Hi Anne,
I have some experience with this client base, and I was raised by hippies so I have a lot of anecdotal experience. I do have a few questions. Is the baby going to be with her during this time? How many days does she plan on using the medicine? The things you gave her are great so far. In general, there are a couple of things that I would pass along; remind her to stay hydrated and eat. The combination of the two decrease appetite significantly (for about 12 hours). She will also need to remember to express her milk while using the medicine. She most likely will not enjoy using a pump during this time (due to the body feeling sensitive), but hand expressing would actually feel enjoyable, keep up milk supply, and prevent plugged ducts. She may be going to a festival or a retreat where electricity is not easy to find. I would ask her about her previous experiences, and find out what is she most concerned about (transferring into breastmilk or affecting her milk supply)? Does she plan to take it all at once, or does she plan to spread it out in doses? Is this a one day thing, or more? If this is more than a 24 hour thing, I have noticed a decrease in milk supply (because of the lack of milk expression for multiple days in a row).
If she can be honest and upfront with you, the better you can help her make schedule. For example, if she plans on using both drugs for one night, this is what I typically see: She will most likely take both drugs once in the early evening, and once again later in the night. She will be awake for most of the night, then she will sleep until the late afternoon. I’m sure you see the possible problem here. There is the possibility that she won’t eat or drink, or express her milk for almost 24 hours, unless you two can come up with a plan. Now imagine this is more than a one day retreat…it could be problematic.
I would advise her to hand express at the same time that she usually breastfeeds or pumps (or at least before she takes medicine, before a second dose of medicine, and before bedtime) while using the medicine. Depending on the situation, advise her on what to do with that milk. Drink lots of water leading up to, and during the event, and eat.
One thing to keep in mind, Psilocybin (mushrooms) does not have an effect on the dopamine receptor, so it doesn’t reduce prolactin levels (Western Australia Centre for Evidence Based Nursing & Midwifery, 2007, p. 4-5). LSD does affect dopamine receptor and can lower prolactin levels, so the two combined could affect her milk supply (Passie, Seifert, Schneider, & Emrich, 2002, p. 362).
Nearly all drugs pass into breastmilk, but almost all appear in the amount of less than 1% of the mothers dose (Western Australia Centre for Evidence Based Nursing & Midwifery, 2007, p. 2). The average dose of dry mushrooms is 1 gram. The dose for fresh mushrooms is ten times higher (but people don’t typically eat fresh mushrooms). They take effect about 30 minutes, peak at 50 minutes, and slowly decline over the next 6 hours after ingestion (Passie et al., 2002, p. 360). LSD however, is characterized as an L5 and and breastfeeding contraindicated (limited data). It has a low molecular weight, which allows for transfer into breastmilk. Since there is limited data, it is suggested to not breastfeed for 24-120 hours (Western Australia Centre for Evidence Based Nursing & Midwifery, 2007, p. 21).
Obviously it is best for her not to take any “medicine” at all while providing her baby with breastmilk. Since the goal is to keep her breastfeeding for as long as possible, you can provide her with more evidence based information (like you are doing already).
So this is just information for you to look at and help guide your client. I would advise her to stick away from LSD while she is breastfeeding. Anecdotally speaking, if you came across someone taking mushrooms in low doses, you would never know it. Their coordination is much better than someone who has had a few alcoholic drinks. But LSD is different, and especially if her baby will be with her, I would recommend that she does not take it. Not only for her milk supply, but for the safety of her baby as well in regards to coordination and possible neglect.
I hope this was somewhat helpful:)
Shaland Verdi, IBCLC
>
> Mother 23 yrs. baby 4 mo. Exclusively pumped breastmilk.
>
> Mother wants to use lsd and psilobycin for medicinal purposes. Possibly 10 mcg. She is curious about milk transfer. I already sent Medications and Mother’s Milk LSD page information. She wants information or anecdotal information bc there is probably a lack of statistical information. Do any of you have client bases with usage of either of these? Can you tell me anything about noticeable decreases in milk? I explained many pumping schedules to save up and then use previously pumped milk if she is concerned about transfer.
>
> Mother has used both prior to pregnancy and has experience with them but not while pumping and breastfeeding.
>
> We talked about fat solubility. Half lives. I rec she buy or use a copy of Hale’s. I rec calling Infant Risk hotline.
>
> What else would you pass along?
>
> Warmly,
> A
>
> #8.14 at.home
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