OBJECTIVE. In a sample of methadone-maintained breastfeeding women and a matched group of formula-feeding women, this study evaluated concentrations of methadone in breast milk among breastfeeding women and concentrations of methadone in maternal and infant plasma in both groups.METHODS. Eight methadone-maintained (dose: 50–105 mg/day), lactating women provided blood and breast milk specimens on days 1, 2, 3, 4, 14, and 30 after delivery, at the times of trough and peak maternal methadone levels. Paired specimens of foremilk and hindmilk were obtained at each sampling time. Eight matched formula-feeding subjects provided blood samples on the same days. Infant blood samples for both groups were obtained on day 14. Urine toxicological screening between 36 weeks of gestation and 30 days after the birth confirmed that subjects were not using illicit substances in the perinatal period.RESULTS. Concentrations of methadone in breast milk were low (range: 21.0–462.0 ng/mL) and not related to maternal dose. There was a significant increase in methadone concentrations in breast milk over time for all 4 sampling times. Concentrations of methadone in maternal plasma were not different between groups and were unrelated to maternal dose. Concentrations of methadone in infant plasma were low (range: 2.2–8.1 ng/mL) in all samples. Infants in both groups underwent neurobehavioral assessments on days 3, 14, and 30; there were no significant effects of breastfeeding on neurobehavioral outcomes. Fewer infants in the breastfed group required pharmacotherapy for neonatal abstinence syndrome, but this was not a statistically significant finding.CONCLUSION. Results contribute to the recommendation of breastfeeding for methadone-maintained women.
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机译：目的。在一项由美沙酮维持的母乳喂养妇女和一组配对的配方奶喂养妇女的样本中，该研究评估了两组母乳喂养妇女中母乳中美沙酮的浓度以及母婴血浆中美沙酮的浓度。八名美沙酮维持量（剂量：50-105毫克/天），哺乳期妇女在分娩后第1、2、3、4、14和30天，即低谷和母体美沙酮含量高峰时提供血液和母乳标本。在每个采样时间获得配对的前乳和后乳标本。八名匹配的配方奶喂养对象在同一天提供了血液样本。两组均在第14天获得婴儿血样。在妊娠36周至出生后30天之间进行尿毒理学筛查，证实受试者在围产期未使用违禁药物。母乳中美沙酮的浓度很低（范围：21.0–462.0 ng / mL），与母体剂量无关。在所有四个采样时间中，母乳中美沙酮的浓度均随时间显着增加。两组间母体血浆美沙酮的浓度无差异，与母体剂量无关。在所有样本中，婴儿血浆中美沙酮的浓度均较低（范围：2.2–8.1 ng / mL）。两组婴儿在第3、14和30天都进行了神经行为评估。母乳喂养对神经行为结果没有显着影响。母乳喂养组中较少的婴儿需要针对新生儿禁欲综合征进行药物治疗，但这并不是统计学上的重要发现。结果有助于推荐美沙酮维持治疗的妇女进行母乳喂养。
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