Two case reports of breastfeeding mothers on high doses of methadone and a literature review reveal that minimal transmission of methadone into breast milk occurs regardless of the mother's methadone dose. The current American Academy of Pediatrics recommendations that only women in drug treatment programs on less than 20 mg/day of methadone be advised to breastfeed should be reconsidered.
1. Blinick G, Wallach R, Jerez E, Ackerman B.Drug addiction in pregnancy and the neonate. Am J Obstet Gynecol1976; 125:135-142.
2.
2. Committee on Drugs. The transfer of drugs and other chemicals into human milk. Pediatrics1994; 93:137-137.
3.
3. Blinick G, Inturrisi C, Jerez E, Wallace R.Methadone assays in pregnant women and progeny. Am J Obstet Gynecol1974; 121:617-621.
4.
4. Foerster EH, Hatcher D, Garriott JC. A rapid comprehensive screening procedure for basic drugs in blood and tissues by gas chromatography. J Analytical Toxicolog. 1978; 2:50-55.
6. Kreek MJ, Schecter A, Gutjahr CL, Bowen D, Field F, Queenan J, et al. Analyses of methadone and other drugs in maternal and neonatal body fluids: Use in evaluation of symptoms in a neonate of mother maintained on methadone. Amer J Drug & Alcohol Abuse1974; 1:409-419.
7.
7. Kreek MJ. Methadone disposition during the perinatal period in humans. Pharm Biochem Beh1979; 11:7-13.
8.
8. Smialek JE, Monforte JR, Aronow R, Spitz WU. Methadone deaths in children. JAMA1977; 238:2516-2517.
9.
9. D'Apolito K.Methadone maintenance and breastfeeding: Do they mix?Neonatal Network1994; 13:64-65.
10.
10. D'Apolito K.Methadone maintenance and breastfeeding continued. Neonatal Network1995; 14:77-78.
11.
11. Wilton JM. Breastfeeding and the chemically dependent woman. NAACOG's Clinical Issues1992; 3:667-672.
