excerpted from Medscape-
Methadone Maintenance and Breastfeeding in the Neonatal Period
The authors speculated that the lack of sufficient data about the effects of breast milk exposure to methadone is one of many barriers that limit breastfeeding among addicted women on methadone therapy.
Maternal methadone doses did not correlate with infant plasma methadone concentration. When comparing the breast-fed to formula-fed infants at the prespecified timepoints, the authors could demonstrate no difference between the groups on the concentration of plasma methadone or on the Neonatal Intensive Care Unit Network Neurobehavioral Scale.
The authors concluded that the amount of methadone in breast milk is small in the first 30 days of life and suggested ongoing support of the recommendation that women on methadone maintenance should breast-feed their infants if they so desire.
The authors cautioned that much more research is needed into whether even small exposures to methadone are detrimental to neonates. The authors also noted the limitation of the relatively short follow-up period. It illustrates how difficult it must be to conduct addiction research that it took the authors 5 years to assemble 8 nursing mothers and infants and matched pairs!
The greatest value to general practitioners is that this study serves as a reminder of the general protective effect of having addicted pregnant mothers in treatment programs, and methadone exposure of infants may indeed be the lesser of 2 evils. It emphasizes the very difficult job that these moms have in caring for their infants, reminding us to be especially supportive to them and their babies.
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