Maternal Buprenorphine Maintenance and Lactation

Lauren M. Jansson, Nancy Spencer, Krystle McConnell, Martha Velez, Michelle Tuten, Cheryl A. Harrow, Hendrée E. Jones, Madeleine J. Swortwood, Allan J. Barnes, Karl B. Scheidweiler, Marilyn A. Huestis

Research output: Contribution to journalArticle

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Abstract

Background: In addition to the well-known benefits of human milk and breastfeeding for the mother and infant, breastfeeding may mitigate neonatal abstinence syndrome severity in prenatally opioid-exposed infants. However, lack of conclusive data regarding the extent of the presence of buprenorphine and active metabolites in human milk makes the recommendation of breastfeeding for buprenorphine-maintained women difficult for many providers. Objective: This study seeks to determine the concentrations of buprenorphine and its active metabolites (norbuprenorphine, buprenorphine-glucuronide, and norbuprenorphine-glucuronide) in human milk, maternal plasma, and infant plasma of buprenorphine-maintained women and their infants. Methods: Up to 10 buprenorphine-maintained women provided paired breast milk and plasma samples at 2, 3, 4, 14, and 30 days postdelivery, and 9 infants provided plasma samples on day 14 of life. All samples were analyzed via liquid chromatography tandem mass spectrometry to determine concentrations of buprenorphine, norbuprenorphine, buprenorphine-glucuronide, and norbuprenorphine-glucuronide by a fully validated method. Results: Concentrations of buprenorphine and metabolites are low in human milk and maternal plasma. Breastfed infant plasma concentrations of buprenorphine were low or undetectable and metabolite concentrations undetectable at 14 days of infant age. There were significant correlations between maternal buprenorphine dose and maternal plasma and human milk buprenorphine concentrations. Conclusion: These data find low concentrations of buprenorphine and metabolites in human milk and lend support to the recommendation for lactation among stable buprenorphine-maintained women. However, the correlation between maternal dose and maternal plasma and human milk buprenorphine concentrations bears further study.

LanguageEnglish (US)
Pages675-681
Number of pages7
JournalJournal of Human Lactation
Volume32
Issue number4
DOIs
StatePublished - Nov 1 2016

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Buprenorphine
Lactation
Mothers
Human Milk
Glucuronides
Breast Feeding
Neonatal Abstinence Syndrome
Tandem Mass Spectrometry
Liquid Chromatography

Keywords

  • breastfeeding
  • chemically dependent women
  • drug-exposed infants
  • substance abuse

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Jansson, L. M., Spencer, N., McConnell, K., Velez, M., Tuten, M., Harrow, C. A., ... Huestis, M. A. (2016). Maternal Buprenorphine Maintenance and Lactation. Journal of Human Lactation, 32(4), 675-681. DOI: 10.1177/0890334416663198

Maternal Buprenorphine Maintenance and Lactation. / Jansson, Lauren M.; Spencer, Nancy; McConnell, Krystle; Velez, Martha; Tuten, Michelle; Harrow, Cheryl A.; Jones, Hendrée E.; Swortwood, Madeleine J.; Barnes, Allan J.; Scheidweiler, Karl B.; Huestis, Marilyn A.

In: Journal of Human Lactation, Vol. 32, No. 4, 01.11.2016, p. 675-681.

Research output: Contribution to journalArticle

Jansson, LM, Spencer, N, McConnell, K, Velez, M, Tuten, M, Harrow, CA, Jones, HE, Swortwood, MJ, Barnes, AJ, Scheidweiler, KB & Huestis, MA 2016, 'Maternal Buprenorphine Maintenance and Lactation' Journal of Human Lactation, vol 32, no. 4, pp. 675-681. DOI: 10.1177/0890334416663198
Jansson LM, Spencer N, McConnell K, Velez M, Tuten M, Harrow CA et al. Maternal Buprenorphine Maintenance and Lactation. Journal of Human Lactation. 2016 Nov 1;32(4):675-681. Available from, DOI: 10.1177/0890334416663198
Jansson, Lauren M. ; Spencer, Nancy ; McConnell, Krystle ; Velez, Martha ; Tuten, Michelle ; Harrow, Cheryl A. ; Jones, Hendrée E. ; Swortwood, Madeleine J. ; Barnes, Allan J. ; Scheidweiler, Karl B. ; Huestis, Marilyn A./ Maternal Buprenorphine Maintenance and Lactation. In: Journal of Human Lactation. 2016 ; Vol. 32, No. 4. pp. 675-681
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