Drug treatment advocates worry about New Britain breast milk homicide case

Posted July 19. 2018

methadone and other drugs in his system when he died.

The recent arrest of a New Britain Township woman on homicide charges in the drug overdose death of her breastfed infant has local medical and drug treatment professionals concerned that the case will spread misinformation about medication-assisted drug treatment and breast feeding.

Samantha Jones

Amanda Johns, who runs a parenting group at Aldie Foundation Counseling Center in Doylestown Township, said some clients have worried about how they will be viewed following the July 13 arrest of Samantha Jones, 30, on homicide charges in the death of her 11-week old son.

“The assertion by those in the community, who through online comments have suggested that women who utilize methadone during pregnancy should have automatic removal of children, or that women who utilize methadone should not breastfeed, has caused hurt and upset among our moms who found sobriety through medication-assisted treatment,” said Johns, a clinical outreach worker.

Court documents allege that Remington Jones died April 2 as a result of a fatal combination of methadone, amphetamine and methamphetamine, which a medical examiner concluded was ingested through his mother’s breast milk. Court documents state that Jones, who also has a 2-year-old son, was prescribed methadone while pregnant with Remington and continued on the drug after she delivered, which is considered a common and effective treatment for opiate dependence. The document didn’t mention anything about Jones’ previous use of methamphetamine or amphetamine, which is a methamphetamine byproduct.

Bucks County prosecutor Kristin McElroy, who initially called the case “a sad and tragic example of the opiate crisis,” acknowledged in an email she is aware that women can take prescribed methadone and continue to breast feed, but “the cause of this (death) is the combination of methadone, methamphetamine and amphetamine.”

Child advocate Cathleen Palm, founder and executive the Center for Children’s Justice in Berks County, suggested that the Pennsylvania Department of Human Services put out immediate guidance to child welfare agencies to reinforce with clients when breastfeeding is appropriate for mothers taking opiate-replacement drugs.

“If I were a mom, I’d be in a panic at this time,” Palm said. “No mom wants to injure their own child.”

Available medical research suggests that methadone in any dose cannot accumulate in breast milk in concentrations that would be harmful for breastfeeding infants in the short term; long-term outcomes of infants breastfed by mothers taking opiate-replacement drugs has not been well studied.

A 2011 study found breastfed infants, even those born to mothers taking a high does of 200 milligrams of the drug a day, received a minuscule amount of methadone through breast milk, in amounts well below the doses typically given every 12 hours to treat opioid withdrawal symptoms in newborns. 

Other studies suggest abruptly weaning breastfed infants of women on methadone maintenance can trigger an increase in drug withdrawal symptoms in the child.

Medical organizations including the American College of Obstetricians and Gynecologists support breast feeding with medically supervised opioid-dependent mothers because it offers advantages, including critical parent-child bonding and health benefits that are critical for infants with prenatal drug exposure, who are often born premature. 

A 2009 study showed a 50 percent reduction in the need for medical interventions for neonatal abstinence syndrome in methadone-exposed babies that breast fed for more than three days.

But it’s a risk that some mothers won’t take.

Most women prescribed methadone through the Penn Foundation, a Sellersville behavioral health treatment center, choose not to breast feed, said Gordon Horning, coordinator of the center’s Mobile Engagement Services program, which works with drug-dependent new parents.

“This basically was the fear — that they did not want to see their babies getting the drug through breastfeeding,” he said.

Amphetamine and methamphetamine are transferable in breast milk, but studies examining the effects on newborns as a result of this transfer has not been well studied. The prevailing medical recommendation is to discourage breastfeeding in women abusing either drug.

In the Jones case, court documents allege that she told authorities she had recently started Remington on infant formula because she was not producing enough breast milk.

The day of his death, Jones told police that she tried to feed him at 3 a.m., but she was not sure if he latched onto the breast and received milk. A few hours later, the baby was crying again and Jones said she asked her husband to make the baby a formula bottle, which he did. Jones fed the child the bottle and put him back in his bassinet.

An hour later Jones claims she woke to find Remington pale with bloody mucus coming out of his nose, police said. The infant was pronounced dead a short time later.