ABM Clinical Protocol #21: Guidelines for Breastfeeding and Substance Use or Substance Use Disorder, Revised 2015

Reece-Stremtan, Sarah; Marinelli, Kathleen A.

doi:10.1089/bfm.2015.9992

Cited by 232 publications

(155 citation statements)

References 47 publications

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“…The guidelines conclude by stating, ''At this time, although the data are not strong enough to recommend not breastfeeding with any marijuana use, we urge caution.'' 12 This recommendation appears consistent with what many lactation professionals reported in our survey, that is, that they make decisions on a case-by-case basis.…”

Section: Discussionsupporting

confidence: 90%

“…Of note is that the ABM very recently revised its guidelines 12 (published in April 2015) and made recommendations regarding use of several specific drugs of abuse during lactation, including marijuana. The guidelines conclude by stating, ''At this time, although the data are not strong enough to recommend not breastfeeding with any marijuana use, we urge caution.''…”

Section: Discussionmentioning

confidence: 99%

“…The recent ABM protocol, 12 the current LactMed entry on cannabis, 5 and a 2013 review by Hill and Reed 14 address the shifting appraisal of marijuana use as a contraindication to breastfeeding. All three sources reiterate concerns over certain potential risks, like infant sedation, maternal inability to care for her infant while she is under the influence of marijuana, and developmental disruptions, while also acknowledging the general lack of research in this area.…”

Section: Discussionmentioning

confidence: 99%

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Surveying Lactation Professionals Regarding Marijuana Use and Breastfeeding

Bergeria

Heil

2015

Breastfeeding Medicine

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Background: Breastfeeding is associated with substantial benefits for both the child and mother. Most guidelines state that women who use illicit drugs should not breastfeed. Although this recommendation has traditionally included marijuana, this drug's changing legal status and the limited scientific research regarding marijuana's effect on breastfeeding and the nursing child may lead to varying recommendations made by lactation professionals to clients who use marijuana. Additionally, to our knowledge, there are no data estimating the prevalence of marijuana use among breastfeeding women, making it unclear how common it is. This study assessed recommendations around breastfeeding and marijuana use and estimated the prevalence of marijuana use among breastfeeding women. Materials and Methods: A convenience sample of lactation professionals who practice throughout New England and were attending the 2014 Vermont Lactation Consultant Association conference was offered the opportunity to complete a five-item survey. Results: Of 120 conference attendees, 74 completed the survey. Forty-four percent reported their recommendations around breastfeeding and marijuana use depended on factors like the severity of maternal use. Another 41% reported recommending continued breastfeeding because the benefits outweigh the harms. The remaining 15% reported recommending that a woman should stop breastfeeding if she cannot stop using marijuana. Survey completers estimated that 15% (1,203/7,843) of their breastfeeding clients in the past year used marijuana. Conclusions: Lactation professionals vary widely in their recommendations to breastfeeding clients who use marijuana. The estimate of prevalence also suggests this is a relatively common issue. More research is needed to assess the generalizability of these findings.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Surveying Lactation Professionals Regarding Marijuana Use and Breastfeeding

Bergeria

Heil

2015

Breastfeeding Medicine

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“…Another study concluded that: potential infant alcohol doses were low (3.0 – 58.8 mg (mean 13.4 mg)); predicted time required for milk to return to zero alcohol content was 175 minutes after drinking; health risks to the infant from a single dose were low; but nursing activity should be postponed for three hours after the maternal alcohol use of a dose equal to one standard drink [30]. Academy of Breastfeeding Medicine guidelines also recommend a two hour wait before resuming nursing, but state that “possible long-term effects of alcohol in maternal milk remain unknown” [31]. Therefore, frequent drinking, and heavy, binge drinking over time during the breastfeeding period appear to present a risk to the development of an infant and toddler, for alcohol is a potent teratogen and may also negatively affect development postpartum.…”

Section: Introductionmentioning

confidence: 99%

Breastfeeding and maternal alcohol use: Prevalence and effects on child outcomes and fetal alcohol spectrum disorders

May

Hasken

Blankenship

et al. 2016

Reproductive Toxicology

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Objective Determine any effects that maternal alcohol consumption during the breastfeeding period has on child outcomes. Methods Population-based samples of children with fetal alcohol spectrum disorders (FASD), normally-developing children, and their mothers were analyzed for differences in child outcomes. Results Ninety percent (90%) of mothers breastfed for an average of 19.9 months. Of mothers who drank postpartum and breastfed (MDPB), 47% breastfed for 12 months or more. In case control analyses, children of MDPB were significantly lighter, had lower verbal IQ scores, and more anomalies in comparisons controlling for prenatal alcohol exposure and final FASD diagnosis. Utilizing a stepwise logistic regression model adjusting for nine confounders of prenatal drinking and other maternal risks, MDPB were 6.4 times more likely to have a child with FASD than breastfeeding mothers who abstained from alcohol while breastfeeding. Conclusions Alcohol use during the period of breastfeeding was found to significantly compromise a child’s development.

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“…40 Methadone and buprenorphine can be found in low concentrations in breast milk. 41 However, according to the Academy of Breastfeeding Medicine's clinical guidelines, women on stable doses of methadone and buprenorphine should be encouraged to breastfeed. 41 Naltrexone enters breast milk and has potential adverse effects for the newborn.…”

Section: Special Populationsmentioning

confidence: 99%

Inpatient Management of Opioid Use Disorder: A Review for Hospitalists

Theisen‐Toupal

Ronan

Moore

et al. 2017

Journal of Hospital Medicine

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The United States is experiencing an epidemic of nonmedical opioid use and opioid overdose-related deaths. As a result, there have been a number of public health interventions aimed at addressing this epidemic. However, these interventions fail to address care of individuals with opioid use disorder during hospitalizations and, therefore, miss a key opportunity for intervention. The role of hospitalists in managing hospitalized patients with opioid use disorder is not established. In this review, we discuss the inpatient management of individuals with opioid use disorder, including the treatment of withdrawal, benefits of medication-assisted treatment, and application of harm-reduction strategies.

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ABM Clinical Protocol #21: Guidelines for Breastfeeding and Substance Use or Substance Use Disorder, Revised 2015

Cited by 232 publications

References 47 publications

Surveying Lactation Professionals Regarding Marijuana Use and Breastfeeding

Surveying Lactation Professionals Regarding Marijuana Use and Breastfeeding

Breastfeeding and maternal alcohol use: Prevalence and effects on child outcomes and fetal alcohol spectrum disorders

Inpatient Management of Opioid Use Disorder: A Review for Hospitalists

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