Alcohol While Breastfeeding
Alcohol — arguably the most socially acceptable drug of them all — can certainly find its way into your breast milk. Despite that, most medical professionals agree that having a drink or two once or twice a week won't do your baby any harm, even if you don't "pump and dump" after drinking. Do be mindful that "a drink" has quite a specific meaning. It refers to 25ml worth of spirits, 125ml of wine, or half a pint of beer.
Drink more than that in a single sitting, and you may want to wait a few hours before nursing your baby, and you may want to consider pumping and dumping in the meantime, while offering your baby previously pumped milk that wasn't "intoxicated", or feeding your baby formula. Heavy drinkers who consume more than two drinks a day while nursing may, on the other hand, be putting their baby's development at risk.
Over-The-Counter And Prescription Medications: Safe While Breastfeeding?
Most mothers are extremely careful with taking over-the-counter drugs while breastfeeding their babies and only use them when they feel they absolutely have to. While this is good, there is no need to suffer through a headache or fever just because you're nursing — the most commonly used medications are safe to use for nursing mothers. Though they may cross into your milk, they do so in only very small amounts. If you are in doubt, you can always, of course, contact your healthcare provider first.
Many prescription medications are likewise safe for breastfeeding moms and their babies, but there are some exceptions. If you're about to use lithium, drugs used to treat cancer, retinoids taken orally, amiodarone, idione, or gold salts, you're likely to discuss the fact that you're breastfeeding before you take them with your healthcare provider anyway, but just to be on the safe side, you, as an informed patients, should know these medications are not safe for breastfeeding mothers. The golden rule here is — whenever you're prescribed a medication, let your doctor know that you are breastfeeding and would like to keep breastfeeding unless you absolutely need to take a drug that is incompatible with nursing, for the sake of your own health.
Street Drugs And Nursing: What Do You Need To Know?
The topic of drug use and breastfeeding is a complex issue, not least because it covers mothers struggling with substance abuse as well as casual drug users. If you're a casual marijuana user who'd like to know if smoking pot while breastfeeding is OK, we'd advise you against it and encourage you to wait until you're done breastfeeding, the same way we'd advise a nursing mother who would like to be tattooed to wait — you have nothing to lose by waiting a bit!
If you're using street drugs and would like to know whether it's safer for you to breastfeed or formula-feed your infant, we'd advise you to turn to your own healthcare provider, ideally someone very familiar with maternal drug use, for advice.
In the most general terms, mothers using street drugs should know that crack and cocaine pass into the breast milk readily, because their molecules have a lower weight. Addicted moms who would nonetheless prefer to nurse their babies are advised to wait until 24 hours have passed since their last use to breastfeed their babies. It is certainly best, however, to abstain from these drugs.
Marijuana, heroin, methadone, and buprenorphine (the latter often used as substitution therapy) have higher molecular weights and do not transfer into your milk quite as easily. Besides molecular weight, numerous other factors play a role, such as the drug's half-life and your infants weight and health.
If you are using substitution therapy, certainly discuss this and breastfeeding with your healthcare provider. If you're using street drugs, we understand you may be reluctant to discuss this with any doctor, but would nonetheless encourage you to do so. While breastfeeding generally offers some important health benefits, these may be counter-acted by the effects of any drug you use, and formula feeding may be the better choice. This kind of risk-benefit analysis is best made in conjunction with a medical professional who knows your personal situation.
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