That is the question a California district attorney will ask a jury at the trial of a breastfeeding mother. Most women do not intend to harm their children but substance abuse and addiction comes with a heavy price. Such was the case of Maggie Jean Wortman, who has been charged with second degree murder after medical tests revealed that her newborn son died from methamphetamine intoxication obtained through her breast milk. Wortman’s 19-month-old daughter also tested positive for methamphetamine and was placed in protective custody. How could this happen?

The transfer of drugs from the mother’s blood to human milk depends on the chemical composition of the drug. Antibiotics such as penicillin will remain in the mother’s blood for long periods of time whereas certain types of blood pressure and heart medications will remain in the milk. During the first three days after birth, higher concentrations of medicine remain in breast milk. Workman’s attorney is attempting to argue that methamphetamine in breast milk could not kill a baby but here’s why he’s wrong:

1. Methamphetamine is a stimulant that affects that brain and its nervous system

2. It produces long-lasting euphoria and is extremely addictive

3. Drugs that affect the brain are in a higher concentration in breast milk

4. Newborns have immature brains that cannot protect it from harmful substances or infections. Therefore a drug such as methamphetamine could potentially cause significant harm to a newborn’s brain

5. Newborns have immature kidneys and livers and therefore are not able to get rid of harmful substances such as methamphetamine from their bodies

6. Nearly all harmful drug reactions from breast milk will occur in the first 6 months of life

Although the AAP recommends that mothers breastfeed for the first 6 months of a newborn’s life and WHO recommends children receiving breast milk for up to age 2, any mother who is using cocaine, methamphetamine, amphetamine, marijuana, alcohol or heroin should NOT breast feed for reasons listed above. Many public health clinics and OB providers are reluctant to perform urine toxicology tests for prenatal patients based on cost factors. However, there are companies that offer urine toxicology tests at very competitive pricing of less than $10.00 per test. A positive urine test followed by drug rehabilitation might have kept Workman’s newborn alive.
Are you a pregnant mom who has questions regarding drug safety and breastfeeding? An excellent resource is offered by the National Library of Science (http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT). This service provides information regarding prescription and over-the-counter medications and access to its database is free of charge.

Could breastfeeding kill a newborn? Yes, it could if there is a deadly substance in human milk. Both Wortman and her newborn paid the ultimate price for a miscalculation of judgment. Let us hope it never happens again.