国际母乳会 N0-1487-27, 2004.4
There are plenty of reasons to quit smoking, both for you and your baby. You’ve probably heard about lots of them from health care providers, friends, family members, or other sources. But even if you can’t quit smoking breastfeeding your baby is still the best choice you can make.
为了妈妈和宝宝的健康，有很多戒烟的理由。你也许已经听到了很多这方面的原因，从医生，朋友，家人及其他信息来源等。但是，即便妈妈无法戒烟，母乳喂养依然可以作为最好的喂养选择。
Infants of smokers are at increased risk of colic, respiratory infections, and SIDS(Sudden Infant Death syndrome). But breastfed infants are at lower risk for these diseases compared to artificially fed infants, even when their mothers continue to smoke. And breastfeeding helps to protect babies from the potential risks of environmental smoke.
吸烟妈妈的宝宝罹患喊百日﹙肠绞痛﹚，呼吸道感染及SIDS（婴儿猝死综合症）的风险会增加。但母乳喂养的宝宝，即便他们的妈妈持续吸烟，他们罹患上述疾病的几率也比人工喂养的宝宝低。同时，母乳喂养也能为宝宝抵御二手烟的潜在威胁提供保护。
The American Academy of Pediatrics(AAP) recently made a change in its recommendations about smoking and breastfeeding. Nicotine was removed from its list of substances considered to be “contraindicated” during breastfeeding. An AAP statement issued in 2001 says, in part:
美国儿科学会（简称AAP）最近改变了他们对吸烟及母乳喂养的建议。将尼古丁从AAP的哺乳期禁用清单上去掉了。一份AAP2001年发布的声明中提到：（节选）
“One study reported that, among women who continue to smoke throughout breastfeeding, the incidence of acute respiratory illness is decreased among their infants, compared with infants of mothers who bottle fed. It may be that breastfeeding and smoking is less detrimental to the child than bottle feeding and smoking.”
“一项研究指出，相比起瓶喂的婴儿来说，在母乳喂养期间继续吸烟的母亲的婴儿罹患呼吸道疾病的几率是较少的。有可能吸烟妈妈母乳喂养较吸烟妈妈瓶喂对孩子的伤害更小。”
Breastfeeding provides significant health differences for mother and babies. For babies, it provides protection against diarrhea, certain kind of cancers, diabetes, and many other health challenges. For mothers, it protects against breast cancer, helps with postpartum weight loss, and encourages a unique mother-child bond that can’t be duplicated. Breastfeeding is just as beneficial for the smoking mother and her baby as it is for the nonsmoking mother and her baby. Here are some recommendations that can help minimize the potential effects of smoking on your baby.
母乳喂养能为妈妈和宝宝提供不同却显著的健康益处。对于宝宝来说，母乳可以使他们免受腹泻、某些癌症、糖尿病以及很多其它疾病的侵扰。母乳喂养也使妈妈们免于罹患乳腺癌，帮助妈妈在产后减重，并且鼓励妈妈与孩子建立一种无法复制的母婴纽带。母乳喂养对于吸烟的妈妈和不吸烟的妈妈及她们各自的宝宝都有同等的益处。以下是一些建议，可以帮助妈妈们最大限度的降低吸烟对宝宝的影响。
SMOKE AS FAF AWAY FROM YOUR BABY AS POSSIBLE
吸烟时尽量远离宝宝
To prevent exposing your baby to environmental tobacco smoke and particulates small enough to inhale, any smoker in your household should smoke outside or at least in a room away from the baby.
为了避免宝宝吸环境中的二手烟以及吸入微小的颗粒物，建议家庭里所有的吸烟者都最好在室外吸烟，至少在一个远离宝宝的房间里吸烟。
Some health care providers suggest that family members who smoke should always wash their hands after smoking and before touching the baby. A smoker can also wear a jacket or other outer garment while smoking to protect clothing from smoke particles. This garment may be removed before reentering the home or having any contact with the baby so the baby will be exposed to fewer smoke particles.
