Smoking and Breastfeeding – CNGOF-SFT Expert Report and Guidelines on the management for Smoking Management During Pregnancy

Tabagisme et allaitement — Rapport d’experts et recommandations CNGOF-SFT sur la prise en charge du tabagisme en cours de grossesse

Maela Le Lous (1) , Héloïse Torchin (2, 3)

1 LTSI - Laboratoire Traitement du Signal et de l'Image
2 AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris]
3 CRESS (U1153 / UMR_A 1125) - Centre for Research in Epidemiology and Statistics | Centre de Recherche Épidémiologie et Statistiques

Introduction - The consequences of smoking have been studied more during pregnancy than during breastfeeding. There is a passage of nicotine and other substances in breast milk and some modifications of milk composition. The objectives of this chapter are to study the benefits of breastfeeding in women who smoke, and the adaptation of smoking, medication and behavioral habits in case of incomplete withdrawal to better guide women. Methods - The Medline database, the Cochrane Library and foreign guidelines from 1999 to 2019 have been consulted. Results - The conservation of the benefit of breastfeeding in smokers with regard to the prevention of respiratory infections, infantile colic, cognitive deficits, obesity, sudden infant death, is not known to date. It is therefore not recommended to include smoking status in the choice of feeding mode for the newborn (professional agreement). However, since breastfeeding is a factor associated with a reduction in smoking and/or withdrawal (NP2), it is recommended to promote breastfeeding in non-weaned women in order to limit smoking (grade B). The use of nicotine replacement therapy is possible during breastfeeding (professional agreement). In the absence of data, bupropion (Zyban®) and varenicline (Champix®) are not recommended for women who are breastfeeding (professional agreement). A free interval between smoking and breastfeeding reduces the concentration of nicotine in milk (NP4). For non-weaned women who are breastfeeding, it is therefore recommended not to smoke just before breastfeeding (professional agreement). Conclusion - The results indicate that breastfeeding is possible in smokers, although less often initiated by them. If the conservation of its benefits for the child is not demonstrated to date, breastfeeding allows the mother to limit smoking.

Mots clés: Tobacco; Smoking; Cigarettes; Breastfeeding; Nicotinic substitutes; Lower respiratory tract infections; Cognition; Infantile colic; Sudden infant death syndrome

Mots clés: Tabac; Traitement substitutif; Infections respiratoires basses; Cognition; Coliques du nourrisson; Mort inattendue du nourrisson; Cigarettes; Allaitement

Domaines: Ingénierie biomédicale; Gynécologie et obstétrique

Maela Le Lous, Héloïse Torchin. Tabagisme et allaitement — Rapport d’experts et recommandations CNGOF-SFT sur la prise en charge du tabagisme en cours de grossesse. Gynécologie Obstétrique Fertilité & Sénologie, 2020, 48 (7-8), pp.612-618. ⟨10.1016/j.gofs.2020.03.032⟩. ⟨hal-02563157⟩