Women on methadone may safely breast-feed
In women on methadone maintenance who have recently given birth, concentrations of the drug in breast milk are low and have no apparent behavioral or neurological effects on their breast-fed infants, according to the results of a small study.
Dr. Lauren M. Jansson, of Johns Hopkins University School of Medicine, Baltimore, and colleagues evaluated the concentrations of methadone in the breast milk and blood of eight women at 1, 2, 3, 4, 14 and 30 days after delivery.
Blood samples were also obtained on the same days from eight women on methadone maintenance who fed their newborns with formula.
Blood samples from infants in both groups were obtained on day 14, Jansson’s group reports in the medical journal Pediatrics.
Low concentrations of methadone were observed in breast milk, ranging from 21 to 462 nanograms per milliliter. Methadone levels in breast milk were not related to maternal dose.
Even though methadone concentrations in breast milk increased significantly over the sampling period, the average amount was less than 0.2 milligrams per day.
The blood concentrations of methadone in the infants were low in all samples, ranging from 2.2 to 8.1 nanograms per milliliter.
When all of the infants underwent neurobehavioral assessments on days 3, 14 and 30, the investigators found no significant effects that could be attributed to breast-feeding.
More infants in the formula-fed group required drug treatment for opioid withdrawal syndrome; however, this association was not statistically significant.
“In general, these results support the recommendation for breast-feeding among methadone-maintained women if it is appropriate and desired,” Jansson and colleagues conclude, although they acknowledge that further studies are needed to assess the safety of long-term breast-feeding.
SOURCE: Pediatrics, January 2008.
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