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

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]; chi(2) = 4.35, p = .03), despite no difference in their prenatal intention to breastfeed (87% vs. 81%; chi(2) = 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 (chi(2) = 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]; chi(2) = 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.