Doctors question ‘avoid alcohol if breastfeeding’ call

Doctors have raised concerns over a coroner’s finding that linked the possibility of alcohol being passed on in breastfeeding to the death of a baby.

Sapphire Williams, 2 months, died in January 2017 with a high level of alcohol in her system. The cause was unclear, but in a finding released on Friday, Coroner Debra Bell urged women not to drink if breastfeeding.

A group of doctors have written an open letter in response. Co-author Dr Heather Johnston said hundreds of signatures had been gathered.

“Using the information available to the public, and some reasonable assumptions, it can be calculated the maximum blood alcohol concentration baby Sapphire could have reached by ingesting her mother’s breastmilk is around a tenth of what has been reported,” Johnston said.

“To reach a blood alcohol level of over 300mg/100ml from drinking breastmilk, her mother’s blood and breast alcohol level would likely have needed to be four times higher than the highest levels ever recorded.”

Johnston said the main danger in drinking and breastfeeding wasn’t alcohol being passed on to the baby.

“Dangers of making poor decisions or having impaired judgment, accidental injury through dropping the baby, or falling asleep in bed with the baby while under the influence of alcohol, are much more dangerous than the baby consuming a small amount of alcohol via the breastmilk.”

Sapphire and her twin sister were born at 33 weeks with low birth weights and medical issues.

About 1am on January 2, 2017,

Dangers of making poor decisions or having impaired judgment . . . are much more dangerous. Dr Heather Johnston

Sapphire woke crying and while her mother waited for baby formula to cool she gave her breastmilk. When the other baby cried, the mother put Sapphire on the bed. On her return, Sapphire had blood coming from her nose and was unresponsive.

Pathologist Dr Simon Stables’ postmortem examination revealed the high level of alcohol — 308 milligrams per 100 millilitres of blood — in Sapphire’s heart and a lesser amount in her liver. Re-testing confirmed the result.

He said the alcohol findings were difficult to explain as no alcohol was found in the stomach.

Sapphire’s mother told police the day before her baby’s death she had drunk a box of premixed bourbon and cola, raising the possibility of transfer through breastmilk.

Stables found the cause of death “unascertained”, but said “contributing conditions were acute alcohol intoxication, dangerous sleeping environment, prematurity, possible septicaemia, possible mechanical asphyxia, asphyxia due to suffocation”.

However, he also cited a research paper that found if a mother had four 12gm drinks of pure alcohol and then breastfed her child, the child would still not have a blood alcohol concentration of more than 0.005 per cent.

He concluded it was impossible to fully understand the alcohol reading result, and was of the opinion the cause of death should be stated as “unascertained”.

Coroner Debra Bell found “it is more likely than not” the alcohol reading was a result of the mother drinking. The case also highlighted the risks of bed sharing, she said.

“This case does highlight the fact that even with the knowledge of the dangers of drinking alcohol whilst breastfeeding, errors of judgment still occur which may contribute to the death of an infant. Therefore, I stress the importance to breastfeeding mothers not to consume alcohol at any stage.”

Johnston said for most women however, breastfeeding and sensible alcohol consumption was safe.