I have had several phone calls recently from moms about the same issue,
and realize I am unclear on a particular concept.  I am sure many of you
wise folks can anser this question for me.

It's about drugs (or any substance, i suppose) in breastmilk, and how it
dissipates with time, or if it does.  My latest phone call was about
alcohol - and I know that alcohol is present in breastmilk at the same
levels that it is present in blood, so that when blood alcohol level goes
down after time has elapsed, so then does breastmilk alcohol level (fairly
rapidly).  I presume this means that the milk does not have to be pumped
out for the alcohol to dissipate - it must reabsorb back into the mother's
system and be excreted by her or neutralized somehow?

If this is the case, is that also the case with all other substances?
Marijuana?  Cocaine? prescription meds?  is the mother's blood levels of
any given substance generally either greater than or equal to the
breastmilk levels? (greater if the substance desn't transfer to milk readily).

And does it have anyhting to do with the fat solubility or some other
characteristic of hte substance - for example, marijuana (or its
metabolite?) is present in a person's urine (and i presume blood) for
months after use.  would it also be present in breastmilk for as long?

And, if some substances don't fade out by themselves, does that mean that
in some cases the milk needs to be pumped and dumped to produce a "clean"
supply?  or (putting aside the issue of maintaining supply) if a baby
doesn't nurse and a mom doesn't pump, will all substances eventually
dissipate from the breastmilk?  and if so, what is the mechanism for this?
is the breastmilk in the ducts constantly "recycled" or "refreshed" (i know
that milk is created as the demand is initiated by the baby, but there is
some present all the time, right?

oh, also, how would these questions and answers apply to food substances
like dairy protien, citrus, etc. that babies are sometimes allergic to?

do my questions make any sense?

thanks so much for your thoughts and time!

Lyla W.
La Leche League Leader - Oakland/Berkeley
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