Dear Kathy

Methadone pass well in breast milk : level almost the same than in plasma.
The infant takes at most 1,4 mg/kg/jour, about twice the pediatric
posology. There is a case of breastfed infant death attributed to maternal
use of methadone.
It is here contraindicated while breastfeeding, except when mother was
already taking methadone in pregnancy ; in this case, posology in mother
less than 20 mg/day. However, in the last issue of JHL (sept 1997), it is
an article on methadone, and the conclusion of the auteurs is that "the
negligible amount found in breast milk is unlikely to have adverse effects
on the infant, regardless ot the mother's metahdone dose", and that "the
current AAP recommandation that only women in drug treatment on less than
20 mg/day be davised to breastfeed should be reconsidered".

Kindly
Françoise Railhet
LLL France Medical Associates Program