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From:
Brenda Phipps <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 5 Jan 2006 10:51:56 -0700
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Ann,

I am also looking for insight from the LACTNET group on how this issue is being handled.

I assisted in writing an Illegal Drug Use and Breastfeeding policy which is currently being reviewed at the legal department of our hospital. In this policy, we are asking that all mothers with an admitted history or positive maternal drug screen in the last trimester not be assisted with pumping for babies in the NICU, and if the mother does decide to pump on her own, her milk will not be given to her infant. If there is a suspicion of drug use or known history in any other point of the pregnancy, a urine and meconium drug screen are taken on the infant, and if it is positive, infant is not given mother's milk. In the case of marijuana, we are still working out the kinks. If the meconium drug screen is positive for only THC, we may decide to allow breastmilk to be given to the infant, however the mother will be subject to random milk testing (through the hospital lab). CPS is notified, and they often will have mother's milk tested after discharge (they are cracking down in Arizona, so they say).

I know this sounds somewhat harsh, but our first goal is to protect our babies. It becomes much more difficult to enforce this on our well-baby unit, because we can only tell mothers the dangers of drugs (we are developing a handout for all patients), but cannot force them to not put the baby to breast. In this case, the pediatrician is notified and we chart what we have told the patient. 

Hope to hear what others are doing.

Brenda Phipps, BS, IBCLC
Flagstaff Medical Center

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