Lactation Guidance and Patient Education

Evidence-based guidance and resources for providers and patient education materials created by the Washington State Department of Health.

July 2025 Update

Please note the opioid-specific guidance on this webpage is currently under review and will be available January 2026. Chest and breastfeeding are safe and encouraged for birth parents on medications for opioid use disorder (MOUD), such as methadone or buprenorphine. Chest and breastfeeding offer important health benefits for both parent and infant.

For Health Care Providers and Organizations

These evidence-based guidance documents are intended to guide health care providers in providing quality patient care and advice with regard to lactation and infant feeding for parents with history of substance use.

• Guidance on Lactation and Substance Use Guidance for Health Care Professionals
• Resources and articles to expand your understanding of substance use during lactation and related topics.
• A complete list of references from literature review that informed the clinical guidance.

For Patients, Parents, and Families (Drug-Specific and Patient-Centered PDFs)

We have created patient education materials to support parents to make positive infant care decisions and reduce the harms of substance use. The PDFs are available in 12 languages (linked below).

Alcohol and Lactation

Describes risks of alcohol use during lactation, what to do if planning to consume alcohol, and harm reduction strategies. Share with all parents with history of alcohol use.

Benzodiazepines and Lactation

Describes risks of benzodiazepine use during lactation, what to do if planning to consume benzodiazepines, and harm reduction strategies. Share with all parents with history of benzodiazepine use.

Cannabis and Lactation

Describes risks of cannabis/marijuana use during lactation, what to do if planning to consume cannabis, and harm reduction strategies. Share with all parents with history of cannabis use.

Cigarettes, Tobacco, Nicotine and Lactation

Describes risks of nicotine use during lactation, what to do if planning to consume nicotine, and harm reduction strategies. Share with all parents with history of nicotine use.

Medications for Opioid Use Disorder and Lactation

Describes safety of Medications for Opioid Use Disorder (MOUDs) during lactation and addresses NOWS and other concerns. Share with all parents taking MOUD therapy and all parents with history of opioid use.

Stimulants and Lactation

Describes risks of stimulant (cocaine, methamphetamine, amphetamine, methylphenidate) use during lactation, what to do if planning to consume stimulants, and harm reduction strategies. Share with all parents with history of stimulant use.