I have a semi-theoretical question for all of you. Suppose you are asked to work with an 18 year old unmarried girl who has just delivered a baby. The girl has a history of daily marijuana use during pregnancy, although she was advised it was not good for fetus. Says she has used no other drugs. She lives with her mother, who became aware of drug use recently, lectured girl about it, but said, in essence, "You're a big girl now. This is just my advice." Baby's father also has a hx of regular pot use but quit three weeks ago. Mom's drug screen positive for TCH at time of delivery. Baby's screen pending. Social worker has talked to mom, has advised her that a referral to child protective services will be made. Girl asks if baby will be taken away. Soc. worker says probably not now but a possibility if drug use continues. ( No indication how this will be ascertained.) Girl's response is a noncommital, "Oh. OK." Later mother indicates a desire to continue breastfeeding and says she will stop using pot. Pediatrician wants BF to continue, is willing to do a drug screen at each well-baby visit, says she will call CPS if positive. What would you do? My thoughts: 1. Considering mom's past hx, not much reliance can be placed on her stated intention to stop using pot. 2. Grandmother and baby's dad are uncertain sources of influence / support. 3. Pediatrician has no control over whether girl returns regularly for ped. care. BUT 4. Mother and baby certainly need the bonding benefits of BF, and the baby certainly needs the physiologic benefits to offset as much as possible any damage done by the fetal exposure. What would you do? If people would like to send me private opinions, I'll be happy to tabulate fors, againsts, "I don't knows," and rationales and post a synopsis to the list. Judy Dunlap, RNC, BA, IBCLC