Ten-Day-Old Neonate Cocaine Exposure and Human Milk: A Case Report

The World Health Organization recommends exclusive breastfeeding in the first 6 months of life. Substances used by the nursing mother may be transported through human milk (HM) and absorbed through the infant's gastrointestinal tract; thus, a mother's exposure to illicit drugs such as cocaine (COC) may pose a risk to the breastfeeding child's health.

On January 19, a 10-day-old newborn girl was admitted at 9 am to the municipal emergency room with cyanosis, abundant sialorrhea (drooling or salivation), and without clinical response even after being stimulated. The mother reported offering the baby supplementary feeding with formula at 4 am and breast milk at 5:30 am The mother admitted dependence on COC and reported that she had inhaled six lines of COC hydrochloride powder between 6 pm on January 18 and midnight on January 19.

Case reports of lactational intoxications are frequent, especially with drugs, like COC, which can build up in acidic body fluids, like human milk, without the ability to disperse. Development of new biomarkers for early diagnosis of intoxication are needed for substances with toxic potential, such as COC. An increase in activated Partial Thromboplastin Time (aTTP) time may be associated with lactational COC intoxication and may serve as an early biomarker for liver damage. Furthermore, immunochromatography assays serve as alternative screening tools, particularly well-suited for emergency scenarios involving suspected drug exposure, employing biological samples to enable rapid assessment. More studies are needed to assess the influence of COC exposure on coagulation parameters.