Hello
My name is Tammy Lawrence. I am a nursing student at the University of
North Dakota. During my rotation in postpartum nursing, I cared for a
breastfed infant who demonstrated possible signs of drug withdrawal that
could not be otherwise explained. This full-term infant had an
inconsolable cry, irritability and uncontrollable tremors; blood glucose
levels were normal. It was questionable whether the mother was using
illicit drugs. As a nurse, an obligation to protect the infant from
transfer of these illicit drugs through breast milk arose. I want to know
what the short and long-term effects of maternal drug abuse, particularly
cocaine, are on the breastfed infant.
Olds (1996) noted that cocaine is passed easily into the breast milk
because of its high lipid solubility, causing such symptoms in the
breastfeeding infant as extreme irritability, vomiting, diarrhea, dilated
pupils, and apnea. Kaufman, et al. (1998) states that the use of small
amounts of cocaine may cause a narrowing of blood vessels in the brain
that could lead to brain dysfunction. Mohrbacher and Stock (1997) reports
that illicit drugs should not be ingested by nursing mothers even though
adverse reports are not in the literature.
Because there is not much literature on the long term effects, I
am curious to hear if anyone out there has dealt with a situation such as
this. I would appreciate your knowledge on this issue.
Thank you, Tammy Lawrence, College of Nursing Student, University of North
Dakota.
Kaufman, M., Levin, J., Ross, M., Lange, N., Rose, S., Kukes, T.,
Mendelson, J., Lukas, S., Cohen, B., & Renshaw, P. (1998).
Cocaine-induced cerebral vasoconstriction detected in humans with magnetic
resonance angiography. Journal of American Medical Association, 279,(5)
376-381.
Mohrbacher, N., & Stock, J. (1997). The breastfeeding answer
book. Schaumburg, IL: Le Leche League International.
Olds, S., London, M., & Ladewig, P. W. (1996). Maternal newborn
nursing. Menlo Park, CA: Addison-Wesley.
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