Breastfeeding is linked to improved cardiovascular health for both child and mother; however, many hospitals do not encourage or provide support for breastfeeding while either in the hospital or after delivery. This is particular true of mothers with substance use disorder (SUD) more generally or with opioid use disorder (OUD) more specifically. The Drug-Free Moms and Babies Project (DFMB) program was designed to develop and evaluate programs that provide treatment and recovery services for pregnant and postpartum women with SUD; data is now available for 2018 and up to October 2019. Project WATCH collects data on all births in West Virginia (WV) and includes questions about breastfeeding intent and actual breastfeeding practices. A special focus for both programs includes encouraging or assessing breastfeeding in WV, which ranked 46thin the nation for ever breastfeeding in 2015. There were 688 pregnant women in DFMB 2018-2019 with information on breastfeeding intent; at program entry, 54.8% intended to breastfeed. Relative to all births in WV in 2018 (Project WATCH data; N=18177), 57.4% intended to exclusively breastfeed. Among all births with intrauterine substance exposure (IUSE) in 2018 (N=2558), 31% intended to exclusively breastfeed. Of the 688 in the DFMB program, 528 completed the program through delivery and had breastfeeding information. Of those, 225 (42.6%) actually breastfed after birth, and 80.6% were given the opportunity to breastfeed before leaving the hospital. For actual breastfeeding rates among all births in WV (Project WATCH), 37.4% exclusively breastfed before hospital discharge, and among births with IUSE, 32.0% exclusively breastfed. We also examined breastfeeding rates among those infants born with NAS in the DFMB program (N=220, 42.8%). Of these women, 49.7% intended to breastfeed, 37.4% breastfed after birth, and 73.5% were given the opportunity to breastfeed before hospital discharge. Among all 2018 WV NAS births (N=901), actual breastfeeding rate was 9.1%. Results suggest DFMB programs improve breastfeeding rates when compared against all births in the state, and among births with IUSE. The program continues to intervene with this high-risk group to improve breastfeeding rates, which we believe will later impact cardiovascular health for both mothers and babies.