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Maternal Buprenorphine Maintenance and Lactation.

Lauren M Jansson1, Nancy Spencer2, Krystle McConnell1

  • 11 Johns Hopkins University School of Medicine, Baltimore, MD, USA.

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PubMed
Summary

Breastfeeding is safe for infants of mothers on buprenorphine treatment. Low concentrations of buprenorphine and its metabolites were found in human milk, supporting lactation recommendations for these women.

Keywords:
breastfeedingchemically dependent womendrug-exposed infantssubstance abuse

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Area of Science:

  • Pharmacology
  • Neonatal Abstinence Syndrome
  • Human Milk Analysis

Background:

  • Breastfeeding offers benefits but its recommendation for buprenorphine-maintained mothers is hindered by limited data on drug transfer.
  • Neonatal Abstinence Syndrome (NAS) severity may be reduced by breastfeeding in infants exposed to opioids prenatally.

Purpose of the Study:

  • To quantify buprenorphine and its active metabolites in human milk, maternal plasma, and infant plasma.
  • To assess the safety of breastfeeding for infants of mothers undergoing buprenorphine treatment.

Main Methods:

  • Paired human milk and maternal plasma samples collected from 10 buprenorphine-maintained women at multiple time points post-delivery.
  • Infant plasma samples collected on day 14.
  • Analysis using validated liquid chromatography tandem mass spectrometry for buprenorphine and metabolites.

Main Results:

  • Low concentrations of buprenorphine and metabolites detected in human milk and maternal plasma.
  • Infant plasma showed undetectable or low buprenorphine levels and undetectable metabolite levels at 14 days.
  • Significant correlation observed between maternal buprenorphine dose and drug concentrations in maternal plasma and milk.

Conclusions:

  • Low levels of buprenorphine and metabolites in human milk support breastfeeding recommendations for stable buprenorphine-maintained women.
  • Further research is needed to explore the dose-dependent relationship between maternal buprenorphine dosage and drug concentrations in milk and plasma.