Breastfeeding & Drugs: Illicit drugs

All mothers who breastfeed their infants should refrain from the use of illicit drugs. This includes marijuana, cocaine, heroin, phencyclidine (PCP), amphetamines, excessive alcohol, and other drugs of abuse.

1. All these drugs can cross into breast milk in varying amounts and be transferred to the infant.

2. Mothers who use these drugs may impair their own ability to care for their infants.

3. There is little data on the effect of some of these drugs on the infant.

4. During pregnancy and soon after the birth of a baby, mothers are often able to change habits for the good, such as modifying their diet, stopping smoking and stopping the use of illicit drugs or excessive alcohol.

5. In one project, mothers were interviewed prenatally and post-partum for history of illicit drug use and tested for illicit drug use at delivery by toxicologic screen. Mothers who were planning to breast feed their infants had decreased the use of cocaine and marijuana as documented by toxicologic screen at birth as compared to mothers intending to feed their infants formula ( Frank, 1992 ).

6. Women who had a positive toxicology screen for any of the above named drugs were not able to stop the use of these drugs during pregnancy. The American Academy of Pediatrics recommends against breastfeeding for women using over 1 gm/kg/day of alcohol or the illicit drugs discussed below with the exception of Methadone. ( AAP DRUGS, 2001 ).