While many women stop smoking during their pregnancy to avoid passing on the harmful effects of nicotine to their unborn children, many do not know that they can also expose their newborns to nicotine if they smoking while they breast-feed their babies.

And no, smoking away from breast-feeding babies does not spare them from the harmful effects of nicotine

The Health Promotion Board revealed that a study conducted in Canada discovered that cotinine levels were particularly high in babies whose mothers smoked and breast-fed. Cotinine is the major breakdown product of nicotine, and its levels are used to track exposure to tobacco smoke.

Mothers can expose their babies to nicotine not only through second hand tobacco smoke, but also through their breast milk.

And the rise in the number of women smokers in Singapore have caused increasing concern for the health of babies born to these mothers.

Dr Beh Suan Tiong, president of the Obstetrical & Gynaecological Society of Singapore, said: "The increase in young women smokers in Singapore presents a growing concern, particularly in view of the lack of awareness about the transmission of nicotine to their babies through breast milk.

"It is important for breast-feeding mothers to understand the health risks they are exposing their infants to."

How breastfeeding mothers who smoke can affect their baby

Cotinine levels found in babies who are breastfed by smoking mothers are almost as high as an adult who smokes about 20 cigarettes a day, because cotinine levels in breast milk are three times higher than the cotinine levels that are found in the mothers' bloodstreams.

Smoking also affects the milk production in mothers, as nicotine reduces the production of hormones that stimulate milk production, and could also interfere with the reflex muscle that "releases" the milk. This can lead to underfed babies.

Babies exposed to tobacco could also experience nicotine withdrawal - so mothers may find their babies more likely to suffer from sleeping difficulties and excessive crying. Nicotine present in the breast milk could act as an appetite suppressant and babies could reject the breast milk due to a change in taste.

In serious cases where the mother is an excessive smoker who smokes more than 15 cigarettes a day, babies can suffer from nicotine poisoning which could turn their skin grey and cause vomiting, cramping, diarrhoea, rapid pulse and restlessness.

Switching to a formula diet for newborns may not be an optimum solution either.

Ms Alderline Wong, vice president of the Breastfeeding Mother's Support Group, said:  "Mothers should refrain from smoking and breast-feed their babies as breast-feeding not only nurtures the special bond between mother and baby, but breast milk is packed with nutrients and important growth factors, and helps growing babies fight diseases."

Also, using formula milk still does not negate the effects of second-hand tobacco smoke.

Learn more about the Mother's Breastfeeding Support group at http://www.breastfeeding.org.sg/
For information on how to quit smoking, visit www.freshair.sg.