Management of disorders of stimulant use during breastfeeding

Stimulants are found in breastmilk. Exposure to stimulants through breastfeeding is associated with harmful effects on the infant, including behavioural problems such as infant irritability and poor sleepGrigg, 2018.

If a patient uses stimulants and wishes to breastfeed, explore their understanding of the risks and support them to develop a management plan. Advise them of the benefits of abstinence for themselves and the infant.

If a breastfeeding patient uses stimulants rarely, or in binges, discuss harm prevention; this may include:

• recommending abstinence or (if abstinence is not likely) expressing and discarding the breast milk for 24 to 48 hours after the use of stimulantsHealthyWASafer Care Victoria, 2013
• highlighting the value of a back-up feeding plan for events where unplanned use occurs.

If a patient uses stimulants regularly or has unstable use, advise them against breastfeedingCentre for Alcohol and Other Drugs, 2014.