Breastfeeding and Methadone Therapy: The Maternal Experience
Jill R Demirci1, Debra L Bogen, Yael Klionsky
1a Department of Pediatrics , University of Pittsburgh School of Medicine , Pittsburgh , Pennsylvania , USA.
Substance Abuse
|April 8, 2014
Summary
Breastfeeding initiation is low for mothers on methadone maintenance therapy due to misconceptions and lack of support. Addressing these barriers can improve breastfeeding rates for methadone-exposed infants and mothers.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Addiction Medicine
Background:
- Breastfeeding offers significant benefits for mothers and infants.
- Women in methadone maintenance programs have lower breastfeeding initiation rates.
- This study explores breastfeeding perceptions in methadone-exposed populations.
Purpose of the Study:
- To describe breastfeeding decision-making and management perceptions.
- To identify barriers and facilitators to breastfeeding for women on methadone.
- To inform interventions for increasing breastfeeding rates.
Main Methods:
- Qualitative content analysis of interviews and focus groups.
- 11 pregnant and postpartum women in methadone maintenance programs participated.
- Semistructured interviews and focus groups were audiotaped and transcribed.
Main Results:
- Key themes included fears, misconceptions, and perceived benefits of breastfeeding.
- Lack of healthcare provider support and misinformation were significant barriers.
- Women identified needs for better information and support systems.
Conclusions:
- Interventions should address logistical, educational, and psychological barriers.
- Involving women, partners, peers, and clinicians is crucial.
- Educating clinicians on benefits and contraindications is essential for supporting breastfeeding methadone-exposed mothers.
Related Concept Videos
01:29Therapeutic Drug Monitoring: Affecting Factors
429
Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
429
01:17Phase II Reactions: Methylation Reactions
915
Methylation is a phase II biotransformation process involving the attachment of a methyl group to a substrate. Enzymes known as methyltransferases orchestrate this reaction.
The mechanism of methylation unfolds in two stages. The first stage sees a methyltransferase enzyme facilitating the transfer of a methyl group from S-adenosylmethionine (SAM) to the substrate, forming S-adenosylhomocysteine (SAH). The second stage involves further metabolism of SAH into homocysteine, which can be recycled...
The mechanism of methylation unfolds in two stages. The first stage sees a methyltransferase enzyme facilitating the transfer of a methyl group from S-adenosylmethionine (SAM) to the substrate, forming S-adenosylhomocysteine (SAH). The second stage involves further metabolism of SAH into homocysteine, which can be recycled...
915
01:28Development of the Oral Microbiota
65
The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...
65
01:26Drug Administration and Therapy Phases: Overview
1.9K
Drugs, the chemical agents used in diagnosing, treating, or preventing diseases, undergo a four-phase process of development: pharmaceutic, pharmacokinetics, pharmacodynamics, and therapeutic.
The pharmaceutical phase focuses on leveraging the physicochemical properties of the drug to design and manufacture an effective product. Variants include orally administered tablets or capsules, topical creams or ointments, and parenteral-delivery solutions or emulsions.
The pharmacokinetic phase...
The pharmaceutical phase focuses on leveraging the physicochemical properties of the drug to design and manufacture an effective product. Variants include orally administered tablets or capsules, topical creams or ointments, and parenteral-delivery solutions or emulsions.
The pharmacokinetic phase...
1.9K
01:14Drug Metabolism: Phase II Reactions
4.7K
Phase II reactions are essential for the detoxification and elimination of drugs from the body. These reactions involve the conjugation of parent drugs or their phase I metabolites with endogenous molecules, resulting in more hydrophilic drug conjugates. The primary conjugation reactions in this phase are sulfation and glucuronidation. Both sulfation and glucuronidation typically produce biologically inactive metabolites. However, in some cases involving prodrugs, active metabolites may be...
4.7K
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
408
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
408