{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T06:43:46Z","timestamp":1777099426587,"version":"3.51.4"},"reference-count":46,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,7,11]],"date-time":"2019-07-11T00:00:00Z","timestamp":1562803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Midwife Womens Health"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Opioid use is epidemic in the United States. Opioid use disorder (OUD) in pregnancy, as well as neonatal abstinence syndrome, has quadrupled in the last decade, and opioid maintenance therapy is recommended for pregnant women with OUD. Breastfeeding is an important means of improving outcomes for these vulnerable women and newborns. The purpose of this study was to review current policy on breastfeeding and opioid maintenance therapy, the rates of breastfeeding among women in this population, and facilitators and barriers to implementing policy recommendations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>CINAHL, PubMed, the Cochrane Database of Systematic Reviews, Embase, and Web of Science were searched. Inclusion criteria included publication between 2013 and 2018, English language, human only, and original data (except for policy statements). Studies were excluded if they did not report original data and did not examine breastfeeding for women on opioid maintenance therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eight policy statements and 17 original research studies were identified that met the search criteria. All the policy statements support breastfeeding for women who are stable on opioid maintenance therapy and do not have HIV. Despite this, rates of breastfeeding among women receiving opioid maintenance therapy remain low compared with women in the general population. Results of qualitative research indicates that women on opioid maintenance therapy face numerous barriers to breastfeeding, including misinformation from health care professionals. Quantitative research has only begun to identify interventions to improve breastfeeding outcomes in this population. Research was conducted primarily with white women receiving care at urban health care centers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Practice lags behind policy in terms of supporting breastfeeding in women receiving opioid maintenance therapy. There is a need for more research that includes African American and rural women on opioid maintenance therapy, as well as quantitative research that uses findings from qualitative research to identify the best possible interventions for improving breastfeeding outcomes for women on opioid maintenance therapy and their newborns. One significant need is for health care provider education regarding these policies as well as best practices for providing breastfeeding education and support to this population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jmwh.12982","type":"journal-article","created":{"date-parts":[[2019,7,11]],"date-time":"2019-07-11T12:22:30Z","timestamp":1562847750000},"page":"545-558","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Breastfeeding in Women on Opioid Maintenance Therapy: A Review of Policy and Practice"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7284-3523","authenticated-orcid":false,"given":"Rebecca R. S.","family":"Clark","sequence":"first","affiliation":[{"name":"Department of Community and Public Health Johns Hopkins University  Baltimore Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,7,11]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Applying CDC'S Guideline for Prescribing Opioids: An Online Training Series for Providers. Module 5: Assessing and Addressing Opioid Use Disorder (OUD)","author":"Centers for Disease Control and Prevention","year":"2017"},{"key":"e_1_2_8_3_1","volume-title":"Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health","author":"Ahrnsbrak R","year":"2017"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6731a1"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2017.01.011"},{"issue":"1","key":"e_1_2_8_6_1","first-page":"e1","article-title":"Amphetamine\u2010 and opioid\u2010affected births: incidence, outcomes, and costs, United States, 2004\u20102015","volume":"109","author":"Admon LK","year":"2018","journal-title":"Am J Public Health"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2018.04.003"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002235"},{"key":"e_1_2_8_9_1","unstructured":"Centers for Disease Control and Prevention.The US opioid crisis: addressing maternal and infant health. Centers for Disease Control and Prevention website.https:\/\/www.cdc.gov\/reproductivehealth\/opioid-use-disorder-pregnancy\/index.html. Published 2018. Accessed November 1 2018."},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0890334416641909"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001446"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2015.36"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.12378"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2016.0084"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-3524"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0890334418769637"},{"key":"e_1_2_8_17_1","volume-title":"Breastfeeding Report Card: United States, 2018","author":"Centers for Disease Control and Prevention","year":"2018"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-1985"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1751-4851(16)30207-0"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2015.9992"},{"key":"e_1_2_8_21_1","volume-title":"Public Policy Statement on Substance Use, Misuse, and Use Disorders During and Following Pregnancy, with an Emphasis on Opioids","author":"American Society of Addiction Medicine","year":"2017"},{"key":"e_1_2_8_22_1","unstructured":"Substance Abuse and Mental Health Services Administration.Clinical Guidance for Treating Pregnant and Parenting Women with Opioid Use Disorder and their Infants. HHS Publication No. (SMA) 18\u20105054.Rockville MD:Substance Abuse and Mental Health Services Administration;2018.https:\/\/store.samhsa.gov\/system\/files\/sma18-5054.pdf. Accessed September 13 2018."},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2017.04.028"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2010.66"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1521-0391.2012.12005.x"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.3233\/NPM-161610"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(15)30311-X"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.121309"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2014.902417"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2017.04.013"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/0890334417745521"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000532924.42849.b4"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2017.0130"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2018.05.016"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/jmwh.12009"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/ANC.0000000000000392"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/pch\/pxx054"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1177\/0890334415613823"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2018.02.006"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2017.0172"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000099"},{"issue":"1","key":"e_1_2_8_42_1","first-page":"43","article-title":"Breastfeeding and opiate substitution therapy: starting to understand infant feeding choices","volume":"10","author":"Graves LE","year":"2016","journal-title":"Subst Abus Res Treat"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1944"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0b013e31827e6b71"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.2174\/1574887112666170816144818"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000308"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13669-016-0168-9"}],"container-title":["Journal of Midwifery &amp; Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjmwh.12982","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jmwh.12982","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jmwh.12982","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jmwh.12982","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T00:14:42Z","timestamp":1694218482000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jmwh.12982"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,11]]},"references-count":46,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,9]]}},"alternative-id":["10.1111\/jmwh.12982"],"URL":"https:\/\/doi.org\/10.1111\/jmwh.12982","archive":["Portico"],"relation":{},"ISSN":["1526-9523","1542-2011"],"issn-type":[{"value":"1526-9523","type":"print"},{"value":"1542-2011","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7,11]]},"assertion":[{"value":"2018-11-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-07-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}