title: Breast Milk and Hair Testing to Detect Illegal Drugs, Nicotine, and Caffeine in Donors to a Human Milk Bank.
abstract: BACKGROUND
  The use of illegal drugs and tobacco is an exclusion criteria for accepting a nursing mother as a milk donor. The detection window for human milk testing is typically a few hours. Hair testing has been considered the gold standard to assess chronic exposure to these toxic substances.
  
  
  OBJECTIVE
  The aim of this study was to determine the levels of illegal drugs, nicotine, and caffeine in breast milk and hair samples from donors to assess whether these substances were being used during the donation period and the months leading up to it.
  
  
  METHODS
  Thirty-six samples of hair and breast milk were obtained from 36 donors. The tests performed identified nicotine, caffeine, morphine, cocaine, cannabis, amphetamines, codeine, methadone, and other substances derived therefrom.
  
  
  RESULTS
  No illegal drugs were found in any of the samples analyzed. Nicotine and cotinine were found in 33.3% (12/36) of all hair samples. Among these 12 samples, 10 had cotinine concentrations consistent with cutoff values for unexposed nonsmokers, 1 had concentrations consistent with cutoff values for passive smokers, and 1 had concentrations consistent with cutoff values for active smokers. Caffeine was found in 77.7% of the hair samples and in 50% of the donor milk samples. The correlation for caffeine between donor milk and hair samples was r = 0.288, P = .0881.
  
  
  CONCLUSIONS
  Donors do not use illegal drugs during either the donation period or the months leading up to it. They are occasionally exposed to tobacco smoke and almost all of them consume caffeine.
authors.affiliation: Department of Neonatology, Hospital 12 de Octubre, Madrid, Spain diana.e.vieco@gmail.com.
authors.forename: Diana
authors.initials: D
authors.lastname: Escuder-Vieco
authors.affiliation: Unitat de Recerca Infància i Entorn, Institut Hospital del Mar d'Investigaciones Mèdiques, Barcelona, Spain.
authors.forename: Óscar
authors.initials: Ó
authors.lastname: Garcia-Algar
authors.affiliation: Unitat de Recerca Infància i Entorn, Institut Hospital del Mar d'Investigaciones Mèdiques, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Joya
authors.affiliation: Instituto Superiore di Sanitá, Rome, Italy.
authors.forename: Emilia
authors.initials: E
authors.lastname: Marchei
authors.affiliation: Instituto Superiore di Sanitá, Rome, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Pichini
authors.affiliation: Instituto Superiore di Sanitá, Rome, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Pacifici
authors.affiliation: Department of Neonatology, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Carmen Rosa
authors.initials: CR
authors.lastname: Pallás-Alonso
mesh_terms: D000328:Adult; D002110:Caffeine / Q000032:analysis*; D005260:Female; D006197:Hair / Q000737:chemistry*; D006801:Humans; D013287:Illicit Drugs / Q000032:analysis*; D017784:Milk Banks; D008895:Milk, Human / Q000737:chemistry*; D009538:Nicotine / Q000032:analysis*; D013030:Spain; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000175:diagnosis; D014019:Tissue Donors
chemical_list: D013287:Illicit Drugs; D002110:Caffeine; D009538:Nicotine
keywords: biological matrices; breastfeeding; donor milk; drug use; human milk banking