Objective:  To examine the effect of infant feeding methods on neonatal abstinence syndrome (NAS).

Design: Retrospective study.

Setting: Labor and Delivery Unit and Neonatal Intensive Care Unit, Eastern Maine Medical Center, Bangor, Maine.

Patients/Participants: One hundred fifty-two opioid dependent women on methadone maintenance therapy (MMT) (n=136) or buprenorphine maintenance therapy (BMT) (n=16) during pregnancy and their neonates. The neonates were born between January 1, 2005 and December 31, 2007.

Methods: Researcher conducted a review of the electronic medical records (EMR) of all opioid dependent women who were on MMT or BMT when admitted for labor and delivery and their neonates. Infant feeding methods were examined in relation to NAS.

Results:  Infant feeding method did not predict neonatal length of stay (LOS) for NAS however, there were statistically significant differences between formula and breast fed infants in relation to the initiation of pharmacologic treatment for NAS.  For the group of MMT or BMT exposed neonates receiving NAS treatment, those infants who were breast fed began first line therapy with phenobarbital 1.1 day later (p = .008) and their LOS was shorter by 9.4 days (p = .016) as compared to formula fed neonates or neonates who received formula and breast milk. An ANOVA with the three infant feeding methods (formula, breast or mixed formula and breast) revealed significant differences in NAS treatment between formula and breast fed infants but not between the formula fed infants and infants fed both formula and breast milk

Conclusion/Implications for nursing practice: Opioid dependent women on MMT or BMT should be encouraged to breastfeed.  

Keywords:  Opioid dependency, pregnancy, methadone, buprenorphine, neonatal abstinence syndrome.