Announcement

Collapse
No announcement yet.

breastfeeding and suboxone/ subutex

Collapse
X
  • Filter
  • Time
  • Show
Clear All
new posts

  • breastfeeding and suboxone/ subutex

    I was prescribed subutex during my pregnancy and after due to insurance was switched to suboxone. I have started smelling the suboxone in my breast milk plus baby has become more fussy when it comes time to feeding plus through out day. I see my doctor Friday I want to ask to be switched back to subutex which I am willing to pay for since insurance won't cover because I am not pregnant. Can any one tell me about suboxone in breast milk or subutex in breast milk. It irritates me that I have been switched to a drug not safe during pregnancy because I entirely breast feed my baby and I personally feel if its not safe for pregnancy then it is not safe for breast feeding. Any help would be appreciated ~ ~Barbara jean

  • #2
    Dear misfitmama,

    The generic name of Subutex is buprenorphine. Buprenorphine is a long acting narcotic agonist and antagonist used to treat opiate dependence. The amount of buprenorphine that enters breastmilk is very small 0.09 percent to 1.9 percent of your dose. The typical adult dose is 2 to 8 mg by mouth every 6 hours as needed. The time the medication is highest in your milk is 15 to 30 minutes after your dose so you should breastfeed first then take your dose to avoid breastfeeding at the time the drug is most concentrated in your breastmilk. When this medication is used during pregnancy, the baby becomes dependent so any changes in the usual dose may lead to symptoms of withdrawal which are irritability, sleep disturbance, and tremors. Suboxone is a combination of buprenorphine and naloxone. The usual adult dose is 16 mg of buprenorphine in combination with 4 mg of naloxone daily for maintenance therapy. The naloxone may limit some of the effects of the buprenorphine in the baby's system; therefore, triggering symptoms of withdrawal. Suboxone is compatible with breastfeeding, but because your infant is having symptoms, he/she may need either a different medication or other therapy. You should talk with your pediatrician about treatment options to help the baby with his/her symptoms. You may also want to talk with your physician to find the best treatment for your condition also. Hope this information helps. Let me know if you have further questions.

    Sincerely,
    Cindy Pride, MSN, CPNP
    TTUHSC InfantRisk Center

    Comment


    • #3
      Hello I just wanted to ask a question of my own, I am planing on starting a maintenance plan with Suboxone. My son is 18 months and only nurses at night. Would this most likely be alright if I took my does in the morning and nurses again at night? Thnks!

      Comment


      • #4
        Mwiggs1988:

        I think with an infant of 18 months, this product would probably be relatively safe. Just observe for sedation, or difficulty to awaken in the infant. I doubt you will notice anything.

        Tom Hale Ph.D.

        Comment


        • #5
          scared and worried

          Hello, my. daughter is 7 weeks old, throughout my pregnancy I had taken buprenorphine. at the beginning of my pregnancy I had taken 2 to 4 milligrams of buprenorphine but towards the end was at .5 milligrams. my daughter did not need to stay extra days after birth although they did monitor her for withdrawal symptoms but they said it was very slight. I breastfed her.. or at least try to but my milk still hasn't come all the way in ( maybe a good thing) but I got weak and started taking a higher dose of bup up to 1 mg to 1.5 mg a day. When my daughter feeds she usually gets 1 oz to 1.5 oz (sometimes less) of breast milk 6x a day along with each feeding she also gets 4oz of formula, sometimes just the formula. I've been noticing her hand has been shaky but some say thats normal and she doesn't really seen irritable... maybe I can't tell but do you think she has been getting enough buprenorphine to show signs of withdrawal? should I stop breastfeeding her, or what specifically should I look for as signs of withdrawl? I'm planning to dose down again to .5-mg then take 1 every other day then hopefully lead up to taking every 3to 4 days then eventually stopping. what would you suggest?

          Comment


          • #6
            Hi, thanks for your post.

            As mentioned previously, an average infant gets 0.09-1.9% of the mother's buprenorphine dose in the breastmilk. However, that assumes that the infant is exclusively breastfeeding (about 2.5oz/lb/day). It's likely to be quite a bit less in your case. Only about a third of the burenorphine that the baby ingests will make it into the bloodstream to have any effect (that's the oral bioavailbility). You can see that your baby is getting very, very little of this medicine in total. The original studies of this drug in breastfeeding were on women taking the full 4mg/day and they did not have any symptoms of sedation or withdrawal in their babies.

            It is normal for babies to have shaky limbs - their motor pathways are not fully developed yet.

