Bucks prosecution of nursing mom in baby’s death triggers alarm on addiction treatment

A Bucks County judge has ordered an addicted mother whose infant son died after breastfeeding to stand trial on homicide charges, advancing a controversial case that may test how far prosecutors can extend some of Pennsylvania’s most severe felony laws in the midst of the opioid crisis.

The charges against Samantha Whitney Jones have put public health experts on high alert. They worry that mothers who struggle with addiction will be afraid to breastfeed should the case set off additional criminal prosecutions targeting women in that situation.

Jones’ case is thought to be the first time a nursing mother faced homicide charges after breastfeeding, according to the Pennsylvania District Attorneys Association.

“It was not our objective to try and blaze a trail here,” said Bucks County District Attorney Matt Weintraub. “But we need to make sure that all of our citizens, especially our youngest and most vulnerable, the little babies, are protected.”

Back in April, around 3 a.m. at Jones’ house in New Britain Township, her 11-week-old son, identified as R.J in the charging documents, started crying.

Jones was too tired to go downstairs to prepare a bottle of formula for him, so she decided to breastfeed. After that, she put him in his crib and went back to sleep.

Hours later, she woke up to a nightmare: R.J. was paper white and unresponsive. The baby had died.

Those events, said Weintraub, amount to criminal homicide, a killing committed “intentionally, knowingly, recklessly or negligently,” according to Pennsylvania law.

“Mrs. Jones made a conscious choice to feed her baby breast milk, which she knew would be laced with illegal drugs such as amphetamine and methamphetamine, along with methadone,” Weintraub said.

Here is where public health experts enter the picture. Methadone and other addiction medications treating the symptoms of opioid withdrawal are perfectly safe to take while breastfeeding, according to rigorous studies and professional recommendations of organizations such as the National Institutes of Health.

Could case dissuade moms from nursing?

While prosecutors say it was not only methadone but a combination of several drugs that allegedly killed the newborn, Dr. Davida Schiff and other physicians argue that mentioning methadone in connection with the prosecution at all can send the wrong signal to nursing moms.

“I would hate for the message of this really tragic case to deter any women who are in treatment for opioid-use disorder who want the best for their infant to discourage them from initiating breastfeeding,” Schiff said. “That would be probably a really detrimental side effect of this terrible outcome for this family.”

Schiff, a pediatrician in Boston who is the medical director of the HOPE clinic for pregnant women struggling with addiction, helped develop some of the professional guidelines for opioid-dependent moms who are nursing.

She points to studies showing that only about 1-5 percent of the original dose of medications such as methadone are transferred to the nursing child. Women who avoid breastfeeding because they’re taking methadone or other prescribed opioid treatments are not doing the best for their babies.

“Mom is safe to breastfeed with her infant. And, in fact, it’s the best thing she can offer her infant in the period immediately following delivery,” Schiff said.

According to an affidavit of probable cause, an autopsy found levels of various stimulants — including methamphetamine — in the newborn’s blood, in addition to the prescribed methadone. Jones said she was on the meds to treat an addiction to painkillers.

Now, there is no dispute that breastfeeding while taking meth is extremely dangerous. Schiff agreed that Jones should not have done it. Yet it has sparked another debate: Was it tantamount to criminal homicide? It is a crime that, if she is convicted, could send the 30-year-old Jones away for decades?

Jolene Forman, staff attorney with the Drug Policy Alliance, which advocates drug legalization and treatment, admits that it was a tragic choice. But she questions whether the behavior should be criminalized.

“We have learned from the 45-plus years of the war on drugs that using a stick to try to deter people from using drugs doesn’t work,” Forman said.

Jones is already grieving the loss of her son. What she needs now, Forman said, is support to help her stay off opioids and additional drug treatment to help her kick other addictions, not incarceration. What’s more, Forman said, the criminal charges might cause other addicted mothers to hide their habits from health care providers for fear of being arrested.

“It’s going to really dissuade women from being honest with their doctors about drug use, meaning they won’t be able to get the health care they need,” she said.

Opening a prosecutorial path

Weintraub sees the death of a vulnerable 11-week-old as the bottom line — and that’s something he cannot ignore. Addiction might not be a choice, he said, but Jones did not have to put her baby in harm’s way.

“She made a conscious decision, which clearly and definitively resulted in baby RJ’s death, and a price has to be paid for that,” Weintraub said.

To some observers, the prosecution of Samantha Jones is no more than a one-off case that captured sensational headlines around the globe. But for Weintraub, and to other prosecutors around Pennsylvania looking for envelope-pushing ways to respond to the opioid crisis, the outcome of the case might actually turn into a roadmap.

“If a mother decides to subject herself to the influence of illegal narcotics that can cause a baby’s death and chooses to breastfeed that baby,” Weintraub said, she may face the same charges.

Richard Long, executive director of the Pennsylvania District Attorneys Association, agreed.

“A successful prosecution would make more prosecutors aware of the possibility of such a prosecution when the facts and circumstances deem it appropriate,” he said.

Jones’ defense lawyer, Lou Busico, did not respond to numerous interview requests. In court recently, Busico said the charges should be thrown out because Jones’ breast milk itself was never examined for drugs. Prosecutors maintain, however, that there is no other way the baby could have tested positive for so many toxic substances.

At the end of the month, Jones, who is free on bail, will be back in a Doylestown court, where she is expected to plead not guilty and a trial date will be set.

At the last hearing, Deputy District Attorney Kristin McElroy said methamphetamine and amphetamine “had no business being inside that baby.”

“We are not alleging that this was an intentional killing of this baby,” McElroy said, “but it certainly was reckless to know these drugs were in your body and continue to breastfeed.”