MDMA and Breast Milk

[happy_mom]

Hi - I'm trying to understand the affects of MDMA on breast milk. Is it more similar to methamphetamine or adderall? Adderall has a long half life but seems to have little impact on babies unless it is taken at a high dosage and is not contradicted for breast feeding.

MDMA is illegal and not controlled so I understand that makes it inherently more risky, but is the actual impact on the body significantly different? Are mothers who refrain from breastfeeding until they no longer feel the effects actually putting their babies at significantly higher risk if someone else is caring for the child during the "high"? What about very occasional use? Does it matter if the child is a year old as it seems to with prescription amphetamines?

[Sandra]

Happy_mom,

MDMA-Ecstasy or 3,4-methylenedioxymethamphetamine (MDMA) is a hallucinogenic amphetamine. There are no published studies describing RID (relative infant dose range) or safety in infants. However, this drug passes the blood-brain-barrier easily and we expect in to transfer into milk in significant quantities. Even small doses may cause hallucinogenic effects in the infant and repeat exposure may cause neurodevelopmental changes. The half-life of MDMA varies from 7-31 hours, depending on the acidity of the patient's urine. We believe that breastfeeding should be interrupted for 5 half-lives (1.5-6 days) after a single use. For chronic users, refer to ABM protocol #21 "Breastfeeding and the Drug-Dependant Woman."

I hope this helps. If you have any other questions please call the InfantRisk Center at 806-352-2519. Thanks,

Sandra Lovato R.N.
InfantRisk Center

[cdavenpo]

A discussion was just completed with physicians, and nursing staff (one being a Publich Health Nurse) about whether or not a mother with a positive urine test for methamphetamine and a reported history of illicit drug use should be allowed to breastfeed her baby. Would the 1/2 life of what we know as "Meth" be similar to the MDMA? Should the baby be allowed to breastfeed ( colostrum) at least while the mother is in the hospital? Would appreciate your thoughts.

Thanks,

Colette Davenport RN, ICCE, IBCLC

[admin]

Cdavenpo,

Methamphetamine is rated an L5-limited data-hazardous. The half-life is 4-13.6 hours,. We recommend breastfeeding mothers avoid this drug in lactation. Other strategies to minimize infant exposure include waiting until the urine screen is negative or pumping and discarding milk for at least 48-100 hours after last maternal use.


Sandra Lovato R.N.
InfantRisk Center
806352-2519