title: Maternal cocaine use during breastfeeding.
abstract: OBJECTIVE
  In my practice several patients have struggled with cocaine abuse during their pregnancies. One woman, now postpartum, wants to breastfeed her infant. Despite being abstinent for the final few months of her pregnancy, I am concerned about the potential adverse effects on her child if she happens to relapse. What is the current evidence about the risks of cocaine exposure during breastfeeding?
  
  
  CONCLUSIONS
  Given the substantial benefits of breastfeeding for infant health and development, there is no reason for mothers who previously abused cocaine to avoid breastfeeding. It is important for the health care team to counsel patients both on the serious potential risks of cocaine exposure for babies and on the benefits of breastfeeding, to allow for an informed choice. Additionally, attempts should be made to estimate maternal commitment to breastfeeding and discontinuation of cocaine use, and to offer addiction counseling to mitigate the potential risks of infant cocaine exposure. It is paramount to minimize the risk to the infant, which would certainly include mothers ceasing use of cocaine while breastfeeding. For mothers who elect to breastfeed and use cocaine intermittently, breastfeeding should be delayed sufficiently after cocaine use to allow for drug elimination (approximately 24 hours).
authors.affiliation: University of Toronto.
authors.forename: Alex M
authors.initials: AM
authors.lastname: Cressman
authors.forename: Gideon
authors.initials: G
authors.lastname: Koren
authors.forename: Anna
authors.initials: A
authors.lastname: Pupco
authors.forename: Eunji
authors.initials: E
authors.lastname: Kim
authors.forename: Shinya
authors.initials: S
authors.lastname: Ito
authors.forename: Pina
authors.initials: P
authors.lastname: Bozzo
mesh_terms: D001942:Breast Feeding; D003042:Cocaine / Q000493:pharmacokinetics; D019970:Cocaine-Related Disorders / Q000150:complications* / Q000517:prevention & control; D003376:Counseling; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018811:Maternal Exposure / Q000009:adverse effects*; D009294:Narcotics / Q000493:pharmacokinetics
chemical_list: D009294:Narcotics; D003042:Cocaine