Breastfeeding and maternal smoking.

Maternal Smoking I wish to address the statement regarding maternal smoking and breastfeeding. In your article, it states, “Maternal smoking is not an absolute contraindication to breastfeeding but should be strongly discouraged, because it is associated with an increased incidence in infant respiratory allergy.” After this false information, you have cited reference 102. I scrolled down to the references to find this information and see that it was taken from Pediatric Allergy and Immunology 2009;20(1):30–34. However, the content of this reference must have been misunderstood. It states, “Exposure to maternal smoking in the first year of life interferes in breast-feeding protective effect against the onset of respiratory allergy from birth to 5 yr.” This being true, it states nothing of the fact that it “increases incidence” of infant respiratory allergies but that it lessens the protective effect against it. A mother who is smoking while nursing, most likely was a mother who was smoking while pregnant, which means the baby has already been exposed to nicotine. Encouraging a smoking mother not to breastfeed can cause the newborn to go through nicotine withdrawal after birth. Also, the protective effects in the mother’s milk far outweigh the small amount of nicotine that passes through the breast milk. The infant is going to be exposed to smoking in any case because of maternal use of cigarettes, and therefore the benefits of breast milk to that infant would actually prove more important than to an infant in a nonsmoking household. Please reconsider the wording in your article. Many physicians are already severely uninformed regarding the benefits of continued breastfeeding, and giving this false information to them only compounds the problem. Thank you for your time and understanding.