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Risks of Using Cocaine While Breastfeeding

Cocaine is a powerful and highly addictive stimulant that is easily absorbed into the bloodstream. It has a high milk-to-plasma ratio, meaning a significant amount of the drug may pass from a mother’s blood into her breast milk.1

Cocaine is the third most abused substance in the United States. According to the 2020 National Survey on Drug Use and Health (NSDUH), nearly 5.2 million Americans aged 12 or older were current users of cocaine, including 657,000 current users of crack cocaine.2 Among pregnant women, 5.8% reported using illicit drugs while pregnant in the past month.3 One study estimates that there are roughly 750,000 cocaine-exposed pregnancies every year.4

Does Cocaine Transfer to Breast Milk?

Yes. Cocaine may transfer to breast milk. For mothers who use cocaine, the concentration of the drug will likely be higher in their milk than in their blood.5 The high people feel after using cocaine is relatively short, but it takes the body time to metabolize the drug and clear it out of the system.5 This means that long after a mother stops feeling the effects of cocaine, it may still be in her breast milk and may still negatively affect her breastfeeding infant. In fact, newborn babies are extremely sensitive to cocaine.

Under some circumstances, mothers who have used cocaine in the past (and aren’t actively using now) may safely breastfeed their children. However, according to the Academy of Breastfeeding Medicine, women with a history of cocaine use should not breastfeed unless:6

  • They test negative on urine tests for cocaine at delivery.
  • They have been abstinent from cocaine for at least 90 days prior to delivery.
  • They are in a substance treatment program.
  • They plan to continue treatment in the postpartum period.
  • They have the approval of their substance abuse counselor.
  • They have engaged in and are compliant in prenatal care.
  • They have no other contraindications to breastfeeding.

Women who are nursing their children should not use cocaine or crack. It is advised that no one near the baby uses crack. Infants can be exposed to the drug by inhaling the smoke.

How Long Does Cocaine Stay in Breast Milk?

According to the American Academy of Pediatrics, cocaine should not be used by breastfeeding mothers. Mothers who choose to breastfeed and who use cocaine intermittently should delay breastfeeding for at least 24 hours after use.1

Any cocaine present in the body can pass into breast milk in significant amounts. Since the ability to metabolize and clear drugs is not yet developed in an infant, exposure to cocaine through breast milk can cause considerable harm over an extended period.1

Does Cocaine-Laden Breast Milk Harm the Baby?

Feeding an infant cocaine-containing milk can be dangerous to the baby’s health. Cocaine’s powerful stimulant properties can easily overwhelm a baby’s body. Studies have noted that the adverse effects of using cocaine on a breastfeeding infant include:5

  • Changes in mood.
  • Irritability.
  • High-pitched crying.
  • Dilated pupils.
  • Vomiting.
  • Diarrhea.
  • Hyperactive reflexes.
  • Hypertension.

Other harmful effects have been reported in infants who ingested cocaine after the mother applied it to her nipples to relieve pain. This is a dangerous practice and should not be used as a remedy for sore, cracked nipples. Applying cocaine directly to the nipple has been shown to have harmful effects on a child, including:1

  • Irritability.
  • Agitation.
  • Rapid heart rate.
  • Shallow breathing.
  • Hypertension.
  • Seizures.

The best way to stay safe is to stop using cocaine altogether. If you think your baby has been affected by your cocaine intake, you should contact a healthcare professional immediately.

Benefits of Breastfeeding

Using cocaine for a long period of time can affect a mother’s ability to breastfeed, and mothers who use cocaine are more likely to not breastfeed compared to non-using mothers.5 In addition, long-term cocaine use can cause problems with the body’s production of breast milk.

