<<So my question is: Even though we hope that the bonding of mother and
baby might initiate a change in the mother's behavior AND even thought that
baby is surely entitled to the benefits of his/her mother's milk, If a
mother tests at a toxic level when her baby is born, do we have any
responsibility to protect that baby?  Here in NY we won't allow a mom to
take her baby in a car from the hospital without a car seat.  What is our
responsibility here? >>

Barbara, I understand and am concerned about this issue, too (as I am sure
all of us are).  But, the fact remains, that if the mom has toxic levels of
a drug when she is in labor--the baby has already been endangered.  Quite
frankly, the baby probably has been exposed throughout the pregnancy.  I
have a concern on the other side of the issue as well, if the baby is
accustomed to receiving this drug placentally--should we not be concerned
about the adverse effect of baby going cold turkey??

I think that it is common policy in most hospitals in the states, that
babies born to drug positive moms are counseled by social services.  It
also has been my experience that many of these babies are put into foster
care.  I think a much better approach would be for mom and baby to be given
the option of rehab.  I feel quite sure that many women that lose their
babies would care little if they are "clean" or not.  I also think that we
underuse simple protocols--such as testing baby's levels for certain drugs.

Another problem that seems to have much less concern...what about women
that are using "legal" drugs???  We do not routinely screen for these (at
least not at my hospital).  I have worked with moms that were taking Prozac
or one of the SRI's throughout the entire pregnancy, and then were denied
the option of bf'ing the baby.  I have seen several babies really suffer by
the drug supply being cut off like that.

It is a complicated issue, indeed.

                                             Pam Holland, BS, IBCLC
                                               Savannah, GA