title: Postnatal weight loss in substitute methadone-exposed infants: implications for the management of breast feeding.
abstract: It is widely accepted that maternal drug-exposed infants demonstrate excessive early weight loss, but this has not previously been quantified. Among 354 term, substitute methadone-exposed infants, median maximal weight losses were 10.2% and 8.5% for breast- and formula-fed infants, respectively (p=0.003). Weight loss was less in small for gestational age compared to appropriately grown infants (p<0.001). There was no association between maximal weight loss and plasma sodium concentration (p=0.807). Relative to non-drug exposed infants, weight loss was more marked in formula-fed infants, 48% of whom demonstrated weight loss in excess of the 95th centile (compared to 23% of exclusively breastfed infants; p<0.001). Median weight loss nadir was on day 5, excepting those infants exclusively breastfed (day 4). These data suggest that excessive neonatal weight loss among breastfed infants of drug-misusing mothers does not necessarily reflect poorly established lactation and may help to guide management of breast feeding in this population.
authors.affiliation: Neonatal Unit, Princess Royal Maternity, Glasgow, Scotland, UK.
authors.forename: Carol
authors.initials: C
authors.lastname: Dryden
authors.forename: David
authors.initials: D
authors.lastname: Young
authors.forename: Nicole
authors.initials: N
authors.lastname: Campbell
authors.forename: Helen
authors.initials: H
authors.lastname: Mactier
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D001903:Bottle Feeding; D001942:Breast Feeding; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008691:Methadone / Q000494:pharmacology* / Q000627:therapeutic use; D009357:Neonatal Abstinence Syndrome / Q000503:physiopathology; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000534:rehabilitation; D011247:Pregnancy; D011248:Pregnancy Complications; D012189:Retrospective Studies; D012964:Sodium / Q000097:blood; D015431:Weight Loss / Q000187:drug effects* / Q000502:physiology; D055815:Young Adult
chemical_list: D012964:Sodium; D008691:Methadone