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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