A woman on methadone wants to breastfeed. She should be advised that

• A. Methadone must be stopped prior to breastfeeding
• B. Breastfeeding is contraindicated
• C. Supervised methadone use is compatible with breastfeeding
• D. Breastfeeding should be delayed until after methadone dose clears

Answer: (C)

Methadone maintenance is compatible with breastfeeding. Methadone passes into breast milk in small amounts, but the benefits of breastfeeding for both infant and mother—nutrition, immune protection, bonding, and often reduced severity of neonatal abstinence syndrome—outweigh the risks when the mother’s dose is stable and other substances are avoided. Therefore, breastfeeding should be encouraged while the mother continues methadone under medical supervision. There’s no need to stop methadone or delay breastfeeding until the dose clears. Monitor the infant for signs of sedation or poor feeding and ensure regular pediatric follow-up, with attention to other substances the mother might use.