Dear Annette,

Personally, I see my role in these situations as only needing to provide
her with the information I am aware of and/or what I can research for her.
I suppose I don't see this as a yes or no question I would need to answer
for her.  The decision and responsibility is ultimately hers and hopefully
you are able to inform her well, but ultimately you're empowering her to
make the safest and most appropriate decision unique for her and her
nursling.

I suggest making photo copies of the information you are able to obtain and
offer them to her.  Therefore, you aren't directly telling her what to or
what not to do, but rather just informing her to the best of your ability.
Most clients, I assume, would draw the conclusion from the available
information that continuing to breastfeed is in baby's best interest and
your counsel would not make you liable for any ill outcome.  (Tone of voice
and presentation of the information can go a long way.)

God Bless,
Penny Lane RN, IBCLC


> [Original Message]
> From: Arly Helm <[log in to unmask]>
> To: <[log in to unmask]>
> Date: 12/2/2004 1:28:42 AM
> Subject: marijuana
>
> I read that it could show up in the mom's urine for 2-3 weeks and I am
> supposed to tell her to go ahead and breastfeed?
>
> Thanks,
> Annette Leibovitz, IBCLC
>
> Dear Annette:  I don't see that there's much question here--telling her to
> go ahead and breastfeed is the only sensible option.  Sometimes our choice
> is the lesser of two evils--clearly breastfeeding with a small amount of
> marijuana is going to cause much less harm than substituting formula.  We
> don't yet know if marijuana causes any harm--although common sense tells
us
> it's a bad idea to expose a baby brain--and we do have tons (literally) of
> information on the harmful effects of formula.
>
> With this in mind, the question about when the marijuana's components
clear
> out of the bloodstream becomes irrelevant.  One surely is not going to
> suggest pumping and dumping for however many weeks it will take.
>
> What we'd all like to know is, at what level (assuming there is one) do
the
> risks of marijuana outweigh the risks of formula?  It seems that to sit
and
> smoke an entire joint at one sitting suggests a heavy user rather than a
> light user--again, we don't have info on this but I would have a
discussion
> with her about moderation (just as Jack Newman says).
>
> Arly Helm, MS, IBCLC
>
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