Many studies have shown that drugs and alcohol can be transferred from breast milk to infants thus drugs and alcohol should be avoided while breast feeding. Mothers who struggle with reducing drug and alcohol consumption should consider entering a drug or alcohol rehab. In an alternative to AA, a self-empowering approach can be used to help mothers learn how to abstain from all drugs and alcohol and learn tactics to cope with cravings so mothers can continue to breast feed without possible harm to the infant. Individualized treatment plans can be created for mothers who are breast feeding which can emphasize on specific thoughts, feelings and behaviors that may have been the cause for their drug and alcohol consumption, and learn how to manage them.
Should mothers who abuse drugs continue to breastfeed their babies? Should mothers discontinue the use of certain medications when breastfeeding? There has been some confusion and disagreement on this issue in scientific circles. A team of researchers in Spain and Italy reviewed analytical methods of detecting drugs in breast milk and offered recommendations to mothers (Friguls et. al., 2010).
“The general recommendation is to totally avoid drug abuse while breastfeeding, because these substances can pass directly through to the newborn,” said co-author Oscar García-Algar of the Pediatrics Department at the Hospital del Mar in Barcelona, Spain. “This recommendation extends to the prenatal period, because these substances are passed on to the fetus via the placenta, and then in the postnatal period via the environment. If they have exposure through the milk, they will certainly also have had it during the pregnancy, and they can also be in the environment, as is the case with tobacco smoke.”
The research team offered the following recommendations to mothers: Smoking should be given up during pregnancy and breastfeeding. Caffeine consumption during breastfeeding should be reduced to a maximum of 300 mg/day (approximately 3 cups of coffee). Current research suggests that alcohol consumption during breastfeeding may interfere with the infant’s motor development as well as sleep pattern and appetite. According to the researchers, no amount of alcohol consumption can be considered safe while breastfeeding. Risk may be minimized by feeding the baby before consuming alcohol or by waiting for several hours to pass after drinking. The researchers advise alcohol dependent mothers to feed their baby with a bottle.
Cannabis may cause sedation, weakness, and poor feeding in breastfeeding babies, and the long-term risks are unknown. Breastfeeding women are advised to avoid marijuana use, especially several hours before breastfeeding. As for cocaine, the advice is to “totally avoid it” during breastfeeding. Cocaine transferred to the breast milk may cause infant tachycardia and high blood pressure. Amphetamines and heroin should also be avoided by women who are breastfeeding. Opiates used as medicines are transferred to breast milk in minimal amounts and are compatible with breastfeeding as long as the proper dosage is maintained. The effects of antidepressant and antipsychotic drugs on breastfeeding infants are unknown at this time, and further research is warranted.
Friguls B, Joya X, Garcia-Algar O, Pallas CR, Vall O, Pichini S. A comprehensive review of assay methods to determine drugs in breast milk and the safety of breastfeeding when taking drugs. Analytical and Bioanalytical Chemistry. 2010; 397(3): 1157-1179.