Identified drug addicted mothers are not common in our neck of the woods
(Hutt Valley New Zealand),but we have just had one come through and I was
shocked to discover that the hospital policy was to encourage breastfeeding
to help baby with methadone withdrawl.  I was trained in the States and up
until this point I had just assumed that it wasn't a good idea to encourage
breastfeeding to a drug addicted mother.  I have had enough experience with
family addictions to truly believe the sincerity of the best of intentions
but to expect the unexpected.  The policy as it stands encourages
breastfeeding but has no component of follow up.  I think this is
irresponsible as it eases the nurses strain of dealing with a withdrawing
baby but does not address the risk of the infant going home with an
addicted mother who could resume using at any time.  The family is tight on
money and have stated that they want to breastfeed because it is cheaper
and healthier.  I spoke to them both very candidly about how they were
right on both counts, but if for any reason something other than methadone
got into mum then the baby should be fed formula and not the drug laced
milk.  I was very frustrated as this felt very flimsy as support and advice
go.

I would like to develop best practice guidelines for this issue and I would
like help from others who have gone down this path before.  Please email me
privately with any copies of policies that you may have or any references
that you felt were particularly helpful.
Thank you ahead of time.
Mandi Porta, RN, IBCLC
Coordinator for the Breastfeeding Support Team
Hutt Valley District Health Board

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