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Updated: May 16, 2026

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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Maternal cocaine use during breastfeeding
Alex M Cressman1, Gideon Koren, Anna Pupco
1University of Toronto.
Canadian Family Physician Medecin De Famille Canadien
|November 16, 2012
Summary
Breastfeeding is safe for mothers with a history of cocaine abuse, offering significant infant benefits. Healthcare providers should counsel on risks and benefits, encouraging abstinence or delayed breastfeeding after use.
Area of Science:
- Perinatology
- Neonatal Health
- Substance Abuse Treatment
Background:
- Maternal cocaine abuse during pregnancy presents challenges for postpartum infant care.
- Concerns exist regarding infant safety when mothers with a history of cocaine use breastfeed.
Purpose of the Study:
- To review the evidence on risks associated with cocaine exposure through breastfeeding.
- To provide guidance for healthcare providers managing breastfeeding mothers with a history of cocaine abuse.
Main Methods:
- Literature review on cocaine pharmacokinetics and effects on infants.
- Analysis of breastfeeding guidelines in the context of maternal substance use.
Main Results:
- Breastfeeding offers substantial benefits for infant health and development.
- No contraindication exists for breastfeeding mothers with a history of cocaine abuse.
Conclusions:
- Healthcare teams must counsel on cocaine risks and breastfeeding benefits for informed choices.
- Encourage maternal abstinence from cocaine during breastfeeding; if use is intermittent, delay breastfeeding for ~24 hours post-use.
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