Heroin

Heroin use during breastfeeding has not been systematically studied, but it has long been known that infants exposed via breastmilk can be affected and develop abstinence if breastmilk is discontinued.[1] Heroin use by breastfeeding mothers can also prevent symptoms of withdrawal in their heroin-exposed breastfed infants.[2,3] Use of heroin as a street drug by nursing mothers carries the risk of breastmilk contamination with a variety of possible chemical contaminants that may be present in illicit heroin. Heroin use by a nursing mother is generally considered to be a contraindication to breastfeeding. Mothers who discontinue heroin use and begin methadone, naltrexone or sublingual buprenorphine maintenance therapy should be encouraged to breastfeed with ongoing medical support.[4]

Heroin (diamorphine) by the intrathecal or epidural route is recommended for analgesia during cesarean section and for postoperative analgesia in the United Kingdom where a standardized pharmaceutical product is commercially available.[5] However, no research on the effect on the breastfed infant or lactation has been published with this use.