Look, I used the example of cocaine because the opthalmologist used the
example.  The fact remains that cocaine remains in the blood for very
very short periods of time, and the concentration in the milk is
undoubtedly very low and not likely to affect the infant.  I was merely
pointing out the irrationality of the opthamologist's arguments.  I do
not think the remark was glib.

I am strongly in favour of encouraging drug abusers to breastfeed.  Are
they totally lost?  Do we give them no chance to change?  Do we give
them and their children up for hopeless?  Not I.  I've seen women who
have changed their lives around, not many, true, but some. Maybe because
they were encouraged to breastfeed, maybe because they were *not* told
their milk was poison for their babies, maybe because someone encouraged
them to nurture their babies just as we encourage all mothers to nurture
their babies, maybe because they were made to feel that even they can be
good mothers.  Give them a break, maybe the first they've ever had in
their lives for crying out loud.  Breastfeeding is *not* just for the
perfect mothers.  Indeed, these babies need their mother's milk *more*
than the babies of "perfect" mothers.  They are much more at risk for
everything we always talk about in these posts.  And since most drug
abusers are relatively young, this baby won't be the last, usually.
Remember those to come too, and have pity on them.

I just get so frustrated when a nurse from the ICU phones me and asks me
can we give the baby the mother's milk, since she is a narcotic abuser.
I ask, what are we doing with the baby?  I'm told, he's on a morphine
drip.  Uh, you mean the small amount of narcotic in the milk is going to
make a difference?  Undoubtedly the dose of morphine was calculated to
the microgram?

This was a stream of consciousness rant.  But I was most ticked off
being told my remark was "glib".

Jack Newman, MD, FRCPC