也有一些医生会建议吸烟的家人在吸烟后及与宝宝接触前要洗手。也可以在吸烟时穿件外套或者一件专门的外衣作为吸烟服，这样可以保护衣物不沾染上烟的微粒。在回到家中或与宝宝接触前脱掉这件外衣，这样宝宝就能更少的暴露在烟的微粒中。
CUT DOWN ON SMOKING
减少吸烟量
Fewer cigarette smoked means less environmental smoke in the air, lower levels of nicotine in your milk, better health for everyone, and more time with your baby.
少吸一根烟就意味着空气中二手烟更少，乳汁中的尼古丁更少，对大家的健康都有益，妈妈还有更多的时间陪伴宝宝。
MONITOR YOUR BABY’S WEIGHT GAIN
监控宝宝的体重增长
Some research suggests that smoking affects a baby’s weight gain, while other research shows no difference between babies of smoking and nonsmoking mothers. In light of these conflicting findings, it makes sense to monitor your baby’s weight gain at regular well-baby checkups. If you are worried about your baby’s growth, talk to a La Leche League Leader or knowledgeable health care providers. There are many techniques you can use to increase your milk supply.
一些研究认为妈妈吸烟会影响宝宝的体重增长，而另一些研究又认为无论是吸烟还是不吸烟的妈妈，她们宝宝的体重增长没有差异。鉴于这些结论不一的研究发现，吸烟妈妈最好带宝宝做定期的健康检查，如果担心宝宝的体重，和母乳会的哺乳辅导或专业医疗保健人员谈一谈，有许多方法可以增加母乳量。
SMOKE RIGHT AFTER BREASTFEEDING INSTEAD OF JUST BEFORE
吸烟最好选择在哺乳之后，避免在喂奶之前
When a breastfeeding mother smokes a cigarette, the nicotine levels in her blood and milk first increase and then decrease over time. Therefore, smoking right after feeding minimize the amount of nicotine in the milk. About 90 minutes after smoking, the level of nicotine in the mother’s blood and milk decreases by about half. Your baby will probably want to nurse frequently in the early weeks, so you may not always be able to wait that long between smoking and the next feeding. Frequently nursing is good for your milk supply and assures that your baby gets enough to eat.
母乳妈妈吸烟时，血液及乳汁中的尼古丁含量是先升高，经过一段时间后才降低的。因此，在哺乳后再吸烟可以将乳汁中的尼古丁含量控制到最低。90分钟后，血液及乳汁中的尼古丁下降将近一半。在最开始的几周，宝宝需要频繁哺乳，所以妈妈不一定每次都能在吸烟和哺乳间间隔那么长的时间。频繁的哺乳有益于增加乳汁分泌，以便宝宝能够摄入足够的乳汁。
SMOKING CESSATION AIDS
戒烟帮助
Commercial products may help you quit smoking and their use protects your whole family from carbon monoxide and respiratory irritants in the air. If you use nicotine gum or lozenges, treat them as you would a cigarette- use them right after a nursing so that blood levels of nicotine have time to fall before the next nursing. Transdermal nicotine patches provide a steady level of nicotine in your blood and milk. That level will be lower than the level of nicotine when smoking. Consider removing the patch at night to reduce levels of nicotine during nighttime nursing.
一些市售的尼古丁替代产品可以帮助戒烟，也能够保护全家免受一氧化碳及空气中的呼吸道刺激物的侵害。如果妈妈使用尼古丁香口香糖或喉糖，和吸烟的处理方式一致：需在哺乳后使用，这样血液中的尼古丁可以有足够的时间在下次哺乳前代谢掉。通过皮肤接触的尼古丁贴片在血液及乳汁中维持稳定的尼古丁浓度。这种含量要比直接吸烟的量低。为了晚间的哺乳，最好在睡前将贴片揭掉以降低尼古丁的含量。
Breastfeeding mothers should be especially careful not to smoke cigarette while using such products. Smoking relapses while using replacement products may produce very high levels of nicotine in your blood and milk that could be dangerous.
