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Subject:
From:
"Judy K. Dunlap, RNC, IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 29 Jun 1996 17:34:14 -0400
Content-Type:
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I have a semi-theoretical question for all of you.  Suppose you are asked to
work with an 18 year old unmarried girl who has just delivered a baby.  The
girl has a history of daily marijuana use during pregnancy, although she was
advised it was not good for fetus.  Says she has used no other drugs.  She
lives with her mother, who became aware of  drug use recently, lectured girl
about it, but said, in essence, "You're a big girl now.  This is just my
advice."  Baby's father also has a hx of regular pot use but quit three weeks
ago.  Mom's drug screen positive for TCH at time of delivery.  Baby's screen
 pending.  Social worker has talked to mom, has advised her that a referral
to child protective services will be made.  Girl asks if baby will be taken
away.  Soc. worker says probably not now but a possibility if drug use
continues. ( No indication how this will be ascertained.)  Girl's response is
a noncommital, "Oh.  OK."   Later mother indicates a desire to continue
breastfeeding and says she will stop using pot.  Pediatrician wants BF to
continue, is willing to do a drug screen at each well-baby visit, says she
will call CPS if positive.  What would you do?

My thoughts:
1.  Considering mom's past hx, not much reliance can be placed on her stated
intention      to stop using pot.
2.  Grandmother and baby's dad are uncertain sources of influence / support.
3.  Pediatrician has no control over whether girl returns regularly for ped.
care.
BUT
4.  Mother and baby certainly need the bonding benefits of BF, and the baby
certainly         needs the physiologic benefits to offset as much as
possible any damage done by        the fetal exposure.

What would you do?  If people would like to send me private opinions, I'll be
happy to  tabulate fors, againsts, "I don't knows," and rationales and post a
synopsis to the list.

Judy Dunlap, RNC, BA, IBCLC

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