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Randomized Controlled Trial
. 2008 Dec;84(6):710-4.
doi: 10.1038/clpt.2008.119. Epub 2008 Jul 2.

Effects of breast pumping on the pharmacokinetics and pharmacodynamics of ethanol during lactation

M Y Pepino  1 , J A Mennella
Affiliations
Randomized Controlled Trial

Effects of breast pumping on the pharmacokinetics and pharmacodynamics of ethanol during lactation

M Y Pepino et al. Clin Pharmacol Ther. 2008 Dec.

Abstract

This study tested two hypotheses. First, that breast pumping contributes to the previously observed decrease in ethanol bioavailability in lactating women. Second, that the effects of breast pumping are more pronounced when ethanol is consumed after a meal. The within-subject factor was test condition (fed or fasted) and the between-subject factor was experimental group (pumped before, PB; pumped after, PA). Those randomly assigned to the PB group (N = 8) breast pumped 1 h before drinking, whereas those assigned to the PA group (N = 8) breast pumped 0.6 h after drinking. Pumping before drinking significantly decreased blood ethanol concentration (P < 0.05) and ethanol bioavailability (P = 0.05). Pumping after drinking sped up elimination (P = 0.008), attenuated ethanol-induced hypothermia (P = 0.002), and increased feelings of stimulation (P = 0.03). The effects were more pronounced when ethanol was consumed after a meal. Common neural/hormonal responses to food and suckling may contribute additive effects in altering the pharmacokinetics/pharmacodynamics of ethanol, and perhaps of other drugs, during lactation.

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Figures

Figure 1
Figure 1
Blood ethanol concentration curves over time in the two groups of lactating women. Group PB (N = 8; circles) breast pumped 1 h before, whereas group PA (N = 8; triangles) breast pumped beginning 0.6 h after drinking a 0.4 g dose of ethanol per kg of body weight. Open symbols depict values obtained during the overnight fasted condition, and closed symbols depict values obtained during the fed condition. The timing of breast pumping is indicated by the hatched box, and meal ingestion (for the fed condition) is shown by an arrow. There was a significant interaction between group and time [F(14,196) = 3.65; P < 0.05] and the effect of condition (fed or fasting) was also significant [F(14,196) = 11.38; P < 0.001].
Figure 2
Figure 2
Feelings of stimulation, as measured by the Biphasic Alcohol Effects Scale (BAES), during the fed condition. Group PA (N = 8; circles) breast pumped 1 h before, whereas Group PB (N = 8; triangles) breast pumped beginning 0.6 h after drinking ethanol, when blood ethanol concentrations were near peak levels. Group PB felt more of the stimulant effects of ethanol. *P < 0.05 when compared to respective baseline values. PA, pumped after; PB, pumped before.
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References

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