母乳妈妈需特别注意在使用以上产品时不要吸烟，在使用替代产品时吸烟会使血液及乳汁中的尼古丁浓度太高，这样危害更大。
EARLY WEANING?
会提前断奶么？
Some research seemed to indicate that mothers who smoke wean earlier than mother who don’t. However, recent review of such studies suggests that there may not be a physical reason for early weaning. Some experts believe that mothers who continue to smoke may quit breastfeeding because of concerns about whether it’s safe for their babies. More research is needed to determine whether earlier weaning is caused by some physical effect of smoking or some other factor. Mothers need to remember that breastfeeding protects their babies from the very respiratory diseases they may be worried about.
一些研究指出吸烟的妈妈会比不吸烟的妈妈提前断奶。但最新的研究表明有可能并不是身体的原因所导致的。一些专家认为继续吸烟的妈妈有可能是因为担心对宝宝不安全而选择提前断奶。还没有更多的研究来判定提前断奶是由于吸烟对身体影响还是其它的因素所导致。母乳妈妈谨记，母乳喂养可以保护宝宝免受她们所担心的呼吸疾病的困扰。
CONCLUSION
结论
Decide what is realistic for you to do. Some mothers quit smoking during pregnancy and while they are breastfeeding. Other mothers try to minimize the effects of smoking by smoking in a different room from the baby, allowing as much time as possible between smoking a cigarette and the next breastfeeding, and by keeping the number of cigarette smoked per day as low as possible. Less smoking in your household will be good for your whole family’s health, not just your baby’s. But even if you don’t quit or cut down on smoking, breastfeeding still provides important health benefits for both you and your baby.
妈妈需决定什么是对于自己来说最现实的做法。有些妈妈在孕期及哺乳期都戒了烟。而另一些妈妈尝试最低限度的降低吸烟的影响，她们选择不在宝宝的房间里吸烟，在吸烟和下一次哺乳之间间隔足够长的时间，以及最大限度的降低每天吸烟的支数。减少吸烟不仅对小宝宝有益，同时有益于全家人的身体健康。但即便妈妈不能戒烟或减少吸烟量，母乳喂养依然为妈妈和宝宝带来重要的健康优势。
Our thanks to Amy Conway and Kathy Koch, IBCLC, for their help in compiling this information.
感谢国际认证专业哺乳顾问Amy Conway和Kathy Koch为编辑本信息单页所提供的帮助。
(Jerry Jie翻译 Shiuh-jane、Daisy审稿)
References:
American Academy of Pediatrics Committee on Drugs. The transfer of drugs and other chemicals into human milk. Pediatrics 2001;108(3):776-89.
Amir, L. H. Maternal smoking and reduced duration of breastfeeding: a review of possible mechanisms. Early Hum Dev 2001; 64(1):45-67.
Hale, T. Medications and Mothers’ Milk. Amarillo, TX: Pharmasoft Publishing, 2002.
Haug, K. et al. Secular trends in breastfeeding and parental smoking. Acta Paediatr 1998; 187(10):1023-27.
Mohrbacher, N. and Stock, J. The Breastfeeding Answer Book. Schaumburg, IL: LLLI, 2003.
Nafstad, P. et al. Breastfeeding, maternal smoking and lower respiratory tract infections. Eur Respir J 1996; 9:2623-29.
Ratner, P. et al. Smoking relapse and early weaning among postpartum women: is there an association? Birth 1999; 26(1):76-82.
Steldinger, R. and Luck, W. Half lives of nicotine in milk of smoking mothers: implications for nursing. J Perinat Med 1988; 16:261-62.
The Womanly Art of Breastfeeding. Schaumburg, IL: LLLI, 2004.
Woodward, A. et al. Acute respiratory illness in Adelaide children: breastfeeding modifies the effect of passive smoking. J Epidemiol Community Health 1990; 44:224-230.