Mothers who are breastfeeding their infants should not use illicit drugs.
This includes marijuana, cocaine, heroin, phencyclidine (PCP),
amphetamines, excessive alcohol, and other drugs of abuse.
- All these drugs can cross into breast milk in varying
amounts and be transferred to the infant.
- Mothers who use these drugs may impair their own ability
to care for their infants.
- There is little data on the effect of some of these drugs on the infant.
- During pregnancy and soon after the birth of a baby,
mothers are often able to change habits for the good,
such as modifying their diet, stopping smoking and
stopping the use of illicit drugs or excessive alcohol.
- In one project, mothers were interviewed prenatally and post-partum for
history of illicit drug use and tested for illicit drug use at delivery by
Mothers who were planning to breast feed their infants
had decreased the use of cocaine and marijuana as documented by toxicologic
screen at birth as compared to mothers intending to feed their infants formula
- Women who had a positive toxicology screen at the birth of
their infant were not able to stop the use of these drugs during
pregnancy and should not breastfeed. The Academy of Breastfeeding
Medicine has a protocol,
Guidelines for Breastfeeding and Substance Use or Substance Use Disorder, 2015.
It recommends that mothers who are not enrolled
or do not plan to enroll in substance abuse treatment, did not attend
prenatal care, are chronically abusing alcohol, relapsed to illicit
drug use in the 30 days before delivery, or had a positive screen for
drugs other than marijuana or methadone should not breastfeed. For
mothers who had substance abuse treatment and prenatal care that
started in the last trimester of pregnancy, were drug and alcohol free
only in an inpatient setting, lack family and community support
systems, or relapsed to illicit drug use within 90 days of delivery
should have an individual assessment to evaluate the safety of
breastfeeding for these mothers (
ABM Illicit Drugs, 2015