TABLE 2

Drugs of Abuse for Which Adverse Effects on the Breastfeeding Infant Have Been Reporteda

DrugReported Effect or Reason for ConcernReference
AlcoholImpaired motor development or postnatal growth, decreased milk consumption, sleep disturbances.Koren 2002,34 Backstrand 2004,35 Mennella 200736
Note: Although binge drinking should be avoided, occasional, limited ingestion (0.5 g of alcohol/kg/d; equivalent to 8 oz wine or 2 cans of beer per day) may be acceptable.National Academy of Sciences 199137
AmphetaminesHypertension, tachycardia, and seizures.Product labeling
In animal studies of postnatal exposure, long-term behavioral effects, including learning and memory deficits and altered locomotor activity, were observed.
BenzodiazepinesAccumulation of metabolite, prolonged half-life in neonate or preterm infant is noted; chronic use not recommended.Jain 2005,38 Malone 200439
Apnea, cyanosis, withdrawal, sedation, cyanosis, and seizures.
CocaineIntoxication, seizures, irritability, vomiting, diarrhea, tremulousness.Chasnoff 1987,40 Winecker 200141
HeroinWithdrawal symptoms, tremors, restlessness, vomiting, poor feeding.vandeVelde 200742
LSDPotent hallucinogen.
MethamphetamineFatality, persists in breast milk for 48 h.Ariagno 1995,43 Bartu 200944
Methylene dioxy-methamphetamine (ecstasy)Closely related products (amphetamines) are concentrated in human milk.
Marijuana (cannabis)Neurodevelopmental effects, delayed motor development at 1 y, lethargy, less frequent and shorter feedings, high milk-plasma ratios in heavy users.Djulus 2005,45 Campolongo 2009,46 Garry 201047
PhencyclidinePotent hallucinogen, infant intoxication.AAP 2001,6 Academy of Breastfeeding Medicine48
  • a Effect on maternal judgment or mood may affect ability to care for infant.