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  • Cocaine

    Hello,

    My sister has an 11 month old child who is combined formula fed and breastfed. She had decided to wean them and switch primarily to formula. However, now she has changed her mind and wants to continue breastfeeding. The issue is - after she made the original decision, her and her husband went away for a weekend to celebrate their anniversary. She said they were drinking heavily and she ended up partaking in about 0.25 grams of cocaine over an 8-hour period. This isn't normal for her at all. She has not done this in over 10 years since her college days, and even then it was not often. It won't happen again.
    When she returned home, she realized she didn't want to end her breastfeeding journey completely but is now concerned about what is in her system.

    This incident happened last Saturday night into early Sunday morning. She has been formula-feeding ever since.

    She bought an at-home urinalysis that tested positive at the 36-hour mark but negative at the 60-hour mark. It's been almost 80 hours now since she partook - but is still formula-feeding since the research is not very straightforward and she wants to be sure her baby is safe.

    Couple Questions:
    1) If her urine is clean - is her breastmilk? I read somewhere that it can take longer to exit the breastmilk as it attaches to the fat cells. If this is the case, when can she safely resume breastfeeding?
    2) Even if her urine is clean, will her baby still test positive right now for cocaine because of the metabolite? Is the metabolite dangerous to infants?
    3) Several places state that a woman should not breastfeed AT ALL if they have taken cocaine in the last 90 days. Why is this? Is she better off discontinuing her breastfeeding journey altogether? Or is this more of a rule of thumb for those who have a history of abuse?

    Thank you for your help.


  • #2
    Couple Questions:
    1) If her urine is clean - is her breastmilk? I read somewhere that it can take longer to exit the breastmilk as it attaches to the fat cells. If this is the case, when can she safely resume breastfeeding?
    2) Even if her urine is clean, will her baby still test positive right now for cocaine because of the metabolite? Is the metabolite dangerous to infants?
    3) Several places state that a woman should not breastfeed AT ALL if they have taken cocaine in the last 90 days. Why is this? Is she better off discontinuing her breastfeeding journey altogether? Or is this more of a rule of thumb for those who have a history of abuse?

    Answers:

    1: Yes more than likely. Cocaine has a short half life. Its inactive metabolite( benzoylecgonine) hangs around for up to a week, but the metabolite is not active and won't bother an infant.
    2. Don't know if baby will absorb inactive metabolite, probably will to some small degree. Metabolite is not dangerous to infant, but infant might be drug screen positive. Remember, cocaine drug screens check for benzoylecgonine, the inactive metabolite.
    3. Waiting 90 days is garbage. Active cocaine has a half life of about 1 hour. Its inactive metabolite(benzoylecgonine) is longer, perhaps 12 hours or so.

    Benbenzoylecgonine indicates use of cocaine within last 4 days.

    Mom can resume breastfeeding in 24 hours after using cocaine, but its still Stupid to use cocaine.



    Tom Hale Ph.D.
    InfantRisk Center

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