ABM protocol

Academy of Breastfeeding Medicine Clinical Protocol #21: Breastfeeding in the Setting of Substance Use and Substance Use Disorder (Revised 2023)

Infant Risk Center

Tennessee Breastfeeding Hotline at 1-855-4BF-MOMS (1-855-423-6667)

Post Partum Support International

Breastfeeding is not contraindicated for mothers in stable medication-assisted treatment; modern ABM protocols support initiation with appropriate multidisciplinary follow-up including SUD care, lactation, and mental health services.

Breast milk's unique benefits for opioid-exposed infants—including colostrum's protective properties and comfort during withdrawal—make it particularly valuable; however, exclusive breastfeeding may not be realistic given these infants' high metabolic needs, requiring planned supplementation.

The amount of MAT transferred through breast milk is negligible and not bioavailable; educating mothers and families on this fact directly counters the primary misconception preventing breastfeeding initiation.

Perinatal mood and anxiety disorders require careful assessment; breastfeeding can support recovery or worsen mental health depending on individual circumstances—flexible, individualized approaches prioritize maternal wellbeing as essential to infant wellbeing.

Accessible resources (Infant Risk Center, Tennessee Breastfeeding Hotline, LactMed, insurance-covered in-home lactation visits) enable clinicians without IBCLC support to make evidence-based decisions; establishing hospital protocols and escalation pathways prevents outdated blanket restrictions.

Quotable Moments

"My main goal is helping women to be the best mother that they can be. I want to decrease stigma and definitely improve child outcomes."

"Breast milk is what will comfort those symptoms. That in the early days, that colostrum is such a protective factor. It's thick, it's rich, it coats the intestine, and it's so easy to digest that it requires less work of the gut."

"You can't give from an empty cup. And you've got to take care of yourself and your baby needs a completely healthy mom, mentally and physically."

"Addiction is a disease, not a moral failing... MAT allows these women to lead normal, happy lives. It's what helps them be a good mother."

Show Notes by Barevalue

No content or comments made in any TIPQC Healthy Mom Healthy Baby Podcast is intended to be comprehensive or medical advice. Neither healthcare providers nor patients should rely on TIPQC’s Podcasts in determining the best practices for any particular patient. Additionally, standards and practices in medicine change as new information and data become available and the individual medical professional should consult a variety of sources in making clinical decisions for individual patients. TIPQC undertakes no duty to update or revise any particular Podcast. It is the responsibility of the treating physician or health care professional, relying on independent experience and knowledge of the patient, to determine appropriate treatment.