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Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 22 Jul 1998 21:35:08 -0400
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> In the past few weeks during my orientation period, I've worked with a
> couple moms that were "suspected" of marijuana use during pregnancy.
> Therefore, I was ordered very specifically (per our LC) to refuse these moms
> to breastfeed (which they very much wanted to do) until their drug screen
> and their infant's urine tested negative (could take anywhere from 12-36
> hours-- collection isn't easy!).

re: the
> legal implications (violation of civil rights, I would guess-- I'd sue in a
> heartbeat!) and the implications for bonding/milk supply/nipple
> confusion/morale/etc..

> Any replies greatly appreciated (and your staff protocols, too! I'd love to
> hear how others are handling this situation..):
>
In our hospital, we don't get too excited about marijuana use.  Child
Protective Services doesn't get involved with this drug, and we don't
interfere with breastfeeding. With marijuana, urine screens can be
positive weeks after the active properties of the drug have left the
system.

When we have a mom with a history of cocaine use, a toxicology screen is
ordered on the Mom and the baby's urine.  We explain to the mom that it
can be life-threatening to the baby to breastfeed if she has used
cocaine within the last 36 hours (per JHL article and University of
Rochester's Lactation Study Center).  Then we leave the baby in the room
with the mom and with abm bottles in the crib.  She does not have to
admit to the drug use to us, but has the option of what to feed her
baby.

Because we do not have the tox result back yet, we do not have any legal
right to limit her breastfeeding.  We trust her judgment and caring as a
mother to do what is right for her child.  Most of those who have used,
will choose to bottlefeed the abm.  We have had a few who BF even after
drug use.  When the tox screen comes back positive, then we can limit
their BF until 36 hours after hospital admission.  We assume that she
has been clean since then, although we have suspected some of using
drugs supplied by visitors while inpatients.

We very carefully chart the information given to the mom and her
response.  That is how we cover our liability.  It is very important to
discuss the consequences of drug use and BF with all these moms, because
once they are discharged, they will do whatever they want.  You cannot
prevent their breastfeeding at home after subsequent drug use.  So they
have to have the facts to make an informed decision.

Barb Berges BS, RN, IBCLC
Rochester, NY

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