Can Drugs Get Into My Breast Milk?

Medically Reviewed By: Dr. Patricia Sullivan MD, MPH

mother breast feeding her baby worried about drug use

Table of Contents


Nicotine Addiction and Breastfeeding


Substance abuse during pregnancy also applies to cigarettes and other tobacco products since nicotine is transmitted through breastmilk.

Using any drugs while breastfeeding is not recommended, and nicotine is no exception.

A cigarette contains about 12 mg of nicotine, depending on the potency of the tobacco. The breast milk of smoking mothers contains (on average) about 200-240 nanograms of nicotine per milliliter. Since babies consume between 414-650 milliliters of breast milk per day, they receive a dose of 0.3 to 36 micrograms every day the mother smokes.

Even being in a closed room with other smokers or around any secondhand smoke can result in increased nicotine levels in your breast milk.

If you are breastfeeding, it is best to limit your cigarette intake as much as possible. Try and prolong the time between smoking and breastfeeding as much as possible. Make sure family and friends who do smoke do so outside of your presence to ensure that secondhand smoke isn’t an issue.

Nicotine Patches

While nicotine patches are better than smoking, they keep certain carcinogens out of breast milk; they still infuse nicotine into the milk. The nicotine in breast milk about a 21 mg nicotine patch accounts for the same exposure level as 17 smoked cigarettes.

Substance abuse during pregnancy and using any drugs while pregnant is detrimental to infant health. A child exposed to nicotine during pregnancy and post-birth is more likely to suffer from colic and respiratory infections. Remember, the choices you make will ultimately impact your infant’s long-term health.


Marijuana Use While Breastfeeding

Unfortunately, long-term cannabis use and its effect on babies are not well understood. Many people are under the impression that marijuana isn’t a harmful drug. However, this recreational drug (when consumed while breastfeeding) has observable consequences.

Some people take cannabis medicinally and cannot cease use during pregnancy. In these instances, they are recommended to use it as infrequently as possible. Try to smoke cannabis at least several hours before feeding your child, or if you take edibles, consume low THC concentrated ones. Additionally, try not to expose your child to secondhand marijuana smoke.

It doesn’t matter if marijuana is eaten or smoked during pregnancy; substance abuse of any kind during pregnancy and when breastfeeding will affect your child. Cannabis use has been known to cause weakness, poor feeding habits, lethargy, and sedation in very young children.

Heroin and Opioids While Breastfeeding

Heroin is highly addictive and is the most concerning recreational drug about breastfeeding. Substance abuse during pregnancy can lead to addiction regardless of the drug used. But heroin use almost guarantees that a child risks becoming addicted since the drug passes so easily into breast milk.

If you are in the grips of heroin addiction and cannot resist using, wait at least 24-48 hours afterward before feeding the baby. Consider contacting an addiction professional before quitting “cold turkey,” as the effects can seriously harm an infant. It is important to seek help as soon as possible, as substitute treatments like methadone reduce the risk of addiction in your child.

Methadone does appear in breast milk but in minimal amounts that generally do not affect the infant. If you’re on methadone while pregnant, your baby may suffer minor withdrawal symptoms upon birth, which can be relieved by supplying them with your breast milk. The milk can provide micro-doses of methadone which weans the baby slowly. Since methadone is generally a safer drug than heroin, using it to treat a heroin use disorder is a healthier choice for both you and your infant.

Cocaine Use and Breastfeeding

Using cocaine while breastfeeding poses its own set of risks. The drug easily transfers into breastmilk, and using this recreational drug while breastfeeding can have dire consequences. Babies easily get a high dose of the drug when it is present in breast milk, which can cause trembling, dilated pupils, tachycardia, irritability, and high blood pressure.

Newborns are hypersensitive to trace amounts of cocaine because they cannot produce enzymes that counteract cocaine. Their bodies work differently than adults. The same goes for any form of crack cocaine, including secondhand smoke. All of these substances pose a serious health risk.

