Breastfeeding Intention Compared With Breastfeeding Postpartum Among Women Receiving Medication-Assisted Treatment

• Published in: Journal of human lactation Vol. 35; no. 1; pp. 71 - 79
• Main Authors: Yonke, Nicole, Maston, Rebekah, Weitzen, Sherry, Leeman, Lawrence
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-02-2019
• Subjects: Adult; Breast Feeding - statistics & numerical data; Cohort Studies; Female; Humans; Infant, Newborn; Intention; Longitudinal Studies; Neonatal Abstinence Syndrome; New Mexico - epidemiology; Nursing; Opiate Substitution Treatment; Opioid-Related Disorders - complications; Opioid-Related Disorders - drug therapy; Pregnancy; Pregnancy Complications - drug therapy; Prenatal Care; Prevalence; Retrospective Studies; New Mexico; breastfeeding rates; breastfeeding; postpartum care; breastfeeding initiation; breastfeeding barriers; mother-infant dyad
• ISSN: 0890-3344; 1552-5732
• DOI: 10.1177/0890334418769637

Background:
Women taking methadone or buprenorphine are encouraged to breastfeed if stable without polysubstance use.
Research Aim:
We aimed to determine the difference between stated intention to breastfeed prenatally in women taking methadone or buprenorphine compared with breastfeeding at discharge and 2 months postpartum. Secondary outcomes were determining whether breastfeeding was more common in women taking buprenorphine, in women without hepatitis C infection, and in women without a history of heroin use, and whether breastfeeding reduced the need for pharmacological treatment of neonatal opioid withdrawal syndrome.
Methods:
This was a retrospective cohort study of 228 women enrolled in a perinatal substance abuse treatment program. Electronic medical records were reviewed to abstract data on mother-infant dyads. Chi-square tests were used to analyze our outcomes.
Results:
Women taking buprenorphine had a higher prevalence of breastfeeding compared with women taking methadone (83% [n = 100] vs. 71% [n = 76]; χ2 = 4.35, p = .03), despite no difference in their prenatal intention to breastfeed (87% vs. 81%; χ2 = 1.28, p = .25). Only 31% (n = 38) of women taking buprenorphine and 19.6% (n = 21) of women taking methadone exclusively breastfed at discharge (χ2 = 5.43, p = .06). Exclusively breastfed infants required less pharmacological treatment for neonatal opioid withdrawal syndrome compared with formula-fed infants (15.8% [n = 21] vs. 47.4% [n = 38]; χ2 = 19.72, p < .05).
Conclusion:
Despite most women reporting a high prenatal intention to breastfeed, exclusive breastfeeding at hospital discharge postpartum was low. Breastfeeding was associated with a decreased likelihood of pharmacological treatment for neonatal opioid withdrawal syndrome.