Neonatal abstinence syndrome: the role of breastfeeding

Substance misuse within the UK population continues to be a major public health concern (FIGURE 1). Approximately one in four of those entering drug treatment programmes in 2010-2011 were female, many of who were of childbearing age. Pregnant substance misusing women need supportive and coordinated care during pregnancy. They have been highlighted as a specific group in need by the National Institute for Health and Care Excellence (NICE) in their guidance on the management of pregnant women with complex social factors. Locally in Leeds, between 50 and 80 pregnant drug users book for antenatal care at the Leeds Addiction Unit (LAU) every year. The numbers have remained relatively static over a five-year period (FIGURE 2). The vast majority of these women are receiving prescribed opioid maintenance therapy (ie methadone or buprenorphine) with many using additional illicit substances. Infants born to substance misusing mothers are at a higher risk of poor pregnancy outcomes including prematurity, intrauterine growth restriction and stillbirth.