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PostPosted: Thu Aug 11, 2016 12:47 pm 
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I've been taking hydrocodones for months, while breastfeeding. I go to the dr on Monday and I'm just curious if starting suboxone and breastfeeding will cause my daughter to go into horrible withdrawal. She'll get my milk at daycare and then I'll nurse her at 6. Has anyone been thru this? Should I give her formula during the day at daycare so she goes a full 12 hours before getting any of the suboxone that might make it to her from my milk


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PostPosted: Thu Aug 11, 2016 1:35 pm 
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Hey A,

Surly ur suboxone dr can answer that question, definitely ask him. I honestly don't know but hopefully Dr Junig can help answer it. But ur own doctor needs to know ur breastfeeding. I wish I could be more help but that's a first for me.

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PostPosted: Thu Aug 11, 2016 10:16 pm 
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I assumed I'd heard every question about buprenorphine, but I haven't come across this one.

I assume you know, from your question, that the issue is buprenorphine-- not naloxone. Naloxone is barely absorbed when taking Suboxone, and whatever tiny amount makes it past your liver isn't enough to amount to anything significant in your breast milk.

But buprenorphine IS found in breast milk in very small amounts. Babies, like adults, efficiently break down swallowed buprenorphine at the liver. But I would expect at least a few molecules of buprenorphine to pass from breast milk, across the oral mucosa, and into baby's bloodstream.

Likewise, some of the hydrocodone you are taking likely has been transferred from breast milk to your baby. I think it is reasonable to assume that the baby has some amount of circulating hydrocodone, and will be exposed to some (tiny) amount of buprenorphine.

Is there enough of BOTH substances to cause problems? It will depend on the amount of hydrocodone that you are taking. A quick search for info about hydrocodone and breastfeeding shows that babies receive about 1.6% of the dose that mom receives (http://www.ncbi.nlm.nih.gov/pubmed/21343764). The total amount that a baby receives from a mother taking a normal therapeutic dose of hydrocodone is about equal to 1% of a typical therapeutic dose for an infant.

In other words, if a normal dose of hydrocodone for an infant is 1 mg, the amount in breast milk is 0.01 milligram-- a very small amount. To put it into an adult perspective, say you are taking 5 mg of oxycodone (one Percocet tablet) every 4 hours, equal to 30 mg every 24 hours... it would be like you getting a tenth of one milligram of oxycodone every 8 hours. Not very much at all.

So mom, if you are taking TONS of hydrocodone, you may want to take some caution with buprenorphine by giving one formula feeding after starting buprenorphine, so your baby goes 6 hours without any hydrocodone at all before being exposed to buprenorphine in breast milk. But if you are taking a normal therapeutic dose-- equivalent to a couple vicodin every 4 hours-- the chance of any noticeable problem is very low.

Please follow-up here, and let us know how things go. Use this discussion, if you want, to spark a conversation with your doctor-- but in any case, follow your doctors' instructions.


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PostPosted: Mon Aug 15, 2016 8:40 am 
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Thank you. So I actually went from 6pm to 10 am 4 days in a row without taking anything, and pumped at 7 and 9am. I was taking a bit more than my prescribed amount, 3 7.5mgs every 3-4 hours, some days more. And the days I took an excess she was given formula. I'm so nervous for my appointment today, thank you for your replies, it gives me an idea of how this conversation will go with my dr


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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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