10 Comments

  1. micha

    I gave birth to a healthy 8lb 12oz baby boy 6 days ago I was on 4milligrams a day of subutex which i was switched to from suboxone after becoming pregnant on accident. The Dr. who was covering at the hospital for my normal Dr. came in the room and in front of my family started repremanding me telling me I just cant take any pills I want to when the nurse informed him I had taken Subutex, instead of looking at my records he just assumed I was a pill popping junkie who scored a pill from somewhere! After realizing HIS mistake and rush to judgement I spent 6 hours in hard labor with him minimizing my pain and refusing to give me anything for pain relief I guess to try to punish me, some of the nurses were no better offering their opinions on subutex. My baby sneezes a couple times a day and gets a rash under his chin and now they will not let me take him home, if he was in distress I would understand and now I do not know the future for my child and I feel helpless.

    • All three of my babies sneezed from time to time, and the rash, from drooling, is common too– and they had no opioid exposure. It is really too bad; studies show that about 20% of infants from bupe moms show signs of w/d when they aren’t labelled that way ahead of time. I had two patients deliver in the past two weeks, at two hospitals. One baby was held 7 days, and placed on a morphine infusion, and is now at home tapering off morphine. The other baby (at a hospital that, in my opinion, has much better care in general) was discharged on day 2 along with mom, and came to my appointment on day 3. He slept through the appoinment, as normal babies of his age do— although it would have been just as normal if he screamed the entire time.
      The problem is ‘selection bias’– the common phenomenon that makes people see things once they start looking for them. Doctors used to at least have some exposure to science– including knowing how to detect bias, and knowing why we ‘blind’ studies. But now, all it takes i one idiot in the care chain to freak out, and suddenly every member of the care team wants to show influence by exerting control over the baby’s care.

  2. Amanda8711

    I have a question so I am 8 months pregnant and i was a herione addict, when i found out i was pregnant actually the day i found out i stopped using and started on suboxone i didnt have a doc so i took my boyfriends till i got my own doctor, i take 2 mg a day, my question is or worries for that matter are is my baby going to withdrawl really bad I feel like the worst person in the world when i think about it. And I wonder will I be able to bring her home from the hospital with me or is she going to have to stay, I cant even sleep when i think about this…I dont know anyone who would be able to give me advice so will somebody please….

    • Your baby is better off with you taking Suboxone than heroin– but it would be better if you had your own doctor, because taking your BF’s meds could cause him to get kicked out of treatment. I can’t predict what social service does, but you will be at risk if someone visits your home and finds needles and paraphernalia. If you have a doctor, and you are on Suboxone, I wouldn’t expect any problems along that line– assuming you are keeping a home that is safe for a baby in other ways.

  3. Wayne

    I was told by my doctor that our newborn was addicted to buprenorphine and they told me he will experience seizures and organ failure if he does not get treatment is this true?

    • No. Of course nobody should ever say ‘it could NEVER happen’, because there are always very bizarre things that happen in the field of medicine that can’t be explained. But I’ll provide some information to guide your decisions….
      First, understand that when babies are involved, medicine always goes to the most extreme, safe position (unless the baby is unwanted, in which case the field of medicine has no problems with ending pregnancies by the most barbaric means possible… but that’s another discussion). In the cases of ‘desired pregnancies’, doctors will go to great lengths to make sure that money is spent on every possible test. Part of that is because babies are deemed ‘innocent’ of the actions of their parents, and not treated with the same disdain as how hospitals and doctors treat grown-ups suffering with addictions. And part of it is because when a baby is harmed, lawsuits are based on an entire lifetime of earning potential, i.e. the numbers go to the sky. I hope I don’t sound cynical, by the way.
      For example, many states do not allow the use of plain buprenorphine in any condition…. except pregnancy. There is no known harm to the fetus caused by naloxone, but the people who make the rules still insist that babies shouldn’t have to risk even trace exposure to naloxone. They say that ‘since the naloxone doesn’t do anything, why expose a baby to it?’ Of course I always say, ‘since naloxone doesn’t do anything, why do we expose ANYONE to it?’ But apparently babies deserve much, much mroe protection from innocuous substances than grown people, so the rules persist.
      My point is that the doctors will err on the safe side with babies. But understand that seizures and organ system failure are NOT typical consequences of opioid withdrawal. Firstly, many studies have shown that only about half of babies born to moms on buprenorphine have ANY withdrawal symptoms. When withdrawal does occur, it tends to be much more mild than withdrawal from agonists like heroin or oxycodone. So your baby may not have any withdrawal at all, and if he/she does, it will be mild.
      As an aside, no baby is born ‘addicted’ to buprenorphine. The baby may by physically dependent on opioids, a totally different concept. A doctor who uses the word ‘addiction’ in regard to a newborn is at best insensitive, and at worst, ignorant or mean, trying to take a good ‘dig’ into you for being such a horrible, drug-addicted person.
      If your baby has symptoms of NAS or neonatal abstinence syndrome (the proper term), you’ll see some tremor, more crying, increased tone, and possibly problems nursing (one of my kids had problems nursing, and he was NOT opioid-dependent– so the relationship is not 100%). In most cases, the symptoms pass on themselves. They take a few days to start, so treating the symptoms is never an emergency. The issue comes down to whether the baby is taking in enough hydration, judged by having a wet diaper every few hours. If not, then the baby should receive treatment. But ‘multi-organ system failure’ will only be an issue after several days of severe dehydration, when the kidneys would start to fail. A few days later you would see problems with other organ systems.
      The safest thing, of course, is to do what the doctor says. That would allow you to sue the doctor if anything goes wrong, whereas if you go on your own, everything is ‘on you’. Since we’re talking about a baby, I err on the side of caution. See? I even do it too!!

