Pregnant or new birth parents with a history of nonprescribed substance use or substance use disorder (SUD) often experience lack of support to breastfeed. These individuals require education for shared decision-making regarding breastfeeding or provision of their milk, as both the parent and infant have the right to health equity afforded by breastfeeding and lactation. Unfortunately, pregnant and new birth parents are often faced with a variety of breastfeeding rules and limitations that are not evidence based.
The Academy of Breastfeeding Medicine (ABM) recently published their updated protocol #21 regarding guidelines on breastfeeding in the setting of substance use and SUD.
According to the 2021 US National Survey on Drug Use and Health data, 7.7%, 10.8%, and 9.8% of pregnant women reported past-month use of nonprescribed substance use, tobacco use, and alcohol use, respectively.
The protocol points out that interdisciplinary prenatal care that includes mental health and addiction treatment, along with social support services leads to improved OB and neonatal outcomes.
There is a great deal of valuable information in this protocol- Test yourself with this week’s question before reading the protocol!
Cecile Tran
Dear Dr. Eglash, thanks for updating us on the latest ABM protocol #21. I have a question concerning Cannabis. In terms of what are the actually route , type of cannabis product and potency and frequency we can inform clients that are considered the lowest risk to the baby and mother dyad? The protocol doesn’t give that info just tells us to discuss about that to mothers who wish to use cannabis while breastfeeding (perhaps it is beyond the scope of the article). But where can we get that info or if you can share what info you actually provide in your practice in that situation. Thank you !
IABLE
Hi Cecile,
I don’t have that information. I would encourage you to contact the Infant Risk Center. Dr. Thomas Hale has done cannabis research and may be able to give better guidance on this. OVerall, though, the less cannabis use the better, and the lower the strength the better.