In case no one has pointed it out, there is an excellent article about women
on methadone maintenance therapy and lactation in the most recent Journal of
Human Lactation.  The article has an overview of the issue of subance abuse
among women of childbearing age as well as the nuts and bolts issues related
specifically to the mother on methadone.  The authors include a
comprehensive bibliography of ref. of articles on the subject, which would
be a good place to start reading if someone is interested in this specific
subject.

Substance abuse is a very hidden problem due to the social stigma attached
to diseases of addiction.  This is so unfortunate, because the experience of
birth can be transforming. Pregnant women and new mothers may suddenly have
motivation to get and stay sober.  So bringing the discussion out of the
closet and talking more honestly with populations of preg. families about
these issues would be a good thing.  Obviously there is a social serv.
problem related to the mother who continues to consume certain drugs and/or
large quantities of alcohol.  Their ability to care for their children is
obviously compromised -- even beyond the whole issue of the substance in the
milk.

One needs to be cautious however, about overstating the risks of occasional
drug taking and occasional alcohol intake.  Over zealousness about this may
encourage moms who are perhaps more at risk for bonding disorders to wean,
when in fact, continuing to breastfeed would be best for all concerned.

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com

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