Charges against a California mother have been upgraded from manslaughter to second-degree murder this week after evidence at preliminary hearings suggested that she knowingly endangered her infant's life by breast-feeding while using methamphetamine.
Six-week-old Anthony Acosta III died last year after an allegedly lethal amount of the drug was passed to him when his mother, Maggie Jean Wortman, 26, continued to breast-feed despite her meth habit.
Wortman is pleading not guilty to charges of murder, arguing that it was not the meth in the infant's bloodstream that resulted in his death, Wortman's attorney, M.C. Bruce, told ABC News.
According to court documents, Wortman tested positive for methamphetamine use while six months pregnant with Anthony and also admitted to investigators that she used the drug during pregnancy and approximately three times after Anthony was born, the Times-Standard of Eureka, Calif., reported.
Wortman reported to police that she used meth as recently as two days before Anthony's death, but because meth supposedly has a half-life of only 11 hours, Bruce said the idea that the meth killed Anthony "does not compute."
While meth's half life -- the time when a drug is considered active -- is nine to 12 hours, it remains detectable in the saliva for as long as three days and in the urine for up to five days. Also, infants are much more sensitive to low levels of meth than adults are, according to toxicologists, and breast milk tends to concentrate the drug.
"Mothers who are abusing amphetamines through any route -- smoking, snorting, swallowing, injecting -- can pass amphetamines to their babies via breastfeeding," said Dr. Marcel Casavant, chief of Pharmacology and Toxicology at Nationwide Children's hospital. "In fact, amphetamine is concentrated into breast milk, which means breast tissue takes amphetamine from the mother's bloodstream and actively moves it into the milk."
It is also possible that the infant died from other causes, however, said Casavant, as some studies have shown that infants nursing from mothers on meth do not show adverse effects.
Wortman claims that she had no knowledge of the fact that using meth while breast-feeding could be dangerous to her baby.
"I don't know what in the preliminary hearing made them decide to charge her with murder," Bruce said.
He suspected the prosecution may have changed the severity of the charges because of a policeman's testimony that Wortman was given a pamphlet on the dangers of breastfeeding while using meth.
Wortman's 19-month-old daughter also tested positive for methamphetamine and is reportedly in protective custody.
The Dangers of Passing on Substances Through Breast Milk
Wortman's case is one of at least four court cases in California that have been brought against mothers who allegedly killed or injured their infants by breastfeeding while taking methamphetamine. Only 31-year-old Amy Lieanne Prien was actually convicted of murdering her baby, a 3-month-old son named Jacob, back in 2003, but the conviction was later appealed and overturned. All other convictions have been of child endangerment, not murder.
Nationwide, there have been dozens of cases of infant deaths associated with overdoses of cocaine, meth and other illegal substances via breast milk. Adverse effects are also possible in cases where prescribed doses of legal drugs, such as painkillers, are taken by the mother while breastfeeding.
"Some people think that using drugs and nursing won't affect the child, but that's not true at all," said Bruce Goldberger, director of toxicology at the University of Florida College of Medicine in Gainesville. "There have been hundreds of studies with pharmaceutical drugs that show that these substances are delivered to the child through breast milk.
"Children are very fragile beings," he added. "It doesn't take very much drug to alter their physiology and have a bad effect."
"Many antidepressants or psychotropic drugs will be distributed to breast milk and expose the nursing infant," said Luann White, director of the Tulane Center for Applied Environmental Health. "An infant is very tiny and cannot metabolize the drug as quickly as an adult, so a lethal dose would be much smaller for the infant than for the mother."
For that reason, mothers should always be careful about taking any drug, whether recreational or prescription, while nursing, toxicologists say.
Nursing mothers, Casavant said, should review all their medicines, even over-the-counter medicines, with their physicians, the child's pediatrician or their pharmacists.