Hi Heather
As with any drug that is contra-indicated or suspect or only recommended at
certain doses, the situation should be explained to the mother and then she
should make the decision. This is the direction we would like to pursue more
actively at out institution with methadone. However, there are many problems
surrounding methadone moms, and other organizations such as social services
and in many cases - the prison system! - are involved. (Many of our moms are
incarcerated and wanting to breastfeed during the hospital stay, after which
they usually go back to prison  with no baby - some go to halfway houses
depending on time of sentrence left to serve). The same issue arises all the
time with our cocaine moms. We advise them not to breastfeed. Of course, we
cannot enforce that decision....Our main issue with methadone is the AAP
recommendation of 20mg, which accoridng to the evidence available, seems low.
I would be very interested to know what the UK guidelines suggest - do you
know?
Anne Merewood  IBCLC
Boston Medical Center

>
>
> Genuine question: are the circumstances where a mother in the US is
> truly *not allowed* to breastfeed? In the UK, too, there has been at
> least one high profile case where a mother was told she coud not bf
> her baby (b/c of HIV) and she had to escape/try to escape social
> services who were attempting to take her baby into care.
>
> It perturbs me if the state can get involved to this extent, and
> actively not allow a mother to feed her baby how she wishes. I
> perfectly well understand the issues and that carers may be concerned
> with the baby's health, but it seems to me there may be alternatives.
> I heard  of a drug users unit in Glasgow where workers encourage drug
> addicts to breastfeed, support them, and make sure they support the
> mother through weaning so the baby does not suffer withdrawal, if the
> mother continues to use drugs.
>
>
> Heather Welford Neil
> NCT bfc Newcastle upon Tyne UK
>

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