Will my baby have withdrawal from Suboxone? Can I have an epidural with Suboxone? Will Suboxone hurt my baby? Can I breast feed on Suboxone?
Wed Mar 18, 2015 4:45 pm
Hi all, longtime lurker, and after reading the posts in the Sub and Pregnancy section I feel like I should finally contribute. I'm trying to help, but I am not a doctor, so if what I'm advising doesn't feel right-- well, just ignore me! Anyway here goes (it's a doozy!):
I have been on suboxone now-- 16mg/ daily--for four years, and have had one baby and a tonsillectomy in the process. When I found out I was pregnant with my daughter, I told my sub doc right away, and she switched me to Subutex immediately. She gave me a taper schedule and told me she wanted me completely off the meds at least 48 hours before the due date so that the epidural (this was my second child so I knew I wanted the epidural!) and post-delivery pain meds could work. She told me a horror story about a former patient who hadn't tapered in time, so her pain meds didn't work, and the bay went into withdrawal and the NICU, and on and on. I didn't want that to happen, obviously, so I started to taper.
I also told my OB, by the way. I explained what the medication was for, and that I had a very high tolerance to painkillers. There is often some kind of opiate in an epidural, so I said I would probably need at least double the dosage of meds for that and the post-delivery meds, even with the bupe out of my system-- especially bc of bupe' long half-life. I gave her the name and number of my sub doc and asked the OB AND THE ANESTHESIOLOGIST who would be performing the epidural to contact her, and then I followed up and made sure that they had spoken with one another.
About 30 weeks into the pregnancy, I was a little behind with the taper and at about 2mg daily. I started reading that, at a certain level, one could still take the bupe and receive anesthesia, pain killers, epidurals, etc. successfully, as long as they were given at a higher than normal dose. I also read that, at that low dosage of bupe (it was about 1-2 mg), the baby was unlikely to suffer withdrawal-- especially if it was breastfed by a mom still taking (a) the painkillers from the delivery and/or (b) that small dose of subutex (not suboxone, that's bad for the baby! Your insurance will likely keep you on subutex as long as you are nursing, if they support you breastfeeding the baby).
That sounded good to me-- I was already uncomfortable from withdrawals and unable to take much to relieve the symptoms. I decided to keep taking the subs, but I told both docs that I was going to try to taper off completely before my baby was born. This was a lie-- I normally would recommend telling the truth, but the sub doc and I weren't on the same page about the issue, and I didn't want to risk losing her. She's great.
So I tapered down to 1.5mg and surprise!! The baby came 4 weeks early! I couldn't have tapered off completely if I had wanted to. I had taken 1.5mg at about 6AM, then went into labor around one, had the baby at nine, and took another dose that I had smuggled into the hospital the next morning. She was born completely healthy and withdrawal-free, the epidural wasn't as fun as it was the first time I gave birth, but it worked, the post-pain meds worked, and I kept taking the 1.5 mg the whole time. i breastfed her and she weaned off the meds when I weaned her off the breast-- I was sure to go very slowly.
So everything worked out perfectly, and last year, when I had to have a tonsillectomy, I did the same thing: told the docs I was off the meds, but they still needed to up the pain pills bc of my tolerance, and I continued to take less than 2mg of bupe daily. Everything worked out perfectly once more, and the bupe offered some extra much-needed pain relief because boy did that procedure suck.
I hope that helps anyone out there who might be scared and in a similar situation. I will check the board so feel free to ask me any questions. Thanks for reading!