Smoking While You Are Pregnant or Breastfeeding

How does smoking when you are pregnant affect your unborn baby’s health?

Pregnant women who smoke risk the health and lives of their unborn babies. The nicotine, carbon monoxide, and other toxins in tobacco smoke enter the mother’s bloodstream, go into the baby’s body, and can keep it from getting the key nutrients and oxygen it needs to grow and develop. Almost every developing organ system is affected by the chemicals in tobacco smoke. This increases the risk of things like:

  • Miscarriage
  • Premature delivery
  • Stillbirth
  • Infant death
  • Low birth weight
  • Smaller head circumference
  • Slightly higher risk of heart defects, cleft lip or palate, and possibly other birth defects
  • Hearing problems
  • Sudden infant death syndrome (SIDS). Research suggests that babies of mothers who smoke during and after pregnancy are much more likely to die from SIDS than babies born to non-smoking mothers.

Some research has suggested that children whose mothers smoked while pregnant or who have been exposed to secondhand smoke, even in small amounts, have a higher risk for:

  • Behavior problems, including ADHD (attention-deficit/hyperactivity disorder)
  • Being slower learners in school
  • Being more likely to have high blood pressure, asthma, ear infections, tonsillitis, cavities, impaired lung function
  • Being overweight or obese than children of non-smokers
  • Being more likely to smoke when they get older

Quitting smoking during pregnancy can help

Women who quit during pregnancy are less likely to have low birth-weight babies than those who keep smoking. They are also less likely to have babies that are born too early.

Women who stop smoking before they get pregnant lower their risk of having a low birth-weight baby to that of women who never smoked.

If you managed to quit smoking while you were pregnant, don’t pick up the habit again after your baby is born. When you find yourself tempted to start back, get help right away. And keep in mind that parents who smoke are more likely to have children who smoke. If you stay tobacco-free your child stands a better chance of never starting.

Smoking while breastfeeding

Breastfeeding is the best way to feed a new baby. But mothers who smoke expose the baby to nicotine and other substances through breast milk. Nicotine can cause unwanted symptoms in the baby, such as restlessness, a faster heartbeat, and shorter sleep times. Smoking while breastfeeding has also been linked to:

  • Having more trouble breastfeeding
  • Shorter duration of breastfeeding
  • Colic
  • SIDS

It’s best not to smoke while breastfeeding. But even if you smoke, breastfeeding is probably still healthier for a baby than bottle feeding. If you are unable to quit right away, you can do other things to help reduce your baby’s exposure to smoke, such as:

  • Make your entire home smoke-free to keep your baby away from secondhand smoke
  • Smoke right after breastfeeding rather than before to give your body more time to clear nicotine from breast milk
  • Cut back on smoking as much as possible

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

American Academy of Family Physicians. Breastfeeding, Family Physicians Supporting (Position Paper). 2014. Accessed at www.aafp.org/about/policies/all/breastfeeding-support.html#Appendix%204:%20AAFP%20Policies%20Related%20to%20Breastfeeding on November 9, 2015.

Banderali G, Martelli A, Landi M, et al. Short and long term health effects of parental tobacco smoking during pregnancy and lactation: A descriptive review. J Transl Med. 2015;13:327.

Centers for Disease Control and Prevention (CDC). Tobacco Use and Pregnancy. September 9, 2015. Accessed at www.cdc.gov/reproductivehealth/MaternalInfantHealth/TobaccoUsePregnancy/index.htm on November 6, 2015.

Centers for Disease Control and Prevention (CDC). Trends in Smoking Before, During, and After Pregnancy – Pregnancy Risk Assessment Monitoring System, United States, 40 Sites, 2000-2010. MMWR. 2013;62(SS06):1-19. Accessed at www.cdc.gov/mmwr/preview/mmwrhtml/ss6206a1.htm#Tab3 on November 6, 2015.

Hackshaw A, Rodeck C, Boniface S. Maternal smoking in pregnancy and birth defects: A systematic review based on 173 687 malformed cases and 11.7 million controls. Hum Reprod Update. 2011;17(5):589-604.

U.S. Department of Health & Human Services. Tobacco Use and Pregnancy. Accessed at http://betobaccofree.hhs.gov/health-effects/pregnancy/ on November 10, 2015.

Zhou S, Rosenthal DG, Sherman S, et al. Physical, behavioral and cognitive effects of prenatal tobacco and postnatal secondhand smoke exposure. Curr Probl Pediatr Adolesc Health Care. 2014;44:219-241.

Last Medical Review: November 12, 2015 Last Revised: November 12, 2015

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