BREAST-FEEDING AND DRUG EXPOSURE

Breast-feeding provides many health benefits for mothers and infants. Concerns about the safety of breast-feeding, however, arise when the p hysician is confronted with a woman who wishes to breast-feed her infa nt, but who has an illicit drug use problem or history. More common, b ut perhaps more confusing, is the management of a mother who uses ''re latively contraindicated'' substances such as tobacco or alcohol durin g breast-feeding. How should the physician counsel such mothers? How s hould mother-infant dyads be followed? What are the benefits and risks of continuing to breast-feed? This article provides guidance for the obstetrician confronted with these clinical dilemmas.