Whoa! This is more than a can of worms -- and we must be VERY CAREFUL yes
I'm shouting if we choose to discuss this. It's certainly worthy of a
think-through.

But I remember years ago reading an ICEA scenario (I think...) to help us
think through these kinds of mom v baby (and seemingly also v health
professionals)situations. It involved a mother who had been in labor in a
hospital for a long while and was refusing consent for a cesarean. Should
the healthcare provider go to court to make her have the cesarean?

As we think about drug use, smoking  and other behaviors that are risky for
mom and bad for an unborn (and born!) baby's health, we need to think about
how this plays out in real life. I was very taken aback when I went to
nursing school to come across the idea that moms who were doing drugs,
drinking, smoking were often self-medicating.

I think of it now when a friend's son, who she open-adopted at birth, says
that he likes to drink because it makes him feel better than any other
"helpful" drug they have tried.

Compassion, remembering the importance of getting something done v getting
it perfect...and thoughtful rational discussion, should all be a part of our
Lactnet dialogue on this one.

Dawn Kersula MA, RN, LCCE, IBCLC in southern Vermont

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