April 15, 2026 | Guidelines for the Use of Human Milk in the Context of Substance Use Disorder
Presenter: Kara Kaikini, MS, IBCLC
Breastfeeding initiation rates are significantly lower in pregnant women with substance use disorder (SUD). While prenatal intention to breastfeed is often high in women receiving SUD treatment, actual initiation is hindered by stigma, inaccurate information, and a fear of substance exposure in milk. To address this challenge, MaineMOM and Maine State Breastfeeding Coalition worked collaboratively to develop guidance for healthcare providers for the use of human milk in infants born to women with SUD and/or who recently used non-prescribed substances. Providing evidence-based recommendations enhances the quality and consistency of care and reduces the stigma and bias of SUD.
Learning Objectives:
- 1. Review the most recent evidence-based information about how to best support breastfeeding in patients with SUD and discuss the related barriers patients often encounter.
- 2. Describe a decision-making pathway for lactation in the context of substance use including the importance of lactation consults to support the initiation and expression of breastmilk while awaiting clearance of illicit substances, and the importance of clear communication between the breastfeeding individual and the medical team caring for the dyad.
Presenter
Kara Kaikini, MS, IBCLC has been an IBCLC since 2009 and brings a rich breadth of experience to her work, having served as a home visitor, postpartum doula, childbirth educator, group facilitator, and hospital childbirth education and lactation services program manager. Kara is the Executive Director of the Maine State Breastfeeding Coalition, whose mission is to empower and nurture Maine’s families throughout their human milk feeding journeys. She is passionate about supporting people through the vulnerable transitions to new parenthood and their lactation journeys by enhancing the systems around them. Kara participates in statewide perinatal quality and maternal health initiatives and deeply values the opportunity to collaborate with the many dedicated organizations across Maine working to improve maternal and child health outcomes. Kara lives with her husband, two active boys, and one energetic dog in coastal Maine.
Continuing Medical Education
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Hanley Center for Health Leadership and Education and CCSME. The Hanley Center for Health Leadership and Education is accredited by the Maine Medical Association Committee on Continuing Medical Education and Accreditation to provide continuing medical education for physicians.
The Hanley Center for Health Leadership and Education designates this regularly scheduled series for a maximum of
1 AMA PRA Category 1 Credit ™. Physicians should only claim credit commensurate with the extent of their
participation in the activity.
*Nurses and Nurse Practitioners will be awarded a certificate of participation with a maximum of 1 AMA PRA
Category 1 Credit ™.
Contact Hours
1 contact hours for social workers, licensed clinical professional counselors, and behavioral health professionals.
1 Category 1 Contact hours for psychologists. CCSME is a pre-approved sponsor and provider of Professional
Education Activities for Psychologists.
1 contact hours for Alcohol and Drug Counselors pending approval by the Maine Board of Alcohol and Drug Counselors
1 contract hours CHES. CCSME is a designated provider of continuing education contact hours (CECH) in health education by the National Commission of Health Education Credentialing, Inc.
This course has been approved by Co-Occurring Collaborative Serving Maine (CCSME), as a NAADAC Approved Education Provider, for 1 educational credits. NAADAC Provider #324712, CCSME is responsible for all aspects of the programming.