Breastfeeding and Methadone Therapy: The Maternal Experience.
BACKGROUND
Despite evidence of low transfer of methadone into breast milk and the potential physical and psychological benefits that breastfeeding offers for methadone-exposed mothers and infants, the rate of breastfeeding initiation in this population is about half that reported nationally. This study describes the perceptions surrounding breastfeeding decisions and management among pregnant and postpartum women taking methadone.


METHODS
Seven pregnant women and 4 postpartum women enrolled in methadone maintenance programs participated in semistructured, audiotaped interviews and focus groups, respectively, about their breastfeeding experiences. Transcripts were analyzed and coded using qualitative content analysis.


RESULTS
Three major content categories were identified: (1) fears, barriers, and misconceptions about breastfeeding while taking methadone; (2) motivation and perceived benefits of breastfeeding; and (3) sources of information, support, and anxiety about general breastfeeding management and breastfeeding while taking methadone. Lack of support from the health care community and misinformation about the dangers of combining breastfeeding and methadone therapy represented significant, yet modifiable, barriers to breastfeeding success in methadone-exposed women.


CONCLUSIONS
Interventions to increase the prevalence of breastfeeding among women taking methadone should address identified logistical, educational, and psychological barriers and consider inclusion of women themselves, partners, peers, and clinicians. In particular, clinicians who care for methadone-exposed mothers and infants should be educated on therapeutic communication, up-to-date breastfeeding contraindications, and the health benefits of breastfeeding in this population.
a Department of Pediatrics , University of Pittsburgh School of Medicine , Pittsburgh , Pennsylvania , USA.
Jill R
JR
Demirci
Debra L
DL
Bogen
Yael
Y
Klionsky
D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use; D001942:Breast Feeding / Q000523:psychology*; D000075202:Contraindications; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008691:Methadone / Q000009:adverse effects* / Q000627:therapeutic use*; D009035:Mothers / Q000523:psychology*; D058850:Opiate Substitution Treatment / Q000009:adverse effects*; D011247:Pregnancy; D055815:Young Adult
D000701:Analgesics, Opioid; D008691:Methadone
Breastfeeding; methadone; opioid-related disorders; postpartum period; pregnancy; substance-related disorders