We have a situation here in Alberta, Canada, with a woman charged with
second degree murder in the death of her 11-day old infant. I have a couple
of questions. I'm wanting to keep an eye on news coverage to try to make
sure that it is accurate and balanced. The case is complicated by a report
that the mother breastfed the infant and fell asleep, but reports then
putting the infant beside her in a bassinet.

ME/toxicologist says infant had .23 mg/L of methamphetamine in her blood
stream at time of death, too much to be from ingesting via breastmilk.
Early reports were that the infant must have ingested or received the drug
anally to account for the high amount found in her bloodstream.

Media reports initially focused on the amount of meth and that it couldn't
have come from breastmilk. However, one of our media outlets is pursuing
this angle. It has obtained court records and has interviewed a
toxicologist in Texas who doesn't disagree the amount found in the baby's
blood stream is too much to be from breastmilk, but says there is no way to
know how much meth would be in breastmilk as "we're not allowed to dose
mothers to see the amount of meth in their milk following use."

I know of at least one study in Australia that tested for this. It
estimated an absolute infant dose based on the results and concluded the
would be with in the therapeutic dose range for amphetamines, but noted
methamphetamines cross blood/brain barrier more readily.

I am mindful of a fair bit of reactionary and inflammatory news coverage in
the U.S. around trials where some have been accused of causing the deaths
of their babies due to breastfeeding while using meth. One news article in
2011 quoted an expert, Dr. Marcel Casavant, chief of Pharmacology and
Toxicology at Nationwide Children's hospital, who said meth is
*concentrated* in breastmilk:  "In fact, amphetamine is concentrated into
breast milk, which means breast tissue takes amphetamine from the mother's
bloodstream and actively moves it into the milk."

I'm very concerned that coverage of this case here could contribute to a
lack of support for people to take various legitimate drugs while
breastfeeding for fear of harming their infants. The coverage of the 2011
article quoting Casavant has five paragraphs at the bottom that really
amount to fearmongering about antidepressants and other prescribed drugs.

In my province we do not have good, evidence-based information around the
use of "street drugs" while breastfeeding. Worse, some of our advice lumps
alcohol use with street drug use as a reason to not breastfeed.

So I have some questions:

1) Is there any evidence that amphetamines are *concentrated* from the
blood stream into breastmilk as stated above?

2) Have any of you in communities experiencing events like this seen
negative impacts due to news coverage of the incidents? I'm interested in
hearing about what you have seen, and what steps you may have taken to
educate your local news media to encourage accurate and inflammatory or
harmful news coverage.

Thanks.

Jodine Chase
Edmonton, Alberta, Canada


Australian study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2679109/

Coverage of situation here in Edmonton including Texas expert quotes:
http://globalnews.ca/news/3496624/impossible-to-know-how-much-meth-edmonton-newborn-ingested-toxicolgist/

2011 California coverage:
http://abcnews.go.com/Health/Drugs/california-mother-charged-murder-breastfeeding-meth/story?id=14231552

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