Drugs of abuse

Despite the large volume of research proving the risks associated with tobacco use, many pregnant and breastfeeding women smoke cigarette. Increased infantile colic, increased susceptibility to respiratory infections, and decreased respiratory rates and oxygen saturation following suckling characterize the infants of smoking mothers.

Nicotine is presented in human milk in high concentrations and as a weak base it may

index depends on the number of cigarettes smoked by the mother daily. Harm minimization would be the best advice to the mothers that can be solved with limiting smoking as much as possible, prolonging the time between the last cigarette smoked and breastfeeding, switching to nicotine patches, smoking outside the house and avoiding smoky environments.

Breastfed infants with a significant maternal daily intake of caffeine may potentially accumulate toxic concentrations of the drug owing to the newborn‘s surprisingly slow elimination. In these cases irritability, vomiting and insomnia can be noticed in the nursing infants. Restricting caffeine consumption (to less than 300 mg/day) during breastfeeding is b necessary due to the drugs prolonged half-life in newborns.

Alcohol passes easily into breast milk at concentrations similar to those that exist in the mother‘s bloodstream. Only a fraction of the maternal ingested alcohol gets into the infant, but we have to take into account its low detoxification capacity. Alcohol induces several adverse effects on suckling infants. After moderate levels of ethanol exposure on the newborn, impaired motor development, changes in sleep patterns, decrease in milk intake, weight gain, and risk of alcohol-induced hypoglycemia have been reported. For causing mild sedation, acute neuronal dysfunction or death, larger amount of alcohol would be necessary. Harm minimization strategies should be applied by the nursing mothers that include: feeding infant before alcohol ingestion, avoiding suckling for 2-3 hours after drinking alcohol. Chronic or heavy consumers of alcohol should not breastfeed (7, 32).

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