  4. shawn

    My son’s girlfriend was taking suboxone, purchased on the street, while pregnant with my grandson. She felt he was having withdrawls and, rather than take him to the doctor and be honest, she put the drug in his bottle. I found this out the night that he died. The medical examiner ruled his death as SIDS but I can’t help but think that he died as a result of her ignorant and selfish actions. She is pregnant once again and continues to take suboxone and benzos, have also been told she is taking oxycodone, but that is not something that i am certain of. I simply cannot go through another devastation like this. I have read so many different things about affects on unborn babies and newborns. please educate me. From what I have read, you seem to know a great deal on the matter.
    thank you

    • Horrible- I’m very sorry. Would you like me to reply privately to the email you used to register to post?
      A newborn to a mom using heroin or a high dose of methadone will have a high opioid tolerance, which increases the risk of withdrawal but also adds some protection from overdose. But it is possible that your grandson was exposed to a very small fraction of buprenorphine in the uterus– to low to develop tolerance. Buprenorphine rarely causes death because people taking it are protected by the ceiling effect and by tolerance. But a newborn doesn’t have the same protection by the ceiling effect of the drug, and in your grandson’s case may not have had tolerance. Adding buprenorphine in that situation would be like adding any other opioid, including heroin or oxycodone.
      I would recommend you speak with child protective services so that they can protect the baby. It is NEVER safe to add narcotic to formula, except by people who understand all of the pharmacology involved– and in those cases, generally only in monitored settings at least until the proper dosages are established.

  5. Courtney G

    I just came across your site, searching for answers on NAS babies. I am a foster mom who got a call this morning about a 3 day old baby whose mother was using heroin the first 2-3 months of the pregnancy. I’m told She has been incarcerated the past 6 months and on suboxone. The baby was supposedly free from withdrawal symptoms and would be ready to go home tomorrow. But later today I got a call that the she had started showing severe withdrawal symptoms and would need to be put on methodone and gradually weaned off of that. My questions are – why would it take 3 days for her to start showing withdrawal symptoms, and what kind of symptoms can I expect her to have when she is ‘weaned’ off the methodone? I have zero experience with this and feel lost.

    • I’m going to send an email to you about your post, but I don’t know why it took 3 days. The delay is common in babies to moms on buprenorphine because the blood level has to drop below a certain threshold for symptoms to develop. But the drop in opioid tone is immediate in newborns of moms on methadone, causing withdrawal to occur shortly after birth. I can imagine a couple situations that may cause such an effect… patients on methadone-assisted treatment have peak blood levels of methadone (4-6 hours after dosing) that are 1 – 8 times higher than ‘trough’ blood levels (taken just before dosing). I don’t know if those differences are the same in the baby’s blood, but if so, maybe the birth was closer to dosing, and higher peak levels of methadone (combined with an immature liver) delayed the onset of withdrawal. Or a better thought is that methadone withdrawal is much milder than withdrawal from heroin or oxycodone, and the baby’s symptoms were ‘subclinical’ for the first couple days.
      As for symptoms, you should expect looser stools and irritability when the dose is decreased. If the dose is too high, you will see more sleeping and constipation. Appetite will go down in either case, if the dose is too high or too low.
      This is from a presentation at an FDA advisory panel about neonatal abstinence syndrome, and it has a lot of great information: https://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/RiskCommunicationAdvisoryCommittee/UCM452607.pdf or HERE

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