This is in response to Anne Merewood's request for info on hospitals that
allow for breastfeeding for moms who are on methadone. We have upped the
allowable dose of methadone to 80 mg/day at our large teaching hospital
largely based on the work of John McCarthy, MD (JHL 16(2), 2000). This
decision was made by a committee made up of the chairperson of our high risk
OB service, the chief of the neonatology dept and our two lactation
consultants. We do not require a consent form but the patient is advised
that they must remain in a rehab program with negative drug screens in order
to safely continue breastfeeding. They are also counselled on the potential
risks of illicit drug use on their breastfeeding infants. The wording in our
breastfeeding standard of care reads, "Mothers on methadone maintenance
generally considered safe to breastfeed if <80mg/day. Any dose over 80mg/day
requires the advice of the interdisciplinary team (OB, Peds, social work and
lactation consultant) and a physician's order.
Hope this helps,
Kimberly Jackson, RN, IBCLC

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