Cocaine and Cocaethylene

[Ausmum25]

I know this question has been asked many times, but the answers have varied based on person to person. I don’t want any judgement please - I’m already feeling extremely guilty by my actions and seeking advice. I am not a regular cocaine user by any means and it’s been several years since I was last exposed.

I decided to finish up breastfeeding and proceeded to head to a party where I engaged in heavy drinking spanning approx 10 hours and took approx 5 lines of cocaine, overlapping with the drinking.

Upon waking the following morning, I have huge regrets about stopping breastfeeding and even bigger regrets about my drug consumption. I need clarification on when I can resume feeding, because everything I have read contradicts itself, and I was unaware that when cocaine and alcohol mix they create a substance called Cocaethylene that has a longer half life and no information about when it would be safe to breastfeed again. I have not breastfed since before ingesting cocaine, and am coming up to 60 hours since my last exposure. My child is 1 year old.

please help

[kaytlin]

You're right to be cautious, as cocaine concentrates in breastmilk (there are higher concentrations in your milk than in your blood) and cocaine and its metabolites are risky for a breastfed baby. The immediate threat of cocaine (or cocaethylene) in milk is long gone by 60 hours after use. The Academy of Breastfeeding Medicine's protocol for Breastfeeding in the Setting of Substance Use recommends breastfeeding should be avoided during the use of nonprescribed stimulants...returning to breastfeeding after use is a complex question that should address the risks of return to use, along with the benefits to mom and baby breastfeeding provides. That kind of individualization is something your (and your baby's) clinical team are better suited to helping with.

Dr. Krutsch