title: Drugs of Abuse in Human Milk Purchased via the Internet.
abstract: BACKGROUND
  Human milk purchased via the Internet poses a potential risk of recipient infant exposure to drugs, but this risk has not been quantitated by research. Our objective was to test milk we purchased via the Internet for 13 common classes of drugs of abuse to explore the extent of possible exposure to recipient infants.
  
  
  METHODS
  Samples (n = 102) of milk purchased via the Internet were tested for 13 groups of drugs that are commonly abused using immunoassay screening to identify suspected positives, followed by liquid chromatography/tandem mass spectrometry or gas chromatography/mass spectrometry for confirmation. Sellers' advertisements were abstracted for statements about drug use or abstinence.
  
  
  RESULTS
  Most (71%) sellers stated in their advertisement that they abstained from some type(s) of drugs (prescription or illicit), but 29% indicated nothing about drug use or abstinence. No sellers admitted to illicit drug use in their advertisement. No samples tested positive for the selected drugs of interest (prevalence = 0%; 95% confidence interval, 0.0, 2.9).
  
  
  CONCLUSIONS
  We did not detect any of the selected drugs in 102 milk samples. Our sample was too small to detect less commonly used drugs and to provide a narrow confidence interval around the prevalence estimate and did not include milk shared at no cost. Thus, these findings are exploratory and cannot rule out the possibility of drugs being present in other milk available via the Internet.
authors.affiliation: 1 Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital , Columbus, Ohio.|2 Department of Pediatrics, College of Medicine, The Ohio State University , Columbus, Ohio.|3 Division of Epidemiology, College of Public Health, The Ohio State University , Columbus, Ohio.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Keim
authors.affiliation: 1 Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital , Columbus, Ohio.
authors.forename: Kelly
authors.initials: K
authors.lastname: McNamara
authors.affiliation: 4 Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University , Columbus, Ohio.|5 Department of Microbiology, College of Arts and Sciences, The Ohio State University , Columbus, Ohio.
authors.forename: Jesse J
authors.initials: JJ
authors.lastname: Kwiek
authors.affiliation: 6 Cincinnati Children's Center for Breastfeeding Medicine, Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio.
authors.forename: Sheela R
authors.initials: SR
authors.lastname: Geraghty
mesh_terms: D000328:Adult; D002853:Chromatography, Liquid; D005260:Female; D005506:Food Contamination / Q000032:analysis*; D006801:Humans; D013287:Illicit Drugs / Q000032:analysis / Q000302:isolation & purification*; D007223:Infant; D007231:Infant, Newborn; D020407:Internet; D013058:Mass Spectrometry; D008895:Milk, Human / Q000737:chemistry*
chemical_list: D013287:Illicit Drugs