can cause health problems for you and your baby. It puts you at risk for cancer, asthma and heart disease. Babies exposed to smoke from tobacco before and after birth have a higher risk for sudden infant death syndrome (SIDS), and health problems including lung conditions and ear infections.

Second-hand vapour is the mist made by vaping e-cigarettes. Second-hand vapour has chemicals (called toxins) that are dangerous to you and your baby. There are fewer toxins in vapour than in tobacco smoke, but at least 10 toxins in vapour are known to cause cancer, birth defects, and can harm both men and women’s reproductive systems.

What can I do to protect my baby from third-hand smoke?

Third-hand smoke is the chemicals left on clothing, furniture, and other surfaces from tobacco smoke. Before you smoke, put on a jacket or sweater to help protect your clothing from smoke and the harmful chemicals in tobacco smoke. After you smoke, take off the jacket or sweater and wash your face and hands before you hold and cuddle your baby. If you didn’t put on a jacket or sweater before smoking, change your clothes. This will help protect your baby from the chemicals in third-hand smoke.

Are over-the-counter and prescription medicine, supplements, and herbal products safe to use during pregnancy?

Talk with your healthcare provider about medicines, vitamin and mineral supplements, or herbal products that you take or plan to take while you’re pregnant. These products can pass through the placenta and affect your baby’s health. Some medicine, supplements, and herbal products can even cause birth defects.

Your healthcare provider can tell you which products are safe and give you more information. Take medicines, supplements and herbal products as prescribed by your healthcare provider. If they tell you to take a non-prescription medicine, take only what you need in the smallest amount.

Is it true that it’s okay to drink alcohol when breastfeeding?

No, alcohol passes to your baby through your breastmilk. It’s important to avoid alcohol when you’re breastfeeding. When you drink alcohol, the level of alcohol in your breastmilk is the same as the level in your blood. Drinking alcohol can also cause you to make less breastmilk and can affect your baby’s brain development.

What if I choose to drink alcohol while I’m breastfeeding?

If you choose to have an alcoholic drink once in a while, breastfeed before you drink and don’t have more than 1 standard drink. A standard drink is 148 ml (5 oz) of wine, 341 ml (12 oz) of beer or 44 ml (1 ½ oz) of liquor. After drinking, wait 2 to 3 hours before you breastfeed again. This is the amount of time it takes for the alcohol to leave your breastmilk.

If your breasts get uncomfortable before the 2 to 3 hours are up, express your milk with a pump or by hand. Don’t feed this breastmilk to your baby.

Canada’s Low Risk Drinking Guidelines recommend not drinking alcohol when you’re responsible for the safety of others. When you drink alcohol, you may not be able to properly care for your baby. Always plan ahead if you know you’re going to drink alcohol. Pump or express your breastmilk by hand and store it for later use. You can give your baby this breastmilk if they get hungry before the 2 to 3 hours are up.

If you choose to drink more, talk to your healthcare provider or call Health Link at 811 to learn how to lower the amount of alcohol your baby gets through your breastmilk.

Is it true that it’s okay to smoke or use other tobacco products while I’m breastfeeding?

No. If you smoke or use other tobacco products, nicotine from the tobacco passes into your breastmilk. This can make your baby less likely to feed, make them fussy, sleep poorly and spit up. The best thing you can do for you and your baby’s health is to quit using tobacco products or use them less. Breastmilk has many benefits, so keep breastfeeding even if you choose to use tobacco products. Breastfeed your baby first, before you use tobacco, so less nicotine passes through your breast milk. It’s important for you and others to not smoke around your baby.

Is it okay to use cannabis when breastfeeding?

No, women who are breastfeeding should not use cannabis. Cannabis can affect your mood, judgment and how you watch and care for your baby. Research shows that cannabis can affect a baby’s brain development and cause them to have slower movements and reactions. If you use cannabis, talk to your healthcare provider to learn more about the risks and about how to cut down or quit.

Where can I get help if I can’t quit smoking or using alcohol or drugs?

If you need help quitting smoking or using other tobacco, tobacco-like products, alcohol, cannabis and other drugs during or after pregnancy, talk to your healthcare provider.

Alberta Health Services offers addiction and mental health services including community and support programs, health assessment, and counselling. Call Alberta Health Services’ 24-hour Addiction Helpline at 1-866-332-2322, to talk to a trained counsellor and find out what services are available where you live. The Helpline is toll-free within Alberta.

For more information about pregnancy and breastfeeding, go to Healthy Parents Healthy Children.

Current as of: September 19, 2018

Author: Healthy Children and Families