The Academy of Breastfeeding Medicine has a protocol entitled:

Breastfeeding and the Drug Dependant Woman 
(http://www.bfmed.org/Resources/Protocols.aspx)

Besides the unfortunate typo in the title, there are some other real 
problems with the protocol. For example, the recommendation that women 
who receive no prenatal care should be discouraged from breastfeeding.

I think the authors meant to stipulate something about drug use, and not 
simply the lack of prenatal care, which may be caused by many factors 
other than drug abuse, and would not by itself be a contraindication to 
breastfeeding. When lack of prenatal care is caused by economic and 
social problems, one would hope that breastfeeding would be particularly 
advocated, not discouraged.

Other problems include confusing legal with medical/scientific--in 
France, Pepto-Bismol may be illicit, but its use in the month preceding 
delivery, while not recommended, would not preclude two or more years of 
breastfeeding. Medicine does not exist to serve policymakers by 
supporting the changing tides of drug legality, but rather to serve the 
individual by looking objectively at health risks and benefits.

I would like to talk/email with someone who is working with moms with a 
history of drug abuse; someone or some organization that has their own 
working parameters for testing mom, testing baby, and discouraging or 
disallowing breastfeeding.

Arly Helm, MS, IBCLC

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