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When I turn on the faucet, the water sputters. Why?-- You may have air in your lines. Turn on your tap slowly and run the water until the sputtering stops. 155

Trump's visit to California, his first as president, comes days after the Department of Justice sued the state over its immigration laws. 137

When it comes to methadone treatment for opioid addiction, both the American College of Obstetricians and Gynecologists?and the Academy of Breastfeeding Medicine include it in their guidelines as a safe and encouraged form of medical-assisted treatment for pregnant and nursing women."Babies exposed to opioids ... in utero are at risk for developing neonatal abstinence syndrome, a condition resulting from the newborn going through withdrawal once exposure to the opioids is stopped. An opioid-using mother is secreting small amount of the opioid in her breast milk, which the baby then ingests," Lysouvakon said.The amount babies take in is usually undetectable or very small, he explained."All of the guidelines support breastfeeding for mothers who are in treatment programs and not taking other illicit or non-medically indicated drugs," said Dr. Walter Kraft, an expert in the treatment of neonatal abstinence syndrome at the Thomas Jefferson University Hospital. "There may be other reasons why breast feeding may not be right, such as taking other prescribed medications which are not safe for the baby."Some of the benefits of breastfeeding infants at risk of withdrawal from opioids is not just the methadone in the breast milk but the skin-to-skin contact between baby and mom, which comforts and soothes the baby," said Kraft.And although recreational drug use is?not encouraged during breastfeeding, Kraft said there may be situations in which a mother may breastfeed while on medically prescribed stimulants,"if there is compelling reason to do so for the health and well being of the mother," he said.For example, amphetamines can be prescribed for narcolepsy, and methamphetamine can be used to treat?ADHD and obesity.For those mothers who do use amphetamines recreationally, there is very limited data. One study?advises to wait 48 hours after using before nursing."Healthy mom generally equals happy baby," Kraft said.'Narratives of blame'?Experts said the details of Jones' case are key to understanding what happened: How were the toxicology tests performed? Were the results confirmed in follow-up testing? Was Jones tested for the same substances to corroborate her as a source of the drugs in R.J.'s blood? What levels of drugs were found in R.J.'s blood? Was Jones prescribed any stimulants?Substance abuse is a clinical condition, said Dr. Amina White, a bioethicist and an obstetrician-gynecologist at the University of North Carolina, Chapel Hill."It requires clinical intervention. It would be highly problematic to charge someone with criminal wrongdoing who is in fact seeking or in need of or already undergoing treatment for a substance use disorder," White said. "One would hope that the response to this very unfortunate case would be: What can we do to better support someone like her?" she said.Lynn Paltrow, an attorney and founder and executive director of National Advocates for Pregnant Women, said criminal charges like those facing Jones are part of the larger war on drugs narrative. Paltrow worries about the public health ramifications that can follow from charges like this and ultimately discourage women from breastfeeding, and hospitals from following the scientific evidence."They have far more to do with political expediency and popular narratives of blame than anything about science," she said. 3389

We just want the federal government to do what it expects us to do, which is comply with its own law, said Castellanos. "The Port of San Diego, along with Imperial Beach, Chula Vista, we're suing the federal government to stop this." 233

Updates as big as this one can take a little getting used to, but we hope the community will enjoy it once they settle in, a spokeswoman said. 142