- Is methadone safe for my baby?
- What if I want to taper off methadone?
- What about breastfeeding?
- What if I can’t make it to the clinic (weather, transportation, etc.)?
- Is “the State” (Department of Health and Human Services, Child Protective Services) going to take my baby?
- What if I have other medical issues?
- I’m afraid my family is not going to understand. How can I talk to them?
- What about my dose…should I try to stay below a certain amount?
Methadone treatment for pregnant women has been studied for the past 40 years and is considered the “gold standard” of treatment for pregnant women with opiate use disorder. Most babies born exposed to methadone have withdrawals and the hospital has medications to help the baby stay comfortable and manage withdrawal symptoms. If you stop using opiates suddenly you could miscarry, therefore it’s important to enter treatment if you are using illicit opiates or continue your medication-assisted treatment if you were in treatment when you became pregnant.
What if I want to taper off methadone?
Tapering is not recommend while you are pregnant, but you can always talk the medical staff at your treatment center about this issue. Being pregnant can be a very exciting and wonderful experience, but it can also be very stressful and scary. Tapering can add to that stress and some people have urges to use when they taper, even when they aren’t pregnant. Many pregnant patients feel it’s not worth the chance of relapsing, feeling withdrawals, and possibly miscarriage, so they decide to discuss tapering options after they give birth.
What about breastfeeding?
It is safe to breastfeed while you are taking your methadone. It isn’t safe if you are taking illegal drugs or are HIV positive. If you are taking any prescription medications, over the counter medication, vitamins, or herbal supplements make sure you talk to your doctor about breastfeeding while taking any of these. Your baby will receive a small amount of your methadone, but the nutritional benefits and bonding of breastfeeding are so important medical providers encourage it. This applies to methadone only. There is more information about this topic on the breastfeeding page of this website.
What if on one day I can’t make it to the treatment center to receive methadone (weather, transportation, etc.)?
It’s really important to attend to the clinic every day, so make sure you have a plan B in case your usual transportation options fails you. If you are having problems with transportation, talk to your counselor about options for transportation, reduced or free public transportation programs, or reimbursement options. You will likely be okay if you miss one day of your medication and try to make it into the treatment center the next day.
Is “the State” (Department of Health and Human Services, or Child Protective Services) going to take my baby?
Child Protective Services (CPS) workers want to make sure babies and children are raised in a safe environment. Different states have different laws regarding the involvement of CPS if there is known or suspected present or past history of drug use. In general, if you are in treatment and following your treatment plan, not actively using, and have a stable and safe home environment, CPS may want to make sure your home is safe for your baby, but not launch a full investigation. Some families will have a home visit by a public health nurse, who will check the safety of your home and might make recommendations, such as taking parenting classes or receiving additional counseling.
What if I have other medical issues?
Make sure you tell your medical providers about any medical issues you have, prescription or over the counter medications (including herbs or supplements) you are taking, and any alcohol or illicit drug use. Also, be sure tell your medical provider (your doctor and/or prenatal provider) you are in methadone treatment. Sometimes what may seem like opiate withdrawal symptoms in an infant may be caused by other medical issues, so it’s important to be open and honest with your medical providers. If you have not been tested for HIV and hepatitis C (HCV), or are wondering if you are at risk, talk to your providers. You can learn more about HIV and HCV in this section of this website.
I’m afraid my family is not going to understand. How can I talk to them?
On this website you’ll find a page about talking with your friends and family about why you are in methadone treatment during your pregnancy. Maybe you can sit down with them and go over this website together. Ask your counselor for help with talking to friends and family. If you think it would be helpful, talk to your counselor about inviting them to a counseling session.
What about my dose…should I try to stay below a certain amount?
The most important thing to think about is how are you feeling physically. It’s important to take a dose of methadone that will keep you from having withdrawals or cravings for 24 hours (we call this a therapeutic level of methadone). When you first begin methadone treatment it may take a bit of time before you reach a therapeutic level. There is no certain number of milligrams you should try to stay below. There is no clear evidence that if you stay below a certain level of methadone will guarantee your infant will not have withdrawal symptoms.
Because of the changes in your body during pregnancy, it’s not uncommon for women to need an increase in their methadone during the third trimester. With that said, you can most likely return to your pre-pregnancy dose after you deliver.