Nicotine Replacement Products: Implications for the Breastfeeding Mother

Measurement of nicotine and cotinine in human milk by high-performance liquid chromatography with ultraviolet absorbance detection

“…This practice continues despite the widespread recognition of the proven adverse consequences of environmental tobacco exposure for the neonate [21,22], and the possibility of unwanted pharmacological effects in neonates from direct exposure to nicotine and its metabolic products via breast milk [23]. Using nicotine replacement therapy to assist women smokers to quit is one way of avoiding adverse health effects in the breast-fed infant [23].…”

Use of nicotine patches in breast-feeding mothers: transfer of nicotine and cotinine into human milk

“…The American Academy of Pediatrics has recently highlighted the problems andcontroversies over continuing to smoke while breast‐feeding 7 . Smoking during lactation is prevalent despite the widespread recognition of the proven adverse consequences of environmental tobacco exposure for the neonate, 8 , 9 as well as the possibility of unwanted pharmacologic effects in neonates from direct exposure to nicotine and its metabolic products via breast milk 10 . For mothers who smoke, it has been shown that urinary cotinine levels are some 10‐fold higher in those infants who were breast‐fed versus those who were bottle‐fed 8 .…”

“…Although smoking has been suggested to decrease the duration of breast‐feeding, a recent review has not supported this hypothesis 13 . The use of nicotine replacement therapy to assist female smokers in quitting is one way of minimizing adverse health effects in the breast‐fed infant 10 , 14 …”

“…7 Smoking during lactation is prevalent despite the widespread recognition of the proven adverse consequences of environmental tobacco exposure for the neonate, 8,9 as well as the possibility of unwanted pharmacologic effects in neonates from direct exposure to nicotine and its metabolic products via breast milk. 10 For mothers who smoke, it has been shown that urinary cotinine levels are some 10-fold higher in those infants who were breast-fed versus those who were bottle-fed. 8 There is evidence that maternal smoking may decrease milk supply by decreasing prolactin, 11 and there are also changes in the odor and flavor of breast milk that might affect the breast-fed infant.…”

“…13 The use of nicotine replacement therapy to assist female smokers in quitting is one way of minimizing adverse health effects in the breast-fed infant. 10,14 This study in breast-feeding mothers who smoked presents data on the amount of nicotine and cotinine in breast milk during smoking, as well as while they were treated with nicotine transdermal patches. Data on infant milk intake, plasma concentrations of nicotine and cotinine, and general well-being were also obtained.…”