Nicotine and Breastfeeding

Posted 15th May 2020 by Dave Cross
“Breastfeeding moms’ exposure to nicotine linked to infant skull defect,” say a quartet of researchers at Ohio State University. The findings from the mice study fly in the face of findings by Public Health England (PHE) and the advice from the UK’s National Health Service (NHS).

James Cray, Amr Mohi, Rajiv Kishinchand and Emily Durham claim: “Lactating mothers who use e-cigarettes or nicotine replacement therapies may be putting their breastfed babies at risk for skull defects.”

The quartet haven’t looked at whether infants born to vaping mothers have shown this effect, they fed nicotine-laced water to mice instead. They say they, “found in 15-day-old pups that the skull joints across the top of their heads were narrowed, putting them on a path to fuse earlier than normal. Because mouse pups at this age don’t drink water, breast milk was the only possible source of their nicotine exposure.”

Cray commented: “We knew based on previous data in pregnancy that we’d see some changes, but we were a bit taken aback to find there were discernible differences when the nicotine exposure was occurring only during lactation.”

“Our data suggest that nicotine alone can alter development of the head and face. That means mothers who vape are likely exposing their unborn children or infants to an amount of nicotine and its metabolites that can disturb growth in the same way cigarettes can.”

Mouse studies have been popular within the anti-vape community because they frequently give them just the kind of results they were looking for. It’s a shame the researchers didn’t consider looking for actual data on cranial deformation from vaping given that it would have given a more definitive indication.

But then that wouldn’t pay the bills. Cray has already received further funding to get mice to vape nicotine, “to mimic the effects of e-cigarettes on head and face development in offspring.” He has also received a grant to study nicotine’s effects on bone cells.

PHE’s most recent evidence update found that pregnant women who vape are likely to do so to stop smoking and that vaping in pregnancy is very rare among those who have not smoked. Although it admits pregnancy outcomes are not clear at the moment, switching to vaping prevents a return to smoking and reduces tobacco-related harms.

The Smoking in Pregnancy Challenge Group on Vaping says: “Vaping should be supported if it helps women or households with children to quit smoking or stay smokefree and that regulated nicotine vaping products will always be preferable to smoking.”

The NHS states that even smoking mothers shouldn’t stop breastfeeding. It is unequivocal that: “Licensed NRT products are safe to use while you're breastfeeding,” except Champix and Zyban.

On vaping, the NHS says: “While using an e-cigarette (vaping) is a lot safer than smoking, it isn't completely risk free. As well as nicotine, e-cigarette liquid and vapour can contain toxic substances, although these are mostly at much lower levels than in cigarette smoke. At the moment there are no e-cigarettes licensed as medicines. New mums are advised to use licensed NRT products for help with quitting smoking and staying smokefree. However, if you do choose to use an e-cigarette to help you stay smokefree, it's still better to carry on breastfeeding as the benefits will outweigh any potential harm.”


  • Vaping in England – an evidence update 2020, PHE – [link]
  • NHS Guidance – [link]

 Dave Cross
Article by Dave Cross
Freelance writer, physicist, karateka, dog walker