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  Parenting Advice Column
  Subject: smoking during pregnancy

QUESTION:

My wife and I are due to have our first baby on June 2, 1997. My question to you is a great concern of mine, pretaining to the well-being of our unborn child. I am firmly against her smoking habit during her pregnancy, we had even agreed before our choice to bring a child into this world that she would not smoke during her pregnancy. I have no support from her family... and my wife continues to smoke about one pack a day. My fears are that the smoke may damage the development of our unborn child's organs and brain. Please tell me all the risks involved in smoking during pregnancy.

Thank You,

Glenn


JAN'S REPLY:

In order for you to find the best solution to this difficult situation, the real issue needs to be identified and addressed. Is it smoking, or is it a power struggle between the two of you? This type of conflict is not uncommon during a pregnancy, as both partners naturally feel somewhat out of control as nature takes over the helm.

For you and other parents who may find themselves in a struggle for power in their relationship, I'll address that issue first by recommending counseling with a therapist or mediator. Power struggles are much easier to defuse with the help of a competent third party who can help to sort out complicated issues and teach communication skills. Be sure to do a thorough word-of-mouth search for someone who is compassionate and competent (the local La Leche League might be a good source for recommendations).

I'm emphasizing the marital relationship because that is the larger issue. If there is difficulty with establishing a balanced and mutually respectful relationship, there will always be some specific issue that will arise - be it smoking or some other topic. Such issues can easily become clouded over by face-saving, blaming, resentment, and retaliatory behavior that can overtake a couple locked in a struggle for power.

As to the specific question of smoking during pregnancy, I will quote from The Womanly Art of Breastfeeding:

"You probably know some of the disturbing statistics on the effects of smoking. The potential hazards of smoking during pregnancy may have been incentive enough for you to quit or cut down. However, despite your best intentions you may find yourself still smoking when your baby is born, and you wonder how this will affect breastfeeding.

"The fewer cigarettes smoked, the less chance there is that difficulties will arise. By keeping smoking to a minimum, a mother can decrease the risk. Some mothers smoke and breastfeed with no problem. In general, if a mother smokes less than a pack (twenty cigarettes) a day, the amount of nicotine in her milk is not usually enough to cause any problem for the baby. Nicotine is not readily absorbed by the baby's intestinal tract and is rather quickly metabolized.

"When a nursing mother smokes heavily (more than twenty to thirty cigarettes a day), the risks increase. Heavy smoking can reduce a mother's milk supply and on rare occasions has caused symptoms in the nursing baby, such as nausea, vomiting, abdominal cramps, and diarrhea.

"One study found that smoking lowers prolactin levels in nursing mothers. In other studies, smoking has been shown to interfere with the let-down reflex. If a mother smokes, she should not do so while she is feeding the baby.

"Second-hand, or 'sidestream' smoke is potentially harmful for babies and young children. One study featured in Lancet, a British medical journal, found a significant correlation between parents' smoking habits and the incidence of pneumonia, bronchitis, and SIDS (Sudden Infant Death Syndrome) during their baby's first year of life.

"There are legitimate concerns about the effects of on a breastfeeding mother and her baby. The ideal solution is to avoid smoking. For those who can't seem to quit, cutting down is another option that might seem more within reach. When there are children in the family, it's best to limit smoking to a separate room, away from the children. Keep a window open or use an exhaust fan. Better yet, smoke only outdoors."

I just want to add here a recommendation to a mother smoking in a separate room, to do so only when there is someone else to stay with the baby. Leaving a baby unattended for any reason is a dangerous practice.

Here are a few of the many excellent web sites with information on this topic:

Jan

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