In one case, a woman admitted to using a small amount of cocaine on her gums while nursing her infant. It didn’t appear to the infant, so the next week, she snorted almost 500 mg of cocaine over four hours, unconcerned about her drug use while breastfeeding. She allegedly fed her infant five times during this period.

Three hours later, she began nursing her high baby, and the infant became overly irritable and experienced pupil dilation. The baby quickly developed diarrhea and began vomiting. After four hours, the mother rushed her infant to the emergency room. The staff noted that the baby had a high-pitch cry, unstable moods, and was hyperactive. The infant also suffered from hypertension and had symptoms similar to those found in fetal alcohol syndrome.

The infant’s irritability lasted for 12 hours, and the tremors and hyperactivity lasted a full day. The baby experienced mild hypertension for 72 hours after exposure to cocaine.

Ultimately, this shows the inherent risks involved with cocaine use. A mother is not just directly damaging her body, but her child’s as well.

Methamphetamine Use While Breastfeeding

Methamphetamines are particularly dangerous when it comes to using drugs while breastfeeding. Some recreational drug use while breastfeeding may feel tempting, but mothers who use meth can generally not concentrate on caring for their children because their judgment is impaired.

One recorded case entailed a mother snorting meth while breastfeeding a two-month-old baby. Her drug use while breastfeeding resulted in the child dying eight hours later after consuming trace amounts of breastmilk (and around 120-180 milliliters of formula).

The studies related to using meth while breastfeeding is inconclusive because many sample populations were also involved with other drug use. The exact biological reasons behind meth and its connection to breastfeeding are unclear. However, it is strongly advised you avoid all methamphetamine during both pregnancy and nursing.

Remember, anything you put in your body will ultimately end up in the body of your child. If you ingested meth while pregnant, or if you fear you’ll use this drug while breastfeeding, please reach out to a professional immediately.

Use Caution With Prescription and Over-The-Counter (OTC) Medications

Prescriptions and over-the-counter (OTC) medications are generally safe to take during breastfeeding as long as you take the prescribed dose. Make sure that your doctor knows that you’re nursing during any visits to avoid the potential of being prescribed something unsafe for you or your baby.


Opiates such as morphine, codeine, and meperidine are generally safe at prescribed levels because they excrete minute amounts of drugs into breastmilk. These drugs are often prescribed right after birth, and it’s fine to take them as directed by your prescribing physician.


Benzodiazepines are prescribed to treat anxiety and symptoms of postpartum depression and are also relatively safe to take at the recommended dose by your doctor. They do not show up in concerning levels in breast milk when used responsibly, and you shouldn’t be concerned if you’re using these drugs while breastfeeding.

OTC Painkillers

Nonprescription pain medicines with aspirin should be avoided while breastfeeding because their use is linked to Reye’s Syndrome. Reye’s syndrome is rare, but it is serious. It causes the brain and liver to swell and leads to blood-thinning, which can cause excess bleeding. It’s best to avoid any medication with aspirin while nursing.

Similarly, Aleve (naproxen) is not recommended for children under two months and should also be avoided while breastfeeding. The drug takes a long time to process, and dangerous levels can build up in an infant’s bloodstream. Using acetaminophen or ibuprofen are both safer options.

Nasal Spray

One dose of a nasal spray that contains pseudoephedrine for congestion during breastfeeding can interrupt your ability to lactate. If you’re concerned about drugs affecting breastfeeding, it’s advised to steer clear of this remedy.

Where to Start Getting Help for Addiction

If you are a nursing mother concerned about their drug or alcohol use and would like to learn about treatment options, we are here to help.

Susana Spiegel

Susana Spiegel

Susana has experience writing about addiction, treatment, mental health, and recovery. She holds a Bachelors in Arts of Theology from GCU, and has a deep empathy for those who are struggling with addiction, as she is in recovery herself.

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