Encourage mothers who smoke to stop smoking and help them to do so. Be sure not to smoke while nursing the baby.
If the mother has been using illicit mood-altering drugs, recommendations concerning breastfeeding should be made, on a case-by-case basis, by the health care team.
Drugs that are contraindicated during breastfeeding include bromocriptine, cocaine, cyclophosphamide, cyclosporine, doxorubicin, ergotamine, lithium, methotrexate, phencyclidine (PCP), and phenindione (not used in the United States).16
Radiopharmaceuticals that require temporary cessation of breastfeeding include gallium-67, indium-111, iodine-125, iodine-131, radioactive sodium, and technetium-99m.16
If the mother wishes to breastfeed after treatment with a contraindicated drug is discontinued, assist her with pumping her breasts to maintain lactation and explain why the milk must be discarded.
Request consultation concerning safe medically indicated drugs for use when breastfeeding. (See Study Group on Human Lactation and Breastfeeding, under "Examples of Breastfeeding Projects to Assist Health Professionals," Tab 10.)