Last update May 21, 2017

Heroin

Very High Risk

Very unsafe. Contraindicated. Use of an alternative or cessation of breastfeeding.

It is excreted in milk in sufficient quantity to create addiction in the infant (quoted in Eslami 2015 and Cobrinik 1959). Breastfeeding by mothers who are addicted to heroin can cause symptoms of severe respiratory distress with cyanosis, lethargy, poor nutrition or irritability in the infant (Joya 2011, van de Velde 2007) and prevent possible withdrawal symptoms in the infant (Eslami 2015, van de Velde 2007, Godfriend 1956). Long-term physical and psychomotor development may be diminished (Wilson 1979).

Heroin increases prolactin levels (Spagnolli 1987) and may cause galactorrhea-amenorrhea syndrome (Pelosi 1974).

Illegal psychotropic drugs impair the mother’s ability to care for her child, endangering the life and health of both (Eslami 2015, Joya 2011, Moretti 2000).

Co-sleeping with the baby is not recommended if this drug is being taken (UNICEF 2013, Landa 2012, ABM 2008, UNICEF 2006).

Alternatives

  • Buprenorphine ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Clonidine ( Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.)
  • Dextropropoxyphene ( Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.)
  • Methadone Hydrochloride ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Naltrexone (Moderately safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)

Suggestions made at e-lactancia are done by APILAM team, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Heroin is also known as


Group

Heroin belongs to this group or family:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. Baja - Low %
Molecular weight 369 daltons
Protein Binding 35 %
Tmax 1 hours
T1/2 2 hours
M/P ratio 2,5 -

References

  1. UNICEF UK. Caring for your baby at night. A guide for parents. 2018 Full text (link to original source) Full text (in our servers)
  2. Ball H, Blair PS. (For UNICEF UK). Caring for your baby at night. Health professional´s guide. 2017 Full text (link to original source) Full text (in our servers)
  3. Vallersnes OM, Dines AM, Wood DM, Yates C, Heyerdahl F, Hovda KE, Giraudon I; Euro-DEN Research Group., Dargan PI. Psychosis associated with acute recreational drug toxicity: a European case series. BMC Psychiatry. 2016 Aug 18;16:293. Abstract Full text (link to original source)
  4. Eslami-Shahrbabaki M, Barfeh D, Eslami-Shahrbabaki P. Breastfeeding: Neglect or Excessive Support? A Case Report of Child Abuse by a Negligent Heroin-Dependent Mother. Addict Health. 2015 Abstract Full text (link to original source) Full text (in our servers)
  5. UNICEF UK. Statement on co-sleeping following publication of new NICE postnatal guidance. Infosheet. 2014 Full text (link to original source) Full text (in our servers)
  6. Sachs HC; Committee On Drugs. The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics. 2013 Sep;132(3):e796-809. Abstract Full text (link to original source) Full text (in our servers)
  7. UNICEF UK Baby Friendly Initiative statement on Bed-sharing when parents do not smoke: is there a risk of SIDS? An individual level analysis of five major case-control studies. 2013 Full text (link to original source) Full text (in our servers)
  8. D'Apolito K. Breastfeeding and substance abuse. Clin Obstet Gynecol. 2013 Mar;56(1):202-11. Abstract
  9. L.Landa Rivera, M.Díaz-Gómez, A.Gómez Papi, J.M.Paricio Talayero, C.Pallás Alonso, M.T.Hernández Aguilar, J.Aguayo Maldonado, J.M.Arena Ansotegui, S.Ares Segura, A.Jiménez Moya, J.J.Lasarte Velillas, J.Martín Calama, M.D.Romero Escós. El colecho favorece la práctica de la lactancia materna y no aumenta el riesgo de muerte súbita del lactante. Dormir con los padres. Rev Pediatr Aten Primaria. 14:53-60 2012 Full text (link to original source) Full text (in our servers)
  10. Joya X, Fríguls B, Simó M, Civit E, de la Torre R, Palomeque A, Vall O, Pichini S, Garcia-Algar O. Acute heroin intoxication in a baby chronically exposed to cocaine and heroin: a case report. J Med Case Rep. 2011 Abstract Full text (link to original source) Full text (in our servers)
  11. ABM - Comité de protocolos de la Academia médica de lactancia materna (Academy of Breastfeeding Medicine). Protocolo Clínico de la ABM #6: Lineamientos sobre la práctica de dormir al bebé junto con la madre y la lactancia materna Revisión, marzo de 2008. Breastfeeding Medicine 2008 Full text (link to original source) Full text (in our servers)
  12. ABM - The Academy of Breastfeeding Medicine Protocol Committee. ABM Clinical Protocol #6: Guideline on Co-Sleeping and Breastfeeding. Breastfeeding Medicine 2008 Abstract Full text (link to original source) Full text (in our servers)
  13. vande Velde S, Verloo P, Van Biervliet S, Robberecht E. Heroin withdrawal leads to metabolic alkalosis in an infant with cystic fibrosis. Eur J Pediatr. 2007 Abstract
  14. UNICEF UK. Compartiendo la cama con tu bebé. Guía para madres que amamantan. Folleto 2006 Full text (in our servers)
  15. Moretti ME, Lee A, Ito S. Which drugs are contraindicated during breastfeeding? Practice guidelines. Can Fam Physician. 2000 Sep;46:1753-7. Review. Abstract Full text (link to original source) Full text (in our servers)
  16. Spagnolli W, De Venuto G, Mattarei M, Dal Ri P, Miori R. Prolactin and thyrotropin pituitary response to thyrotropin releasing hormone in young female heroin addicts. Drug Alcohol Depend. 1987 Abstract
  17. Wilson GS, McCreary R, Kean J, Baxter JC. The development of preschool children of heroin-addicted mothers: a controlled study. Pediatrics. 1979 Abstract
  18. Pelosi MA, Sama JC, Caterini H, Kaminetzky HA. Galactorrhea-amenorrhea syndrome associated with heroin addiction. Am J Obstet Gynecol. 1974 Abstract

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