Can I breastfeed if I smoke?

The verdict

Keep breastfeeding. This surprises people who assume that a substance they should not be taking must automatically rule out feeding, but the arithmetic runs the other way.

The NHS states that if you smoke, it is important not to stop breastfeeding, because breast milk protects your baby against infections and diseases and provides nutrition that formula cannot. Breastfeeding partly offsets some of the risks that smoking creates for a baby, which means stopping feeding removes protection while leaving the exposure in place.

That is a different statement from saying smoking is fine. It is not, and the single most useful thing on this page is that support to stop is free, is available while breastfeeding, and works far better than willpower alone.

What passes into milk, and what matters more

Nicotine does pass into breast milk. LactMed's entry on nicotine records that cigarette smoking reduces milk yield, that maternal smoking is a major risk factor for sudden infant death syndrome, and that nicotine in the breast milk of smokers appears to reduce heart rate variability in male breastfed infants.

Two things follow. First, smoking can reduce supply, which is a practical reason many parents notice before any of the theoretical ones. Second, and more importantly, the dominant risk to your baby from smoking is not what is in your milk. It is the smoke in the air and the residue on skin, hair and clothes.

That distinction changes what you should do. Cutting out feeds does almost nothing about the main risk. Making the home and car completely smoke-free does almost everything.

The two rules that are not negotiable

Never share a bed with your baby if anyone in it smokes

The NHS states that if you or your partner smoke, it is important not to share a bed with your baby. The Lullaby Trust lists smoking, including the baby having been exposed to smoking in pregnancy, among the circumstances in which co-sleeping is very dangerous, and says that in those scenarios it is always best to put baby in their own sleep space.

This applies even if nobody smokes indoors and even if nobody has smoked that day. Unicef UK's figures place the risk of SIDS while co-sleeping with a regular smoker at around one in 919, against a background risk for all babies of around one in 3,710.

Our page on feeding lying down covers how to plan night feeds when bed-sharing is not an option for you.

Make the home and car completely smoke-free

The NHS advises that if you or your partner smoke, making your home completely smoke-free will help protect your baby's health. Smoking out of a window, in another room or with the extractor on does not achieve this. Smoke outside, and never in a car with a child in it, which is illegal in the UK regardless.

Timing feeds around cigarettes

The NHS advice is to avoid smoking before breastfeeding your baby, to limit the amount of nicotine in your breast milk. In practice that means smoking straight after a feed rather than before one, which gives the longest possible gap before the next.

Do not extend that principle into skipping or replacing feeds. There is no version of this where withholding milk improves the outcome. Feed on demand, and organise cigarettes around feeds rather than feeds around cigarettes.

Wash your hands and, if you can, change or cover the outer layer you smoked in before picking your baby up. Third-hand residue on clothing and hair is a real exposure route for a baby whose face is pressed against you for hours a day.

Quitting while breastfeeding

This is the part of the page worth acting on. The NHS runs free local stop smoking services, and they support breastfeeding parents specifically.

On nicotine replacement therapy, the NHS states that a small amount of nicotine from NRT products passes into breast milk, but the amount from NRT is lower than from smoking, and that NRT is a safer choice than exposing your baby to secondhand smoke. LactMed records that the Academy of Breastfeeding Medicine considers nicotine replacement products to be compatible with breastfeeding, with the type of product determined by the clinical needs of the breastfeeding mother.

We publish no doses on this site, so ask the stop smoking service or a pharmacist which product and strength suits you. What matters here is the principle: using NRT while breastfeeding is supported, and it is not a reason to wean.

If you are using an e-cigarette instead, our page on vaping while breastfeeding covers the position, which is different again.

Where guidance differs

Nowhere meaningfully, on the central question.

The UK, through the NHS, says it is important not to stop breastfeeding if you smoke, to avoid smoking before a feed, to make the home smoke-free, and never to bed-share.

Australia, through the Australian Breastfeeding Association, says that if you are breastfeeding or caring for a young baby it is best not to smoke or vape, but that if you cannot stop, breastfeeding is still recommended because it helps protect your baby from the harmful effects of smoking.

Canada, through the Canadian Paediatric Society, emphasises that being smoke-free before and after birth decreases a baby's risk of SIDS, and that second-hand smoke, including cannabis smoke, increases that risk after birth.

Internationally, the Academy of Breastfeeding Medicine's protocol on substance use takes the same approach: treat the smoking, not the feeding.

The consistent message across all of them is that smoking is a reason to get help stopping, and never a reason to stop breastfeeding.