Medical Director of the South African Breast milk Reserve (SABR), Dr Mhleli Masango, explains how mothers who smoke during or after pregnancy not only affect their own health, but they can also cause permanent harm to their babies.
As we observe Anti-Tobacco Campaign Month, it is our collective responsibility to educate and support mothers to both limit the harm that their smoking may cause to their children and to stop smoking altogether.
There is no doubt that smoking during pregnancy can harm your unborn child. Tobacco use during pregnancy has been conclusively linked to increased chance of miscarriage, premature birth and low birth weight. It also increases the chance of Sudden Infant Death Syndrome (SIDS) and birth defects like cleft palates.
Many mothers stop smoking during pregnancy but then resume once their baby is born. However, dozens of scientific studies have shown that exposure to even small amounts of cigarette smoke or nicotine in your breast milk can significantly harm your baby.
Children of smokers are far more prone to pneumonia, asthma, ear infections, bronchitis, sinus infections, eye irritation and croup. They are also more likely to suffer from colic, and visit their doctors three times more than children of non-smokers. Perhaps worst of all, children whose parents smoke are more likely to become smokers themselves.
Undoing the harm
The only guaranteed way to prevent this harm is to stop smoking, but mothers who are unable to quit can limit the harm by smoking outside, away from their babies, and by ensuring that no one else smokes near their babies.
They can also smoke immediately after breastfeeding to cut down on the amount of nicotine in their milk. It takes 95 minutes for half of the nicotine to be eliminated from your body, so mothers should wait as long as possible between smoking and nursing.
Mothers who struggle to quit smoking should not stop breastfeeding. The benefits of breastfeeding outweigh any harm caused by smoking; breastfeeding actually counteracts some of the effects of smoking but the best solution is still to quit completely.
Unfortunately, even with these preventative measures, smoking makes it harder to breastfeed. Smoking has been conclusively linked to earlier weaning, with the heaviest smokers tending to wean the earliest. It also lowers milk production and interferes with the flow of milk while nursing.
South African law recognises the dangers of smoking and is making it increasingly difficult to smoke near other people. For example, it is now illegal to smoke in any car, including your own, if one of the passengers is under 12 years old. It’s also illegal to smoke on the premises (including outside of buildings) of any properties used for commercial childcare activities, schooling or tutoring.
Smoking is no longer allowed outside of designated areas in any public buildings, including all restaurants, bars and other businesses. This even includes smoking in partially enclosed areas like balconies and parking areas. The fines for both smokers and property owners are steep.
While it’s not currently illegal to smoke while pregnant, we should expect the laws to continue to tighten. Smoking is increasingly seen as both anti-social and unacceptable. We recognise that quitting can be difficult, but during Anti-Tobacco Campaign Month we urge all parents to make a concerted effort to become smoke free.