Feeding Through Recovery: Mothers’ Perspectives on Breastfeeding while Navigating Opioid Use Disorder and Neonatal Opioid Withdrawal Syndrome

Abstract

Breastfeeding supports positive maternal and infant outcomes, yet mothers who have opioid use disorder (OUD) experience unique challenges that affect breastfeeding decisions. We assessed breastfeeding intentions and experiences of mothers with OUD (N = 50) via in-depth interviews (within one-week of birth through 18 months postpartum). Most mothers had prenatal intentions to breastfeed (82.0%), which was associated with breastfeeding initiation (76.0%), and less strained relationships with their biological mother and less fear during pregnancy. The birth experience impacted mothers’ execution of their intentions to initiate breastfeeding, including the circumstances of labor and delivery, treatment by staff, and involvement with child protective services. Interpersonal relationships, stigma, and self-efficacy were related to breastfeeding continuation (M length = 2.28 months, SD = 1.8). Breastfeeding experiences were largely impacted by experiences during pregnancy and birth, offering two critical windows for intervention through destigmatizing OUD in health care settings, strengthening self-efficacy, and enhancing social support.