Last update: Dec. 30, 2020

Maternal Drug Addiction

Very High Risk for breastfeeding


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

El consumo de drogas legales o ilegales es un problema grave de salud para las madres lactantes y sus hijos.
Es común el consumo simultáneo de varias drogas, además de tabaco y alcohol (ABM 2017).
Los adulterantes con los que se mezclan o cortan las drogas son sustancias con riesgos potenciales para la salud de madres y bebés.
Los consumidores de drogas tienen riesgo incrementado de padecer infecciones como VIH, Hepatitis B y C y problemas psiquiátricos.
Las madres con problemas de drogadicción tienen tasas muy bajas de amamantamiento (MacVicar 2018, Cook 2019) .

La mayoría de drogas son liposolubles y/o tienen una constante de disociación ácido-base (pKa) alta, de tipo base, por lo que se excretan en la leche materna y alcanzan mayor concentración en leche que en el plasma de la madre (D'Apolito 2013, Rowe 2013) y son de riesgo para el desarrollo neurológico y somático de los lactantes (ABM 2017, Sachs 2013).

Hay que desarrollar e involucrar a las madres que lactan y consumen drogas en programas de deshabituación para que puedan beneficiarse ellas y sus hijos de los innumerables beneficios de la lactancia (Cook 2019, ABM 2017). Las políticas de salud deben reemplazar a las acciones punitivas legales para afrontar este problema (Jessup 2019).

Las drogas psicotropas de abuso incapacitan a la madre para cuidar de su hijo, poniendo en peligro la vida y salud de ambos (Cook 2019, Eslami 2015, Joya 2011, Moretti 2000).
No se recomienda compartir cama con el bebé si se consumen drogas debido a riesgo incrementado de asfixia o muerte súbita del lactante (UNICEF 2018, 2017, 2014 y 2013, Landa 2012, ABM 2008, UNICEF 2006).


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Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, 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. UNICEF UK. Caring for your baby at night. A guide for parents. 2018 Full text (link to original source) Full text (in our servers)
  4. MacVicar S, Humphrey T, Forbes-McKay KE. Breastfeeding and the substance-exposed mother and baby. Birth. 2018 Dec;45(4):450-458. Abstract
  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. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  11. 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)
  12. 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)
  13. D'Apolito K. Breastfeeding and substance abuse. Clin Obstet Gynecol. 2013 Mar;56(1):202-11. Abstract
  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 - 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)
  17. 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)
  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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