Subutex Withdrawal In Newborns

Subutex, which contains the medication buprenorphine, is often prescribed to pregnant women who are dependent on opioids. Doctors recommend this treatment because it’s much safer for both mother and baby than continuing to use heroin or misuse prescription painkillers during pregnancy. Subutex helps pregnant women stay stable, attend prenatal appointments, and avoid the dangerous cycle of withdrawal and drug use that can harm a developing baby. For many women, taking Subutex during pregnancy is a path toward a healthy delivery and gives their baby the best chance at a good start in life.

However, babies born to mothers who took Subutex or other opioid medications during pregnancy may experience neonatal opioid withdrawal syndrome, or NOWS. This happens because the baby’s body became dependent on the medication while in the womb, and after birth, they go through withdrawal as the drug leaves their system. While this can sound frightening to expectant parents, it’s important to know that NOWS is expected, manageable, and treatable. Medical teams know how to recognize the signs of withdrawal in newborns and have effective treatments to keep babies safe.

How Do Babies Become Dependent On Subutex?

When a pregnant woman takes Subutex, the medication passes through the placenta and reaches the baby in the womb. This means the developing baby is exposed to buprenorphine throughout the pregnancy, and their body adapts to having the medication present. While this might sound harmful, doctors actually recommend that women continue taking Subutex during pregnancy rather than stopping or trying to detox. Quitting Subutex suddenly can cause severe withdrawal symptoms in the mother, which creates serious risks for the baby, including preterm labor, miscarriage, or fetal distress.

Stopping medication increases the risk that a mother will relapse and return to using more dangerous opioids like heroin or fentanyl, which pose far greater threats to the baby’s health than controlled Subutex treatment does.

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.

Learn more about the effects, risks, and benefits of taking Subutex while pregnant

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
• irritability
• abnormal sleep pattern
• tremors (shaking)
• vomiting
• diarrhea
• 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

According to the U.S. Food and Drug Administration, neonatal opioid withdrawal syndrome is a predictable condition that medical teams are well-prepared to handle. When a baby is born to a mother who took Subutex or other opioids during pregnancy, healthcare providers closely monitor the infant for signs of withdrawal, which typically appear within the first few days after birth. Once NOWS is identified, doctors and nurses can begin treatment right away. The good news is that with proper medical care, babies can get through withdrawal safely and comfortably, and the condition doesn’t cause long-term developmental problems when managed correctly.

Treatment for NOWS usually combines both medical interventions and comfort measures designed to soothe the baby. Non-medication approaches are always tried first and include skin-to-skin contact, breastfeeding (when safe and appropriate), swaddling the baby snugly, keeping the room quiet and dimly lit, and feeding small amounts frequently. These techniques can reduce withdrawal symptoms for many babies. If symptoms are more severe, doctors may prescribe medications like morphine or methadone in small, controlled doses to help the baby gradually wean off opioid dependence.

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 Subutex 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.

Written by the Addiction Resource Editorial Staff