            Please call us at the InfantRisk Center if this has not completely answered your question.*(806)352-2519

            -James Abbey, MD

            Comment


            • #7
              needing a good medical opinion

              OK I've been doing research on breast feeding while on subutex/suboxone ever since I got pregnant t with my second child because I wanted to breastfeed my second just as I did my first, it was a great experience. A month after I gave birth my Dr switched me right back to suboxone strips and never even asked after or before birth if I planned to breast feed. I've noticed that even after 9months he is still sleeping more and longer, he still clinches when I try to put clothes on him and he's fussy alot for no reason, I'm transitioking him from breast milk to formula, but I want to know if these are withdrawal symptoms from the naloxone and if I should be changed back to subutex just until he's fully transitioned to formula?

              Comment


              • #8
                Hi, thanks for your post.

                The amount of buprenorphine in your breastmilk is so low that I really doubt that your baby's behavior is due to withdrawal. You should investigate other possibilities for his fussiness.

                Even if it were a reaction to the drug, the right treatment would be to slowly transition him to formula, just as you are doing. Opiate withdrawal is unpleasant but not dangerous.

                Please call us at the InfantRisk Center if this has not completely answered your question.*(806)352-2519

                -James Abbey, MD

                Comment


                • #9
                  I'm breastfeeding a 5 wk infant. My dose is 16mg of buprenorphine twice a day. If the infant is exposed through breastmilk, when would symptoms be most noticeable? What are the most common symptoms? If considering breastmilk transfer and oral bioavailability then infant dosage is
                  Last edited by dommom; 12-28-2015, 09:54 PM.

                  Comment


                  • #10
                    Dommom,

                    Buprenorphine is rated an L2-limited data-probably compatible. The amount transferred into breast milk is .09-1.9% of your dose. The peak time for sublingual use is 15-30 minutes, with a half-life of 37 hours. Try to breastfeed first then take the medication immediately following breastfeeding to avoid the peak time. This medication has a long half-life so you will have what they call a steady state where you will not have the high peaks and valleys but just a steady level in your system. If you took this medication in pregnancy the infant is exposed to much more in utero than through the breast milk. The side effects to watch for are s[COLOR=#333333][FONT=lucida grande]edation, slowed breathing rate/apnea, pallor, constipation and not waking to feed/poor feeding.

                    I hope this helps.

                    Sandra Lovato R.N.
                    InfantRisk Center
                    806-352-2519[/FONT][/COLOR]

                    ?

                    Comment


                    • #11
                      Will my baby experience withdrawals once he stops breastfeeding? If so, is there anything I can do to ease withdrawals? I've been thinking about trying to taper of my doses to quit and have discussed this with my doctor, any thoughts on this? My baby is now 9 weeks.

                      Comment


                      • #12
                        Dommom,

                        As long as you either wean off the medication, or wean your infant from feeding and do so slowly the infant should not have withdrawal, just do not stop abruptly.

                        Sandra Lovato R.N.
                        InfantRisk Center
                        806-352-2519

                        Comment


                        • #13
                          Hi! I would like to start off saying that I was pregnant in 2010 taking 8mg of subutex daily delivered December 22. She had no withdrawal symptoms. I breastfed for 4 months she did not show any signs of withdrawal. I got pregnant again in July of 2014. I was taking about 16mg daily. I started taking more towards the end of my pregnancy, more like 24mg. I delivered successfully on March 17, 2015. She also showed no signs of withdrawal. I have breastfed the whole time. She is 1 years old. It is now time to start weaning off breast milk. I am currently taking 16mg daily. I am worried since it's twice the amount I was taking with my baby in 2010. Do you think she will go through withdrawal?
                          Last edited by lizziebell217; 04-04-2016, 06:40 PM. Reason: forget the name of the medication

                          Comment


                          • #14
                            I've got quick question, I've been on 2-3mg of subutex my whole pregnancy. My plan was stop when I found out I was pregnant but, doctor advised against it. I have birth to healthy baby girl was in hospital for a couple days than was sent home with everything being fine. At the time there was no symptoms in my newborn. Now since I've been home I've noticed my baby girl shakes in her sleep and has diarrhea. She only shakes when she's in a deep sleep. Are these withdrawl symptoms? We seen pediatrician today he said diarrhea is normal Her lungs sound good & her heart is strong. I'm literally freaking out. This is a nightmare. Please help?

                            Comment


                            • #15
                              Fab26:

                              It's not our place to contradict your pediatrician, but this does sound like subtle signs of withdrawal. These will pass so don't worry.

                              Tom Hale Ph.dl


                              Comment

                              Working...
                              X