I cannot stand by any longer. This is something I have developed over the years (by the way, marijuana use is illegal by federal statute, although the current administration illegally ignores the statute, and is brain damaging for users and breastfed babies):
 



Recreational Drugs Use Recommendations

If used, interrupt breastfeeding for 24-48 hours after last
dose because of half-life of metabolites


Babies may test positive for drug for days to weeks


Extreme warnings: cocaine, LSD, phencyclidine (angel dust,
PCP), hallucinogenic drugs, amphetamines, IV heroin


PCP and cocaine may be most dangerous of all drugs of abuse
because drugs may remain in baby’s system for weeks after last maternal dose
(long half-life of metabolites)


Social considerations include how heavy a user the mother
is, as well as her ability to care for her baby while under the influence


Assess the dependability of the mother


Recommend discontinuing breastfeeding in high risk mothers


For low risk mothers, explain drug transfer into breast milk
and the hazards of the drug to the baby


Explain hazards of Hepatitis B and HIV transfer in
unprotected babies should the mother become infected


Explain the baby will be drug-screen positive for LONG
periods


Explain legal consequences of drug-screen tests in babies


Physicians should recognize the importance of breastfeeding:
risk vs. benefit


Physicians should recognize that drugs of abuse are largely
only dangerous for brief intervals following use


Physicians should counsel mothers strongly and recommend
that the mother should be re-screened several weeks to one month post-partum


If mother tests positive for heroin, cocaine, amphetamines,
or hallucinogens, she should stop breastfeeding

Screen the baby


Most questions health care professionals hear are usually about
alcohol use


Alcohol rapidly exchanges between plasma and breast milk


One study has shown that mothers’ alcohol showed 23%
reduction in amount of milk ingested by babies
May be due to taste of alcohol in milk

Prolactin may be inhibited by alcohol, but not definitively
known


Maternal blood levels have to reach 300mg% before
significant side effects affect baby


Resume breastfeeding after moderate alcohol use as soon as
mother feels normal


Recommend interrupting breastfeeding for 1 hour per drink or
until mother is sober
 


The long-term effects of marijuana on breastfed infants are
unknown.  Experts advise that mothers who
use marijuana must stop breastfeeding or ask for medical assistance to stop its
use, in order for the mother to provide her baby with all the benefits of human
milk. Some mothers who smoke marijuana away from their babies do
not realize that THC from the marijuana is concentrated in breast milk and is
absorbed by the nursing babies. When mothers are informed of that fact, they
may be more willing to give up marijuana for the benefit of their babies.



 In conclusion, from both a philosophical and scientific
viewpoint, recreational drugs of abuse should be contraindicated during
breastfeeding as they are hazardous, not only to the nursling, but to the
mother as well. 


 




Frank J. Nice, RPh, DPA, CPHP


 		 	   		  
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