Dear Christine: Please try to convince your team to agree that she shouldn't be using enough of any recreational drug to cause a difference in mentation. Your team may agree that she shouldn't be breastfeeding, but I do not. I believe she shouldn't be smoking marijuana, if the levels are high enough to indicate she was getting "high." Pumping and dumping seems extremely excessive; I don't believe a mother would take enough on Day 0 to still be "high" 10 or 14 days later. We aren't aiming for a maternal body that has never been exposed to herbs, drugs, medicines, pesticides, herbicides, dust, exhaust fumes, nail salon fumes, the smells of the sewer vent in downtown urban areas, off-gassing of new carpets and paint, etc. We are just trying to find a recommended margin of safety. It doesn't make any sense, health-wise, to deny an infant breastmilk at low levels of THC exposure, or for a high exposure, for the first "offense." I think when we overreact, our advice loses value, and has less impact on the recipient mother. Some of our mothers that test positive for THC have a more chaotic life, and/or are younger--two variables in which breastfeeding can make a profound difference in the arc of the child's life, and of the mother's life as well.
I, too, am interested to hear other's current policies and the references used to support them.
Arly Helm, MS, IBCLC
-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Christine A Raasch
Sent: Monday, May 19, 2014 12:53 PM
To: [log in to unmask]
Subject: Marijuana and Breastfeeding
Hi, I looked at the responses to the question of marijuana and breastfeeding from last year and wrote to some of the posters for additional information. I have been on a committee looking at how we are going to proceed when mother and/or baby have a positive UDS. We all agree she shouldn't be breastfeeding based on the available literature but we also agree that even if she doesn't breastfeed while inpatient, there is nothing stopping her from breastfeeding after discharge. We have been instructing mothers to pump and dump for 10 - 14 days, obtain a UDS and if negative can breastfeed but can't find the reference to support this recommendation. We also suspect there is litte compliance.
Most mothers, when told that the medication they are on is contraindicated, will either try to find an alternative medication or not breastfeed. Marijuana is a totally different drug re how mother's respond to being told that it is contraindicated. I checked with our social worker and positive UDS results are referred to the Bureau of Child Welfare.
I'd like to hear from you re:
1. what your policy is and share it if you can 2. if you instruct mothers to pump and dump, how long and what is the reference that this recommendation is based on 3. what has been your success rate in mothers complying with abstaining and then obtaining a UDS or breastfeeding successfully after.
Thank you so much for your time.
Christine, RN, BSN, IBCLC
Milwaukee, WI
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