You are the Lactation Consultant working in SCBU. Ngaire has a history of drug abuse with early pregnancy 'P' use during this pregnancy. Her baby was initially showing signs of drug abuse, but is now ready for discharge home. Ngaire has a large number of health support people in place, including a Social Worker who was involved with 'lifting' a child from Ngaire in the past, that child remains in foster care for the time being to allow Ngaire to get through the early months with the new baby.
The midwife who will be visiting Ngaire for the next 5 weeks in the community is experienced in caring for women with drug abuse and has the trust of her patients as they know 'she never dobbs them in to the Social Services'. You have heard the midwife say in the past that her clients usually breastfeed as they can't afford to buy formula when they are addicted to 'P', or other illegal drugs. She said if the baby receives a small fix at the same time as mum, that may be what the baby actually needs rather than going through 'cold turkey', or not getting enough formula. She says she keeps a careful eye on them.
Ngaire swears she isn't taking P now, and her breastmilk will be fine for her baby. She says she wants a second chance with this baby and you have seen her caring for her baby well, although she has tended to formula feed more frequently than breastfeed. You have seen Ngaire knock over and spill her EBM about to be given to her baby. You have a niggling doubt that Ngaire may be using 'P' still...
It is proposed that the Social Worker is advised that Ngaire might still be using drugs.