美国儿科学会：母亲滥用药物并不是母乳喂养的绝对禁忌症

母亲滥用药物并不是母乳喂养的绝对禁忌症。麻药依赖但营养良好的母亲，如果接受监控下的美沙酮维持治疗并且 HIV 和其他违禁毒品检测呈阴性，也是鼓励其母乳喂养的。街头毒品，比如致幻剂（苯环己哌啶）、可卡因和大麻都可以在母乳中检测出来，哺乳母亲使用这些毒品应引起关注，这些药物尤其会对婴儿的神经系统发育造成长久的影响，所以这些母亲禁止哺乳。酒精没有催乳作用，相反它可以导致母亲身体对婴儿的吸吮反应迟钝，影响泌乳激素的分泌，还会影响婴儿的运动发育。因此，母亲应该尽量减少摄入酒精饮料，在偶尔一次饮用时也应该控制酒精摄入量，即每公斤人体体重摄入量小于 0.5克酒精，对一位体重60公斤的母亲而言，大概可以摄入2盎司白酒，或8盎司葡萄酒，或者2 杯啤酒。为了保证摄入的母乳中酒精含量最少，母亲饮酒后应该至少超过两个小时才可以进行哺乳。哺乳的母亲抽烟也不是母乳喂养的绝对禁忌症，但是应该被极力劝阻，因为它与婴儿呼吸道过敏和婴儿猝死综合症的发病率增加有着一定的关系。为了尽可能降低婴幼儿被动吸入二手烟的负面影响，不应该在他们面前抽烟。吸烟也是导致乳汁分泌量减少和婴儿体重增加缓慢的风险因素之一。 Maternal substance abuse is not a categorical contraindication to breastfeeding. Adequately nourished narcotic-dependent mothers can be encouraged to breastfeed if they are enrolled in a supervised methadone maintenance program and have negative screening for HIV and illicit drugs.Street drugs such as PCP (phencyclidine), cocaine, and cannabis can be detected in human milk, and their use by breastfeeding mothers is of concern, particularly with regard to the infant’s long-term neurobehavioral development and thus are contraindicated.Alcohol is not a galactogogue; it may blunt prolactin response to suckling and negatively affects infant motor development.Thus, ingestion of alcoholic beverages should be minimized and limited to an occasional intake but no more than 0.5 g alcohol per kg body weight, which for a 60 kg mother is approximately 2 oz liquor, 8 oz wine, or 2 beers.Nursing should take place 2 hours or longer after the alcohol intake to minimize its concentration in the ingested milk.Maternal smoking is not an absolute contraindication to breastfeeding but should be strongly discouraged, because it is associated with an increased incidence in infant respiratory allergy and SIDS.Smoking should not occur in the presence of the infant so as to minimize the negative effect of secondary passive smoke inhalation. Smoking is also a risk factor for low milk supply and poor weight gain. 来源：http://pediatrics.aappublications.org/content/129/3/e827.full 翻译：http://www.weibo.com/2514526082/zvv2Aev2H