Regarding the use of opiates during whilst breastfeeding, certainly in my experience in the UK, breastfeeding was encouraged:
" 4.16 Infant Feeding
The benefits of breastfeeding should be discussed with all women antenatally, 'Breastfeeding
Policy' (NHS Highland). If drug use is stable and the woman is on prescribed methadone,
she should be informed that the advantages of breastfeeding her baby outweigh the
disadvantages. Apart from well-documented evidence of the benefits of breastfeeding, it may
also help to reduce withdrawal symptoms experienced by the baby, as small quantities of
drugs may be passed via the breast milk.
Breastfeeding can bring comfort to the mother at a time when she may experience signifi cant
guilt regarding her drug use and potential withdrawal symptoms for the baby. Skin to skin
contact can also help the baby regulate its temperature, heart rate and breathing, and be
reassuring and comforting to both mother and baby. Breastfeeding should be commenced
as soon as possible following delivery as recommended in the Highland breastfeeding policy.
The exceptions to promotion of breastfeeding are:
If a woman is HIV positive, due to the high risk of transmission
If she is using large quantities of stimulant drugs such as cocaine, 'crack' or
amphetamines, because of vasoconstriction effects
If drinking heavily or taking large amounts of non-prescribed
benzodiazepines, because of sedative effects
(Whittaker 2003)"
http://www.highland.gov.uk/NR/rdonlyres/F370D4D0-34D9-4450-AD19-0FA2FFCC50CB/0/cyp22Women.pdf
The rationale was that the babies were accustomed to the levels of drug and that breastfeeding weaned them off it slowly, as so we didn't need to give them any or as much morphine for withdrawal. If the baby were receiving large doses via breastfeeding then one would imagine that when breastfeeding ceased the baby would exhibit severe withdrawal symptoms. If that's not happening, presumably the mother can be reassured that her baby is not being harmed?

Miranda Buck, RN, (Paeds), IBCLC
PhD Candidate
Mother and Child Health Research 
LaTrobe University
Melbourne

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