Maternal smoking and alcohol use in association with breastfeeding initiation, duration, and infant health – a scoping review

Nakijoba, R ORCID: 0000-0002-6626-0329, Isabella, K, Kiguba, R, Waitt, C ORCID: 0000-0003-0134-5855 and Atuyambe, LM (2025) Maternal smoking and alcohol use in association with breastfeeding initiation, duration, and infant health – a scoping review Women S Health, 21. 17455057251352297-. ISSN 1745-5057, 1745-5065

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Abstract

Introduction: Excessive alcohol consumption is associated with reduced milk production, altered milk composition, and increased risk of adverse outcomes such as sudden infant death syndrome (SIDS), highlighting the importance of managing alcohol intake during breastfeeding. Additionally, maternal smoking is associated with challenges in breastfeeding initiation and an elevated risk of infant respiratory issues, with a significant proportion of women resuming smoking postpartum. The review examined the association between maternal alcohol consumption and smoking during pregnancy and postpartum with breastfeeding initiation, continuation, and infant health. Methods: A scoping review was conducted through a comprehensive search of PubMed, ScienceDirect, and Scopus for human studies on the association of alcohol consumption and smoking during breastfeeding, including articles up to April 2024. The primary focus was to examine the association with maternal alcohol use, smoking, and breastfeeding initiation and continuation. Retrospective and prospective observational studies, as well as clinical trials, were included if they assessed the association between smoking and alcohol on breastfeeding, and infant health. Results: Alcohol consumption was not associated with breastfeeding duration. However, maternal smoking during pregnancy was associated with a shorter breastfeeding duration and an increased risk of childhood overweight up to 7 years of age. Maternal smoking was also linked to adverse mental health outcomes in offspring, including elevated levels of anxiety, depression, and neuroticism. Additionally, breastfeeding rates across different populations were also associated with socioeconomic factors, such as maternal age, educational attainment, and socioeconomic status. Conclusion: This study demonstrates that alcohol consumption was unrelated to breastfeeding duration. Addressing maternal smoking, alcohol use, and breastfeeding requires more than education, as sustainable behavior change is often hindered by limited resources. Public health strategies should focus on addressing socioeconomic and structural barriers while also acknowledging the diverse circumstances of individuals who may not conform to traditional expectations of pregnancy and parenting. It is Important to consider the unique needs and experiences of all individuals, respecting their autonomy and choices in the context of their health and well-being.

Item Type:	Article
Uncontrolled Keywords:	breastfeeding, pregnancy, alcohol, smoking, infant
Divisions:	Faculty of Health & Life Sciences Faculty of Health & Life Sciences > Inst. Life Courses & Medical Sciences Faculty of Health & Life Sciences > Inst. Life Courses & Medical Sciences > Inst. Life Courses & Medical Sciences (T&R staff) Faculty of Health & Life Sciences > Inst. Life Courses & Medical Sciences > Women's & Children's Health
Depositing User:	Symplectic Admin
Date Deposited:	14 Oct 2025 07:13
Last Modified:	28 Feb 2026 20:40
DOI:	10.1177/17455057251352297
Related Websites:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3194829
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