Edinburgh Napier University

  Background: Breastfeeding rates are typically low for women with a substance use disorder. This is despite the specific benefit of breastfeeding to alleviate the severity of neonatal abstinence syndrome and the well-documented generic advantages. This study explored the feasibility of in-hospital, tailored breastfeeding support for the substance exposed mother and baby.

Methods: this was a mixed methods feasibility study, in Scotland from April 2014 to May 2015. Women with a substance use disorder received either standard Baby Friendly Initiative care only or were given additional support which included a dedicated breastfeeding support worker; personalised capacity building approach and a low stimuli environment for 5 days. Feasibility outcome measures were maternal recruitment, satisfaction and acceptability of support; breastfeeding on 5th postnatal day and severity of neonatal abstinence syndrome.

Results: 14 mother/infant dyads participated. Intervention participants demonstrated higher rates of continued breastfeeding and reported a greater degree of satisfaction with support and confidence in their breastfeeding ability. Maternal experience of health care practices, attitudes and postnatal environment influenced their perceptions of breastfeeding support. Breastfed infants were less likely to require pharmacotherapy for neonatal withdrawal and had a shorter hospital stay.
Conclusions: the findings highlight the feasibility of tailored breastfeeding support for the substance exposed mother and baby and endorse the promotion and support of breastfeeding for this group. Future research of a statistically powered randomized controlled trial to evaluate clinical efficacy is recommended.