A mother’s breast milk is the ideal renewable source of food for newborns and infants. Breast milk contains the perfect balance of nutrients to meet a baby’s needs.7,8 Additionally, it contains antibodies that protects newborns from illnesses such as diarrhea, pneumonia, and other common childhood illnesses and infections.7,8

Breastfeeding may also have long-term benefits for the child. Some studies suggest that individuals who were breastfed as babies are less likely to be overweight or obese or to have type 2 diabetes.7 Research also indicates that they perform better in intelligence tests.7

Additionally, breastfeeding provides a mother with a unique opportunity to connect with her child. Breastfeeding may improve mother-child bonding. During breastfeeding, the mother’s body releases increased levels of oxytocin (the love hormone). The release of oxytocin is associated with affectionate contact and maternal-infant bonding.9 Furthermore, breastfeeding has been shown to improve maternal health by reducing the risk of cardiovascular disease, diabetes, and breast and ovarian cancers.7 When a mother does not breastfeed or stops breastfeeding early, she may be at an increased risk for experiencing postpartum depression.10

It is important to keep in mind that every person is different. Some mothers choose not to breastfeed, do not feel comfortable breastfeeding, or cannot breastfeed—and that is okay. What is most important is that the child receives the love and care they deserve.

5 Ways That Quitting Cocaine Benefits Your Baby

  1. You will feel healthier and stronger.
  2. By quitting your cocaine use, you are prioritizing your child and ensuring that they grow up in a safe and drug-free environment.
  3. You have the opportunity to set an example for your child.
  4. Quitting reduces the risk that you will encounter job loss, legal issues, or financial problems.
  5. You will be able to safely breastfeed, providing all the benefits of doing so to your child (and yourself).

Cocaine Addiction Treatment During Pregnancy and Parenting

If you find yourself unable to stop using cocaine, you may be struggling with a cocaine addiction (cocaine use disorder). A component of many addictive processes is what’s known as physiologic dependence. Those who develop a cocaine dependence may feel like they need to continue taking the drug in order to function properly. If you think you have an addiction to or dependency on cocaine, is important that you talk to your doctor. They may offer addiction counseling options and may recommend that you begin a drug treatment program.

Addiction treatment can help you identify the underlying causes of your cocaine use and take steps to become drug-free. There are several options when it comes to treatment, and it is important that you find the one that best fits your needs.

  • Residential treatment provides 24/7 medical care and support, generally in non-hospital settings. If your addiction is relatively severe, this is an excellent option. You will live at the treatment center and, depending on the program, your treatment could last 30 days to 90 days (or longer). Standard treatment regimens will include individual and group behavioral therapy. Some residential programs may offer complementary therapeutic interventions and other health and wellness activities, such as art therapy, yoga and meditation, exercise programs, and specialized nutrition programs.
  • Hospital-based inpatient treatment provides intensive but relatively short treatment. Many hospital-based treatment programs are rooted in the 12-step approach to substance recovery. These programs generally consist of 3 to 6 weeks of hospital-based inpatient treatment followed by a duration of ongoing outpatient therapy to prevent relapse.
  • Outpatient treatment programs are designed to help you go through treatment while continuing to live at home. Outpatient options make it easier to tend to everyday responsibilities—such as work, school, and family—while visiting the center a few times a week for treatment. Group therapy is a major part of outpatient treatment, and you may meet in weekly support groups with others going through the program.
  • Group therapy is a form of counseling that allows you to interact with other individuals. Groups generally consist of 4–12 members, and they can meet as often as once or twice a week. Groups allow members to share experiences with others and provide support to one another.

If you are using cocaine while breastfeeding, make sure to take the cautionary steps to prevent harming your baby.

Find Addiction Treatment Programs

Substance abuse rehabilitation programs have helped many new mothers. Rehab centers are located throughout the U.S., and a variety of treatment types is available. You can use SAMHSA’s Find Treatment tool to search for facilities. Many state government websites will also provide local drug and alcohol resources to those in need. To find your state government’s website, do a web search for your state name and ‘.gov.’

American Addiction Centers (AAC) is a leading treatment provider and has trusted programs across the country. Verify your health insurance benefits now, call us today free at to speak with a trained admissions navigator. There are also free drug abuse hotline numbers you can contact.

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