Drug Use While Breastfeeding: Dangers, Side Effects & More

Statistics on Drug Abuse While Breastfeeding

Available data specifically on people breastfeeding while on drugs is limited. However, a few data points are known that can at least help us begin to understand the scale of this issue and the importance of people who may choose to breastfeed staying aware of the potential for drugs to affect their breast milk. 

It’s estimated about 75 percent of mothers in the U.S. start out breastfeeding. Data on people who may be able to produce milk but are not cisgender females is more or less nonexistent at this time. However, this initial estimate at least allows for a broad, basic data point to work from.

It’s also known that about one in eight children have at least one parent with a substance use disorder (SUD). 

Together, these statistics can begin to show that a significant minority of children may be at risk of potential exposure to drugs through breast milk. It is also worth noting that prescription medication can also sometimes affect breast milk, and a person can abuse drugs without having an SUD. Furthermore, not all illicit and recreational drugs affect breast milk, although many do.

All of the above still leaves many unknowns. For example, it is very likely that many parents who would normally breastfeed choose not to because they are aware of their issues with drugs or the potential for a substance they’re taking to affect their child. 

Data on how aware parents are of this potential health concern and how they act when made aware remains very limited. More research is needed in this area. 

Drug Excretion in Breast Milk & Baby Exposure

The basic health issue related to drug use and breast milk is drug excretion. When a person produces milk, generally as a result of hormonal changes during and after pregnancy, certain actions can affect the quality of that milk. One of the most significant is taking certain drugs, which may affect the milk and expose the baby feeding on that milk to the drug or otherwise change the chemical nature of the milk in a significant, potentially dangerous way. 

While not all drugs have this effect, it is important to talk to a doctor about the drugs you take, both recreationally and as treatment for any health conditions, before breastfeeding. You can also research the drugs you’re taking and see how they may or may not affect a person’s milk. 

While breastfeeding is generally considered healthier than feeding a baby formula, at least before certain benchmarks, it is much preferable to avoid exposing a baby to potentially dangerous natural milk in favor of formula if there is a safety concern. 

Why Is Drug Use & Breastfeeding Potentially Dangerous?

Although the specifics vary, a few key factors make drug excretion a potential threat to a baby’s health. 

Importantly, a baby’s body is much smaller and less developed than an adult’s body. The baby is far more vulnerable to certain chemical changes, and the proportional dose of a drug that is considered dangerous for a baby can be much smaller than it would be for an adult. Furthermore, the younger a baby, the more dangerous drug excretion can be.

In the worst case scenario, a parent’s milk that has been affected by drug use can directly expose the baby to that same drug. While the precise reason this is dangerous varies (and the level of danger varies), it’s clearly generally bad for a baby to be exposed to drugs that are not necessary for their health, even in very small doses. 

In less severe cases, some substances are known to affect the taste of milk or the rate of a person’s milk production, which may mean a baby drinks less than they should to remain healthy. 

Common Drugs That Can Affect Breast Milk

Some common drugs known to affect human breast milk include the following:

• Some anticancer drugs
• Lithium
• Oral retinoids
• Iodine
• Amiodarone
• Gold salts

Some recreational/illicit drugs that are known to affect breast milk include the following:

• Excessive use of alcohol (more than two standard drinks a day)
• Amphetamines
• Ecstasy
• Cocaine
• Heroin and similar opioids

The above list isn’t all-encompassing, and it is important to do your research when seeing if drugs you’re taking may affect the quality of your breast milk. If it’s ever unclear whether a substance is safe or not, avoid feeding your baby your milk until first talking with a doctor to confirm whether it is safe to do so. 

The specific effect a given drug may have on milk and milk production may vary. As a baby’s body can be very sensitive to chemical changes and the alternative of formula exists, it is generally best to play it safe and avoid feeding a baby milk that may even possibly be unsafe for them. Babies are in arguably the most important phase of the human development cycle, so it’s best to err on the side of caution. 

