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Smoking during pregnancy and breastfeeding

Stopping smoking when you are pregnant is the right choice for you and your baby.

What effect does smoking have on me?

  • Smoking is a major cause of heart and lung disease.
  • Smoking is the major cause of lung cancer and also causes cancers of the cervix, mouth, throat, bladder, pancreas, kidneys and stomach.

What effect does my smoking have on my baby?

  • An increased risk of miscarriage.
  • An increased risk of preterm labour. Preterm babies are susceptible to infection and breathing difficulties because their internal organs are not properly developed.
  • An increased risk of your baby weighing less at birth simply because you smoked.
  • A higher risk of complications during childbirth.
  • An increased chance of perinatal illness and death (your baby being sick or dying at or shortly after birth).
  • A higher risk of sudden infant death syndrome (SIDS).
  • There is evidence showing that babies who were exposed to smoking during pregnancy may be at risk of having cognitive, behavioural and developmental deficits.

What does tobacco smoke contain and how does it affect my baby?

Tobacco smoke contains toxic chemicals. When you smoke, these chemicals are absorbed into your blood and passed to your baby through the umbilical cord. Carbon monoxide replaces the oxygen in your blood, reducing the amount of oxygen available to your baby. Nicotine causes your blood vessels to narrow, reducing the flow of blood through the umbilical cord and the amount of nutrients being provided to your baby. It also decreases your baby's ability to exercise their chest muscles in preparation for breathing after birth.

Passive smoking

If you are a non-smoker, being exposed to tobacco smoke from your partner, family and friends exposes you and your baby to these toxic chemicals as if you were smoking.

Young children are more susceptible to the health effects of tobacco smoke because their lungs are smaller and more delicate and their immune system is still developing. Babies and children who are exposed to tobacco smoke have an increased risk of:

  • sudden infant death syndrome (SIDS)
  • bronchitis, pneumonia, and other lung or airway infections
  • respiratory symptoms such as coughing and wheezing
  • middle ear disease

Breastfeeding

Nicotine and other chemicals from tobacco are passed from your breast milk to your baby. This is not healthy for your baby, but it is better than not breastfeeding at all as breast milk contains many essential nutrients for your baby. Nicotine alters the flavour of breast milk and your baby may refuse the breast. Research shows that women who smoke tend to produce less milk and wean their babies earlier.

If you are having trouble quitting, consider the damage every cigarette is causing and decide whether smoking is worth the risk to you or your child. Try not to smoke before or during feeds and preferably go outside to smoke.

Common myths and untruths

Having a low birth weight baby just means a quicker and easier birth. There is nothing wrong with that.

Having a low birth weigh baby does not make things easier for your or your baby during birth. Labour with a low birth weight baby is no longer or shorter that labour with an average size baby.

Smoking relaxes me. That must be better for my baby.

Smoking may calm you down but it also speeds up your heart rate and increases your blood pressure. Every time you inhale tobacco smoke, the carbon monoxide level in your blood stream increases. This replaces the oxygen in your blood, reducing the amount of oxygen available to your baby. This is definitely not better for your baby.

What is the point of stopping now? The damage is already done.

Stopping smoking at any stage during your pregnancy reduces the ongoing harmful effects each cigarette has on your baby.

I have cut down on my smoking. That is good enough.

There is no safe level of smoking. Planning to quit smoking as soon as you can is best for your baby.

I will put on too much weight if I stop smoking.

Nicotine suppresses your appetite so you may find you will eat more after you stop smoking. Eating a range of healthy foods is one of the best ways to stay within a healthy weight range. Physical activity can also help so speak to your doctor before starting any new physical activity program.

How to stop smoking

Making your home a smoke-free-zone will help you to stop smoking and reduce your baby's' exposure to the harmful effects of tobacco smoke.

Discuss stopping smoking with your GP, midwife, pharmacist or community health worker; they can help you plan a strategy to help you stop smoking.

Nicotine replacement therapy

Discuss the use of Nicotine Replacement Therapy (NRT) with your doctor. It should be considered only after you have been unsuccessful in your attempts to stop smoking. Your doctor will consider a risk /benefit approach for you and your unborn baby. That is, weighing up the risks of NRT against the harm of continued smoking. It is recommended that pregnant women who smoke use intermittent, rather than continuous, nicotine replacement preparations and use the lowest dose possible to achieve control. It is also recommended, when possible, to delay therapy until the second trimester in order to avoid any risk to the developing baby. It is not recommended that pregnant women continue to smoke while using NRT.

Resources

  • CHAMP Clinic: this clinic at Mater Mothers Hospital can offer pregnant women information strategies and support to help you stop smoking. Please contact CHAMP on telephone 07 3163 2417.
  • Quitline: 13 QUIT (13 78 48) provides free information, practical assistance and support. Quitline's trained counsellors are available seven days a week to help you get through the process of quitting.
  • http://www.quitnow.gov.au/
  • www.cancerqld.org.au

References

  1. Van Meurs K. Cigarette smoking, pregnancy and the developing fetus. Stanford Medical Review 1999; 1:14-16.
  2. Queensland Government and The cancer Council of Queensland. Smoking and pregnancy. 2010.
  3. Bittoun R and Femia G. Smoking cessation in pregnancy. Obstetric medicine 2010; 3: 90–93.
Mater acknowledges consumer consultation in the development of this patient information.
Last modified 05/11/2015.
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