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breastfeeding and suboxone/ subutex

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  • #16
    Hello, I'm writing as a concerned Aunt. My sister was on subutex while she was pregnant, about 2-3 8mg a day (a lot I know) and she immediately breast fed him once he was born. He didn't really show signs of withdrawals so he went home after 3 days. She continued to only breast feed him until he was around 3 months old then she started incorporating formula as well then eventually around 4 months went to only nursing at night. He is now almost 1 1/2 and she still breast feeds only at night, but not every night. Some nights he stays with his dad for a few nights so she obviously can't nurse him. She still takes 2-3 8mgs or more a day and I have noticed that my nephew is always sick. It's like the poor kid has been hit with a cold every month, pneumonia, high fevers, asthma, croup, you name it. I have asked her if it could be withdrawals since she takes such a high dose then stops for days and goes back but she says no. Maybe I'm wrong, or just worried, but can someone please tell me what could be wrong with my baby nephew? I was on subutex with my daughter, and she was in the hospital for 19 days after, I beast fed for a year and stopped and my daughter was/is perfectly fine. I was/am only on a low dose of 4mg a day tho.

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    • #17
      Jsv1986,

      We are sorry to hear your nephew is sick all the time. It is unlikely the subutex he is exposed to is responsible. Symptoms of withdrawal would present more like agitation, fussiness, tremors, vomiting, or drowsiness. If a child has asthma they are more prone to respiratory infections such as pneumonia and croup. We recommend trying to avoid triggers for his asthma such as pets, dust, cigarette smoke etc.
      You may want to consult with the pediatrician to see what they would recommend as far as follow ups.

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

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      • #18
        Hi. Im currently breastfeeding as well. And im on subutex 8 mg 3x daily. I was wondering if that goes in my sons system. Like if i did a drug test it would be in my urine .. is it the same for him ?

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        • #19
          xOxDDxOx,

          Subutex (buprenorphine) is rated an L2-limited data-probably compatible. The amount that transfers into breast milk is 0.09-1.9% of your dose. Based on the limited studies available there is no evidence that this medication will have any adverse effects on your infant, however we suggest monitoring your infant for sedation, slowed breathing rate/apnea, pallor, constipation, not waking to feed/poor feeding and make sure they are gaining weight appropriately.

          Depending on the type of assay they use, they may be able to detect the buprenorphine in your urine. If the test is able to detect the buprenorphine in your urine it will probably be detected in the infants urine as well.

          refer to this website: [url]https://www.naabt.org/faq_answers.cfm?ID=78[/url]


          Sandra Lovato R.N.
          InfantRisk Center
          806-352-2519
          Last edited by admin; 02-17-2017, 02:34 PM.

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          • #20
            My sister is still breastfeeding her 11 month old while doing 4mg of Dilaudid everyday. She's not prescribed. She also used while pregnant. DCF has been called they don't nothing... Anyway I've seen her take 2mg of Subutex then do 4mg Dilaudid 10 hours later and breastfeed... How long does the Subutex stay in breast milk and can the two drugs mix together in the milk...
            Concerned friend 😔

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            • #21
              lalacrim:

              I too would be concerned. Subutex half-life varies by route of administration. 2-3 h IV; 37 h sublingual; 26 h transdermal. And yes, both drugs will enter the milk.
              She is risking severe breathing problems in the infant and potentially sudden infant death from respiratory arrest.
              She really needs to withdraw cautiously and withdraw the infant from the breast as well.

              The infant has without doubt developed a dependence on these powerful opiates, and it should be carefully weaned from the breast if mom is going to continue these drugs. At 11 months, most benefit from breastfeeding has been transferred to the infant. The risk of opiate toxicity is now greater than the benefit of breastfeeding.

              I strongly suggest this mom carefully wean the baby and go to formula.

              Tom Hale Ph.D.
              InfantRisk Center





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              • #22
                So Subutex is safer to take than opiates

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                • #23
                  I mean if she takes the Subutex to wean

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                  • #24
                    Lalacrim:

                    Yes, subutex is safer than the random use of opiates. Mixing is dangerous. She needs to seek help for this withdrawal.

                    Tom Hale Ph.D.

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                    • #25
                      I'm taking subutex 8ml a day my daughter is 2months and has tubroscrlosis. She is on 4 different medications levetiracetam, levocarnitine, trileptal, and valpronic is it okay to breastfeed. Her nutritionist doesn't think it's a problem but I would rather be safe and make sure it's not going to effect her other medicines?

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                      • #26
                        I'm taking subutex 8ml a day my daughter is 2months and has tubroscrlosis. She is on 4 different medications levetiracetam, levocarnitine, trileptal, and valpronic is it okay to breastfeed. Her nutritionist doesn't think it's a problem but I would rather be safe and make sure it's not going to effect her other medicines?

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                        • #27
                          Roxanne,

                          Subutex is rated an L2-limited data-probably compatible. The amount that transfers into breast milk is only 0.09-1.9% of your dose. We think it is ok to breastfeed on this medication as long as your infant is not symptomatic. Monitor your infant for sedation, slowed breathing rate/apnea, pallor, constipation and not waking to feed/poor feeding.

                          According to the Micromedix database there are no drug to drug interactions with your Subutex and your infants medications.

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


                          ​​​​​​​

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                          • #28
                            Hi there. I currently take 0.7 ml (7 mg) methadone. (Methadose technically). I am breastfeeding my 16 month old. He has some swallowing issues so he doesn't eat solids, he only breastfeeds. I have been struggling emotionally and my doctor told me to switch to suboxone. He sent me home with 2 mg daily dose to start with. I have not made the switch as of yet...and i am concerned that taking the suboxone will put my baby into withdrawal. Won't the naloxone in the suboxone kick the opiates out of his system as well as mine?

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                            • #29
                              BCmomma:

                              No, the narcotic antagonist in Suboxone is naloxone. it is NOT orally absorbed, so your infant would not absorb any of it.

                              Tom Hale Ph.D.

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