Why Do Some People Use Drugs While Breastfeeding?

There are a number of reasons a person may use drugs while breastfeeding. One of the most obvious is that they may be unaware of the potential for drugs to affect their breast milk and, through that milk, their baby’s health. They may also underestimate the potential harm drug use can do to a baby even if they do understand some of the basics of drug excretion. 

Some people struggle with drug abuse, and they cannot stop using drugs on their own even if they want to or know it is affecting their health, their baby’s health, or both. Baby formula can also be expensive in the United States, with some parents not having an easy way to access this alternative to breastfeeding.

Prevention & Harm Reduction

Parenthood can be difficult, especially in the United States where the resources available to people struggling with drug abuse or poverty may be limited. The following are some tips to help prevent or reduce your potential for doing harm to your baby while trying to feed them.

Stopping the Drug Use

While we don’t want to downplay the fact that it is usually much easier to write about solutions to issues than actually implement those solutions, there are essentially two ideal ways to feed a baby if you are using drugs that may affect your milk.

The first is to stop taking those drugs, which often quickly allows your body to produce milk normally again. Admittedly, this may not be possible for people who are taking medications for a serious health condition or those who are struggling with drug abuse. 

You should also talk to your doctor before you stop taking any medications meant to treat a health condition. They can potentially give you a timeline of when your milk might be safe again once you stop taking drugs that were affecting it. Sometimes, it takes as little as 24 hours for production to become normal again.

Formula & Other Sources of Milk

If stopping the drug use is not an option, talk to a pediatrician about switching your baby to formula. Baby formula is often a safe alternative for babies, but you should still talk to a pediatrician about the change, especially if your baby is very young.

If formula is unavailable or for some reason not an option for you, you may be able to feed your baby using alternative sources of milk. However, it’s very important to discuss this option with a doctor, as there are some pitfalls that can put a baby at risk. 

One of the best options is to source human milk from the Human Milk Banking Association of North America (HMBANA), although they have limited supply that often goes to hospitalized babies. 

What to Avoid

Some important things to avoid that may initially seem like good ideas include the following:

• Buying human milk online, which often has very poor (if any) quality control
• Making formula at home, which is a complicated process that introduces many safety concerns
• Watering down formula, which reduces the nutrients in formula and means a baby may become dangerously malnourished when fed in this way
• Using expired formula, which may be dangerous or lacking nutrients
• Ignoring the issue altogether, which can expose your baby to danger if you don’t adjust your habits and are using drugs that are affecting your milk

Getting Help if You Are Breastfeeding & Using Drugs

If you have a problem with drug use, the Substance Abuse and Mental Health Services Administration (SAMHSA) has a helpline you can call. This can be a great resource for those seeking to get control over their drug use but don’t know where to start. It’s free and confidential and available at 1-800-662-HELP (4357) in both English and Spanish. 

If you struggle with drug abuse, consider seeing a mental health professional who specializes in addiction. They can help you identify the root causes of your problem with drugs and equip you with the tools to better resist drugs. 

It’s worth noting that parenthood can be inherently challenging and stressful. Even if you love your child dearly, they can undeniably be a drain on your finances and energy. Talking to a mental health professional about this in a confidential, judgment-free setting can be helpful for processing any negative feelings you have in a healthy way. This can reduce your risk of engaging in drug abuse and also improve your overall quality of life. 

The Difference Between ‘Unknown’ & ‘Safe’ Drugs

When researching drugs, you will often discover a statement reflecting a lack of research into how it may or may not affect breast milk. This can be true of both illicit/recreational drugs and prescription drugs that a person breastfeeding may have a legitimate medical reason to use. 

It’s important to understand that a drug’s effect on breast milk being unknown is not the same as it being safe. As a rule, unless research has outright confirmed a drug is safe and doesn’t affect breast milk, assume it is not safe to breastfeed while that drug may be in your system.