Breastfeeding & Drugs: Illicit drugs

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Breastfeeding and Drugs Topics
Table of Contents
Pre module evaluation
Prescription and Over the Counter Medications
Case Study 28
Case Study 29
Pain Medications
Illicit Drugs
Post module evaluation

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.

  1. All these drugs can cross into breast milk in varying amounts and be transferred to the infant.

  2. Mothers who use these drugs may impair their own ability to care for their infants.

  3. There is little data on the effect of some of these drugs on the infant.

  4. 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.

  5. 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 toxicologic screen. 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 ( Memorize Frank, 1992 ).

  6. 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 ( Memorize ABM Illicit Drugs, 2015 ).

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