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PostPosted: Mon Jun 19, 2017 6:43 pm 
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Hey all. I was on Suboxone for almost 2 years (this time) when I found out I was pregnant in January this year. My psychiatrist (suboxone prescriber) switched me to Subutex and I am his first pregnant patient so he doesn't have a ton of info on what happens after I deliver. My OB recommended I not discontinue or decrease my dose during my pregnancy. I am prescribed 12 mg a day but currently take 4-8 mg a day. The subutex tablets do not break very well and usually crumble. I take half in morning, half at lunch and sometimes another half after work. My OB said the baby would likely be born dependent (although I've not seen that to be the case in every subutex birth I've found) but that if I am planning to nurse then that would help with any withdrawal symptoms that do present.

I've researched and read here that the baby likely will not receive much of the buprenorphine from breastmilk however in the same breath I'm reading that IF baby is dependent then breastmilk will help with that... If they're not receiving it orally through breastmilk then how is it helping with withdrawal?
And if they are receiving some through breastmilk then will my baby experience any symptoms once she begins to wean from nursing?


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PostPosted: Mon Jun 19, 2017 8:28 pm 
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Several studies have shown that the incidence of neonatal abstinence syndrome (NAS) is significantly lower in babies born to mothers on buprenorphine (50%) than in babies born to mothers on methadone (virtually 100%). In babies of moms on buprenorphine, NAS tends to start a bit later-- after 4-5 days, instead of the 2-4 days in babies of moms on methadone.

Please read my blog posts by searching www.suboxsearch.com using keywords 'pregnancy' or 'breast feeding'. Please make sure you read this one: http://suboxonetalkzone.com/withdrawal-in-newborns-lay-off-the-guilt-trip/

I don't have the reference handy, but recent studies showed benefit to breastfeeding when mothers are on buprenorphine. You are correct-- little buprenorphine shows up in breast milk. But that small amount of buprenorphine reduces any withdrawal experienced by newborns, and cushions their transition to life outside of the womb.

Every study out there recommends that pregnant women STAY on buprenorphine until delivery. After delivery, there is no reason to avoid breastfeeding if you take buprenorphine-- and it may have benefits. The baby has a tolerance that is less than yours, so there is no danger in breastfeeding.

Some hospitals keep babies for 5 days to determine whether they will have withdrawal. A much more humane way of doing things, in my opinion, would be to let babies go home with mom, and have mom keep in touch with her OB and the baby's pediatrician. If baby has trouble feeding, rehospitalization might be necessary. Understand, though, that babies born to mothers who are not on opioids, sometimes have problems with breastfeeding.

So yes-- nurse your baby. Try to let go of the guilt trip that people will try to put on you. You're getting help-- and you're doing the right thing. Good luck!


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PostPosted: Tue Jun 20, 2017 2:14 am 
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The response from our doctor tells you everything you really need to know, but I wanted to add that weaning is typically a very gradual process. As your baby starts gaining some of his nutrition from solid food, the amount of breast milk he takes in will gradually decrease. Many babies eventually drop to just a morning and evening feed when they pass a year. My educated guess is that even an abrupt weaning would not cause much distress to your baby, but most babies wean gradually.

Good luck to you and you are doing all the right things! Becoming educated about buprenorphine during pregnancy is smart. I hope that you will continue to keep us updated about your pregnancy and eventually, your delivery.

Amy

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PostPosted: Fri Jun 30, 2017 11:46 am 
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Hi there! I have a 4 month old baby girl and was on 6mg (up to 8mg if I am being totally honest) of suboxone a day at time of delivery. I was at 6mg when I got pregnant and my sub doc (who is my family practitioner as well) immediatly had me start weaning down to 2mg. So for most of the time i wss struggeling at 2-3mg a day until the last 2 months about when I got the 6mg. you can check out all my drama on the "31 weeks pregnant and mentally ill post". But basically, I was a wreck and the things going on around me were pretty shitty.i totally stressed about NAS big time. But my baby didn't get NAS,and if she did it was to little to know for sure. But knowing what things to do to make her feel better if she did haveNAS made me feel a bit better. If i can find time i will try to get you those links.

As for breastfeeding I read a theory that initially babies can absorb more of the bup because their tummies are not breaking things down all the way. But that slowly overtime they start breaking things down more and less bup will be absorbed. So it is like they naturally ween as they grow. That wss just a theory. But I haven't seen issues in my baby yet. And I no longer worry that I will. My girlfriend who has a 4 year old and was and still is on sub had no issues.
I wish you all the best and my advice is to not stress and if you do stress come talk it out here!


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PostPosted: Fri Jun 30, 2017 11:49 am 
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actually... that may not have been a theory... it may have been astudy. I cant remember. Mommy brain. Haha.
Btw.. your docs sound ptetty awesome not to be forcing you down!


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PostPosted: Thu Jul 13, 2017 12:21 pm 
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Pregnant and Lost, I remember your story and how worried and upset you were.

Can I just say that I am so thankful that everything worked out OK. I remember that you were afraid that you wouldn't feel the same love toward your baby girl that you did for your son. And you seemed very depressed and anxious. Are you feeling a lot better now? I really hope so! You seem lighthearted and upbeat, so I hope that is now your state of mind. I was so worried for you for a time!

I'm so proud of you for getting through such a difficult time. It must have taken so much for you to move forward! Can you give us a little update?

Amy

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