Breastfeeding and the substance-exposed mother and baby

Abstract

Background: Breastfeeding rates are typically low for women with a substance-use disorder. This is despite the specific benefits of breastfeeding to alleviate the severity of neonatal abstinence syndrome and the well-documented generic advantages. This study explored the feasibility of in-hospital, tailored breastfeeding support for the substance-exposed mother and baby.

Methods: This was a mixed-methods feasibility study undertaken in Scotland from April 2014 to May 2015. Women with a substance-use disorder either received standard Baby-Friendly Initiative care only or were given additional support which included a dedicated breastfeeding support worker, personalized capacity-building approach, and a low-stimuli environment for 5 days. Feasibility outcome measures were maternal recruitment, satisfaction and acceptability of support, breastfeeding on fifth postnatal day, and severity of neonatal abstinence syndrome.

Results: Fourteen mother-infant dyads participated. Intervention participants demonstrated higher rates of continued breastfeeding and reported a greater degree of satisfaction with support and confidence in their breastfeeding ability. Maternal experience of health care practices, attitudes, and postnatal environment influenced their perceptions of breastfeeding support. Breastfed infants were less likely to require pharmacotherapy for neonatal withdrawal and had a shorter hospital stay.

Conclusions: The findings highlight the feasibility of tailored breastfeeding support for the substance-exposed mother and baby and endorse the promotion and support of breastfeeding for this group. Future research should include a statistically powered randomized controlled trial to evaluate clinical efficacy.

Keywords: breastfeeding; neonatal abstinence syndrome; nonpharmacological care.