《2009ABM吸毒女性的母乳喂养指南》内容预览

Illicit drug use and licit substance abuse remain a signifi-cant problem among women of childbearing age. The 2007 National Survey on Drug Use and Health revealed that among pregnant women 15–44 years of age in the United States, 5.2% had used illicit drugs in the past month.

The healthcare provider faced with a pregnant or recently post-partum woman with a history of current or past drug abuse and desiring to breastfeed often faces a significant challenge for multiple reasons. Substance-dependent women frequently engender behaviors or conditions that portend risk for the breastfed infant independently, in addition to the direct phar-macologic effect of the drug exposure. Polydrug use is the norm for this population, including the use of licit substances such as tobacco and alcohol. Illicit drugs are frequently cut with dangerous adulterants that can pose additional threats to the infant. Drug using populations are at higher risk for in-fections such as those with human immunodeficiency virus (HIV) and=or hepatitis B=C, as well as poor nutrition. Psy-chiatric disorders that require pharmacotherapeutic inter-vention are more prevalent among this population, making breastfeeding a further confounded choice, as little informa-tion is available on the relative safety of breastfeeding with many psychotropic medications. Despite the myriad factors that may make breastfeeding a difficult choice for the drug-dependent woman, the population of drug-exposed infants, at high risk for an array of medical, psychological, and de-velopmental problems, as well as their mothers, stands to benefit significantly from this practice. Many of the above factors may pose risks to the infant, but the benefits of humanmilk and breastfeeding must be weighed against these risks.

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