A parent whose baby is struggling with weight gain is one of your lactation clients. They call you, and announce that this weekend is the first full month home from the NICU, and they are going to celebrate with some champagne on Baby’s original due date! You know the baby is directly feeding at breast/chest. Parent says they may pump-and-dump, as they read on a parent blog this is important to do. Parent also mentions that the other parent doesn’t like to drink, but smokes a little cannabis now-and-again. It’s legal in our state now! They will all finally have a good long night’s sleep in their big bed! Their only question: how long after drinking should they use those strips they bought, that test alcohol content in the milk?
What is your advice for this family?
There is growing science about the pharmacology and toxicology of transfer of alcohol and recreationally-used medicinals into human milk. However, mainstream/online articles inaccurately describe the biology, and conflate true risks to the infant. Parents who use illegal substances, or legal substances to excess, are often shamed-and-blamed for their behaviors. They are reluctant to seek information from healthcare providers. They end up using tactics and techniques advised by profit-driven companies or celebrity bloggers, that unnecessarily deprive the ease and long-term health benefit of direct breast/chestfeeding. Some families end up introducing formula, or even weaning, much sooner than planned.
This session will review the impact of partying on human milk, and the ethics of advising partying parents in your care. The ethical obligation to provide patient-centered, evidence-based information and support will be explored. The conflict-of-interest inherent in “commercial determinants of health” (where parents make decisions based on heavy marketing, not healthcare needs) will be explained. This session is eligible for E-CERPs and covers material from three sections of the IBLCE Detailed Content Outline: IV-Pharmacology and Toxicology, V-Psychology, Sociology and Anthropology, and VII-Clinical Skills/C-Ethical and Legal Issues.
By the end of the session, the learner will be able to:
1. Describe how alcohol consumed by a lactating parent enters the blood stream, and then gets into human milk.
2. Identify sections of IBCLC practice-guiding documents about the ethics of consulting with families drinking alcohol during lactation.
3. List three factors to share with parents, to evaluate the risks of lactating-and-partying.