A drug is a drug is a drug.  One chemical is used to stabilize the
composition of paint, another to decrease blood pressure.  There is
intrinsically no difference between them from the point of view of
breastfeeding.  What determines how much of any chemical gets into the milk
is the mother's plasma levels.  In the vast majority of cases the plasma
levels of any chemical are too low to get into the milk in any significant
amounts.  If they are, somebody should be doing something at her workplace.

This is not the whole question, though.  Of course, even tiny amounts of
chemicals can accumulate, especially if they are fat soluble.  But then,
formula is a hazardous combination of chemicals, and the baby gets it in
large amounts.  The question, again, is which is more hazardous, formula or
breastmilk with tiny amounts of something in them?  The answer is almost
always "formula is more hazardous".

Jack Newman, MD, FRCPC

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