Tox Tuesday: Drug use and breast milk

Baby having mom's careGrowing by approximately 74 million people per year, the United Nations’ World Population Prospects estimates that the world will reach nine billion people by 2040. At the same time, drug use, both legal and recreational, is also expected to continue to grow, including use among women of childbearing age.

This is based on the most recent National Survey on Drug Use and Health, which revealed that among pregnant women in the U.S. between the ages of 15 and 44, 5.2% of them had used illicit drugs in the past month. These statistics concern researchers, including those who are studying the effects of drugs in breast milk on nursing infants, especially as the practice has regained popularity over the past few decades.

The benefits of breastfeeding for both mother and child have been widely studied and promoted as research has shown that breast milk from a healthy mother can supply the necessary nutrients her child needs, as well as being able to protect them against allergies, sickness, disease and infection. However, there is a direct correlation between what a nursing mother consumes and the substances found in her breast milk.

For example, when a mother ingests illicit substances like drugs or alcohol, her milk can become tainted with them as well. According to one article, this leaves the baby’s system responsible for metabolizing the substance(s), which can be very difficult and even potentially deadly.

This can also be a concern for milk banks around the U.S. that take breast milk donations and provide it to infants in need. In these instances milk is usually “pooled,” meaning donations from various women are mixed together before dispensed. If the proper testing is not done, harmful substances in the milk could be potentially passed on and digested by the infant recipients.

Studies have generally shown that a lot of over-the-counter medications and even some prescription drugs are unlikely to cause problems for breastfeeding infants when their mothers consume them as directed. However, healthcare providers continue to stress the importance of speaking with a professional before taking any kind of medication or drugs while breastfeeding. Regardless of these studies, however, real-life examples of the dangers of consuming drugs while breastfeeding have been shown in news stories around the world.

For example, one case  made headlines recently when a nursing mother was convicted and sentenced to 20 years in prison for killing her six-week-old daughter with what prosecutors say was an overdose of morphine delivered through her breast milk. The mother of the child had prescriptions for several painkillers resulting from a serious car accident. Prosecutors argued that she hid her pregnancy from her doctors, while the mother’s lawyers said the prosecutors never proved the possibility for such heavy doses of the painkillers to pass through breast milk and argued there is little scientific research done on the matter.

In another similar case, a woman was charged with murder after her baby also died after ingesting morphine-tainted breast milk. It turned out the woman was a “rapid metabolizer” of morphine, and extremely high levels of morphine were transferred to her breast milk. As stated in the article, this caused controversy because the defense argued women have been prescribed morphine for postpartum pain, as studies have previously shown its relative safety and has few side effects.

In California, a woman was arrested after the death of her baby who was found to have traces of methamphetamine in her system,which she ingested via her mother’s breast milk. The article notes a form of methamphetamine has been used for many years as a treatment for various conditions, including narcolepsy, and has never before been ruled the cause of death in a breastfeeding child.

To go along with these cases, a 2009 study in the Journal of Toxicology, found that compounds in marijuana can be easily passed on from breast milk to a baby during breastfeeding, which may cause developmental delays for the child. A combination of animal trials and human data were used in the study and according to the French researchers, they suggest that women who use marijuana should not breastfeed.

As stated in the article, the primary active component of marijuana, tetrahydrocannabinol, or THC, is what is responsible for marijuana’s stimulating properties and a small percentage of this compound can be transferred to a nursing baby through breast milk. The study found that THC can be excreted in the baby’s urine for up to three weeks after the mother’s drug use. The scientists found that THC can accumulate in breast milk and in some instances there were a measurable effects on infant motor skills after they ingested the tainted breast milk.

The researchers involved in the study suggested that breastfeeding mothers who regularly use marijuana should avoid breastfeeding altogether, since it is unclear how long the drug may be excreted in their milk and what the short- and long-term effects may be in children. THC can stay in maternal fat stores and body tissue for weeks to months, and may potentially pass to the baby during this same time period as well.

While some argue the science behind these incidents, the truth of the matter is that the effects some drugs have on children when ingested through breast milk are largely unknown.

The American Academy of Pediatrics released a report that categorizes drugs of abuse into different areas including the following:

Because of the level of uncertainty when it comes to the effects drugs have on infants when transferred via breast milk, proper testing of the milk can reveal if it is contaminated and help ensure its safety before consumption.

Neogen’s drug detection kits work with a variety of matrices including urine, oral fluid, blood, and breast milk. For more information on Neogen’s drug detection products, click here.

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