Subutex, also known as buprenorphine, is an opioid-based medication that is commonly prescribed for treating opioid dependence in people who are pregnant.
Taking Subutex while pregnant, however, does carry a risk of neonatal opioid withdrawal syndrome (NOWS), which can cause mild Subutex withdrawal in newborns following delivery.
If properly recognized and treated, symptoms of this condition can be safely and effectively managed.
How Do Babies Become Dependent On Subutex?
Babies born to mothers who take Subutex for opioid dependence may be exposed to Subutex that is ingested by a mother during pregnancy.
Although this can seem like a deterrent, it is possible and sometimes recommended to take Subutex while pregnant to avoid complications of maternal withdrawal or relapse.
What Happens If You Stop Taking Subutex While Pregnant?
Stopping Subutex too quickly or too early while pregnant carries a risk for relapse in people with a former opioid addiction. This could lead to serious and potentially fatal fetal outcomes.
Signs Of Subutex Withdrawal In Newborns
Subutex withdrawal can occur in newborns who are born to mothers who take Subutex for opioid dependence during pregnancy.
Signs and symptoms of Subutex withdrawal in newborns include:
- high-pitched crying
- abnormal sleep pattern
- tremors (shaking)
- not gaining weight
The duration of symptoms and their severity in newborns can vary. Once NOWS symptoms are recognized by a healthcare provider, symptoms can be safely and effectively treated.
Treatment For Subutex Withdrawal In Newborns
The U.S. Food & Drug Administration reports that NOWS is an expected and treatable outcome of chronic opioid use, which includes chronic use of buprenorphine.
Once diagnosed, NOWS can be effectively managed. Treatment may involve pharmacological and non-pharmacological interventions, such as breastfeeding, swaddling, and medical supervision.
Subutex And Effects On Newborns FAQs
It’s normal to have questions about the safety of taking Subutex during and after pregnancy. Here are answers to frequently asked questions about Subutex and its effects on newborns.
❓ What Causes Subutex Withdrawal Syndrome In Newborns?
✔️ Babies born to mothers who take Subutex can develop neonatal abstinence syndrome through exposure to Subuex in the womb. This can occur through regular and chronic use of the medication.
❓ Will My Baby Experience Subutex Withdrawal?
✔️ Not all babies born to mothers who take Subutex will necessarily develop withdrawal symptoms.
This will depend on a range of factors, including:
- duration of Subutex use
- history of substance use
- frequency of Subutex use
- overall maternal health and nutrition during pregnancy
❓ What Are Alternatives To Subutex During Pregnancy?
✔️ Subutex (buprenorphine) is one of two top choices for treating opioid addiction in pregnant patients, with the other medication of choice being methadone.
Methadone, or another buprenorphine product, can serve as alternatives to Subutex during pregnancy. Stopping treatment altogether is not generally recommended.
If you’re looking for an alternative to Subutex, consider talking to your healthcare provider about recommended alternatives.
❓ Can You Breastfeed While On Subutex?
✔️ Yes. Treatment with Subutex can continue while breastfeeding. Subutex can pass into breast milk, but little evidence has documented adverse reactions in breastfed babies.
Pregnant patients who breastfeed while taking Subutex may be advised to monitor their newborns for increased drowsiness or breathing issues.
❓ How Bad Is Subutex Withdrawal In Newborns?
✔️ Research shows that NOWS symptoms associated with buprenorphine treatment are generally milder than those that can occur with the use of full opioid agonists like heroin.
The severity of NOWS symptoms in newborns exposed to Subutex, however, may vary according to personal and environmental factors.
Factors that can affect NOWS severity include:
- early recognition of symptoms
- overall fetal health
- duration of maternal opioid use
- hospital protocols
- education of hospital staff
With treatment, symptoms can be effectively managed.
However, research also shows that babies with mild symptoms can recover even without treatment. Nonetheless, seeking treatment is encouraged.
❓ When Do NOWS Symptoms Begin?
✔️ Symptoms of neonatal opioid withdrawal syndrome can begin within 24 to 96 hours after birth.
❓ How Long Does Subutex Withdrawal In Newborns Last?
✔️ Symptoms of neonatal opioid withdrawal syndrome in babies exposed to Subutex may last up to five days. During this time, observation in a clinical setting may be recommended.
Find Subutex Treatment For Opioid Addiction During Pregnancy
Taking medication for opioid addiction while pregnant can be safe and effective with a proper level of support and a treatment team by your side.
If you’re looking for addiction treatment for yourself or a loved one who is pregnant, we may be able to help.
Call us today for more information about addiction treatment options for people who are pregnant, and to find a treatment program that’s right for you.
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- Centers for Disease Control and Prevention (CDC) — Treatment for Opioid Use Disorder Before, During, and After Pregnancy
- U.S. Food & Drug Administration (FDA) — FDA Advisory Committee: Neonatal Opioid Withdrawal Syndrome
- U.S. Food & Drug Administration (FDA) — Neonatal opioid withdrawal syndrome and medication-assisted treatment with methadone and buprenorphine
- U.S. Food & Drug Administration (FDA) — SUBUTEX (buprenorphine sublingual tablets)
- U.S. National Institute on Drug Abuse (NIDA) — Buprenorphine treatment in pregnancy: less distress to babies