Safety in Lactation: Alcohol dependence

Sarah Fenner, Specialist MI Pharmacist, Midlands and East Medicines Advice Service (Midlands site) & UK Drugs in Lactation Advisory ServicePublished

An assessment of the risks associated with breastfeeding by an alcohol-dependent mother, in terms of sustaining successful breastfeeding and possible exposure of the infant to high levels of alcohol, will need to be undertaken before considering the additional risks of exposing the infant to drugs used to treat the mother’s dependence.
Disulfiram is contraindicated in breastfeeding mothers as the infant may develop adverse effects if exposed to alcohol in breast milk or from external sources.
The choice between acamprosate and naltrexone will depend on the clinical situation, although the benefits to the infant of the mother refraining from alcohol appear to outweigh any unknown risks from the drugs.