Thank you Piernette, for posting that note about drug usage. I'd like to
add a bit to that...

>During the time I was practicing pediatrics in  Bakersfield CA, a woman was
> on trial for the murder of her infant.  She was actively abusing
>methamphetamine and decided to breastfeed her infant.  Her infant died and on
>autopsy was noted to have methamphetamine the blood.  The mom was sucessfully
>CONVICTED of murder and is now serving time.

Actually, they tried her for second degree murder, but she was only found
guilty of child endangerment. She is serving a six year prison sentence for
that. Another mother in California is also serving six years for
endangerment for meth and breastfeeding. It IS A SERIOUS ISSUE.

>I'd be very cautious with glib comments that amounts of Cocaine (which is
>very similar to methamphetamine in effect, metabolism), methamphetamine or
>other illicit drugs that pass into breast milk are insignificant.

I am behind on reading my digests, but was not aware that some comments
like this were made. YES BE VERY CAREFUL. In many places, they do a drug
test on the mother when she gives birth. If there is ANYTHING even in JUST
the mother, the social service agency is called in. The baby could easily
be placed in foster care. If anything shows in the baby, you can bet the
mother is in hot water.

AND, IF THE BABY DIES FOR ANY REASON - in Bakersville case, the baby
probably died from SIDS - and there are ANY TRACE AMOUNTS of ANY ILLEGAL
SUBSTANCE, the mother risks prosecution for endangerment, for manslaughter,
or even for murder.

 > Personally, I don't think this is the best way to address addiction,
>recovery or child welfare (treatment and intervention is key from my
>perspective).

I agree. But given the system, we need to alert mothers to this risk. We
cannot condone any illegal drug usage at all. I don't care how minimal the
amount in the baby might be. However, that does not mean we say 'if you are
doing drugs, don't breastfeed'. That is what the Mom in Bakersville was
told. Isn't the implied message "drugs are OK if you don't breastfeed'? The
baby can become contaminated without breastfeeding, and that might well
have happened in that case. If the pacifier rolls through a pile of coke,
or if it is on the father's finger and he pops it into the baby's mouth to
pacifiy her, etc. And what about the impaired parenting?

If a mom is doing drugs, she needs help. One study that was used in the
Bakersville case indicated that mothers should not wean- the program should
help manage it. These babies need to be breastfed, but within the confines
of a program. Unfortunately, there are few programs out there that will do
this. And few that will even help a pregnant mom. This is what needs to
change in our society!

>The greatest irony to me is that tobacco and alcohol are more
>teratogenic and has more long term effects on children (and cost more to
>society in terms of added hospitalization, long term care) than illicit
>drugs.

Yes, but they are legal. This is the system we are talking about.

Thank you for bringing up this important subject!

Liz Baldwin


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