Breastfeeding is encouraged for all patients except those with HIV or other contraindications.

  • If breastfeeding is declined, switch the woman back to co-formulated buprenorphine/naloxone immediately after delivery or continue methadone.
  • If breastfeeding is accepted, consult with the pediatric provider to confirm that he/she is aware of the mother’s medication-assisted treatment and all other medications being taken. Referral to a lactation consultant is warranted to support successful initiation of breastfeeding.
  • If newborn is not receiving methadone, morphine, or other opioid for treatment of neonatal abstinence syndrome (NAS), switch mother back to co-formulated buprenorphine/naloxone.
  • If the newborn is being treated with methadone, morphine or other opioid for neonatal abstinence syndrome, continue buprenorphine monotherapy until neonate is off medication or weaned from breast milk. There may be some women in whom combination buprenorphine/ naloxone is recommended; given evidence of minimal bioavailability in breast milk, breastfeeding should be For more information on breastfeeding see the Breastfeeding Section in this document.