Last update May 21, 2021

Maternal Drug Addiction

Very High Risk

Very unsafe. Contraindicated. Use of an alternative or cessation of breastfeeding. Read the Comment.

The use of legal or illegal drugs is a serious health problem for nursing mothers and their children.
The simultaneous use of several drugs, in addition to tobacco and alcohol, is common (ABM 2017).
Adulterants with which drugs are mixed or cut are substances with potential health risks for mothers and babies.
Drug users are at increased risk for infections such as HIV, Hepatitis B and C, and psychiatric problems.
Mothers with drug addiction problems have very low breastfeeding rates (MacVicar 2018, Cook 2019).

Most drugs are fat-soluble and/or have a high acid-base dissociation constant (pKa), of the base type, which is why they are excreted in breast milk and reach a higher concentration in breast milk than in the mother’s plasma (D’Apolito 2013, Rowe 2013) and present a risk for the neurological and somatic development of infants (ABM 2017, Sachs 2013).

Mothers who breastfeed and use drugs must be enrolled and involved in cessation programs so that they and their children can benefit from the myriad benefits of breastfeeding (Cook 2019, ABM 2017). Health policies must replace punitive legal actions to address this problem (Jessup 2019).

Psychotropic drugs of abuse disable the mother from being able to care for her child, endangering the lives and health of both (Cook 2019, Eslami 2015, Joya 2011, Moretti 2000).
Bed-sharing with the baby is not recommended if drugs are used due to increased risk of suffocation or sudden infant death (UNICEF 2018, 2017, 2014 and 2013, Landa 2012, ABM 2008, UNICEF 2006).


See below the information of these related products:

  • Alcohol (alcoholic beverage) ( Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.)
  • Amfetamine (Moderately safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)
  • Buprenorphine ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Cannabis (Very unsafe. Contraindicated. Use of an alternative or cessation of breastfeeding. Read the Comment.)
  • Cocaine (Very unsafe. Contraindicated. Use of an alternative or cessation of breastfeeding. Read the Comment.)
  • Heroin (Very unsafe. Contraindicated. Use of an alternative or cessation of breastfeeding. Read the Comment.)
  • Lysergic acid diethylamide (LSD) (Very unsafe. Contraindicated. Use of an alternative or cessation of breastfeeding. Read the Comment.)
  • Metamfetamine Hydrochloride (MA) ( 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.)
  • Morphine (Moderately safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)
  • Phencyclidine (Very unsafe. Contraindicated. Use of an alternative or cessation of breastfeeding. Read the Comment.)
  • Tobacco ( Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). 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.

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References

  1. Cook KJ, Larson KL. Breastworks: Breastfeeding practices among women with substance use disorder. Appl Nurs Res. 2019 Jun;47:41-45. Abstract
  2. Jessup MA, Oerther SE, Gance-Cleveland B, Cleveland LM, Czubaruk KM, Byrne MW, D'Apolito K, Adams SM, Braxter BJ, Martinez-Rogers N. Pregnant and Parenting Women with a Substance Use Disorder: Actions and Policy for Enduring Therapeutic Practice. Nurs Outlook. 2019 Mar - Apr;67(2):199-204. Abstract
  3. MacVicar S, Humphrey T, Forbes-McKay KE. Breastfeeding and the substance-exposed mother and baby. Birth. 2018 Dec;45(4):450-458. Abstract
  4. UNICEF UK. Caring for your baby at night. A guide for parents. 2018 Full text (link to original source) Full text (in our servers)
  5. 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)
  6. ABM. Reece-Stremtan S, Marinelli KA. ABM Clinical Protocol #21: Guidelines for Breastfeeding and Substance Use or Substance Use Disorder, Revised 2015. Breastfeed Med. 2015 Abstract Full text (link to original source) Full text (in our servers)
  7. ABM Protocolo clínico de la ABM n.º 21: Pautas para la lactancia y el consumo de sustancias o trastorno por consumo de sustancias, revisado en 2015. Breastfeed Med. 2015 Full text (link to original source) Full text (in our servers)
  8. 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)
  9. 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)
  10. 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. None 2013 Full text (link to original source) Full text (in our servers)
  11. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  12. D'Apolito K. Breastfeeding and substance abuse. Clin Obstet Gynecol. 2013 Mar;56(1):202-11. Abstract
  13. 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)
  14. 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)
  15. 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)
  16. 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)
  17. 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)
  18. UNICEF UK. Compartiendo la cama con tu bebé. Guía para madres que amamantan. Folleto 2006 Full text (in our servers)
  19. 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)

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