Tuesday, 10 May 2011

Buprenorphine (Subutex & Suboxone) and Breastfeeding

Before we look into Burenorphine and breastfeeding, I should point out that Doctors recommend that you switch to Subutex (if you haven't already) during pregnany and lactation. 


Subutex is a relatively new solution to treating dependent mother's. As the drug companies are very keen to avoid future embarrassment (by that I mean law suits) any and all new medicines that they release is by default not recommended in pregnancy and breastfeeding. 



Therefore because Buprenorphine new it falls into this catagory and is still currently under a C-class rating (for more info about these ratings and medications in pregnancy and click here.)
If you were to Google Subutex and Breastfeeding you will find many reports and questions that had been posted in forums years ago and many of them follow the same line of thought:

"Subutex has been found in breast milk and you should be shot for considering it"

However...

We don't need other people's opinions however. Let's look at the up to date facts...

True - Subutex does leech it's way into breast milk 
True - Only tiny quantities find their way into breast milk
True - Breast milk contains many great properties that will help a sickly or under weight baby (like many NAS babies are).
True - Subutex appears to have an negative impact on the production of breast milk (and goats get cranky on Subutex! You can read the published report here.This report also mentions the quantities of Subutex found in breastmilk)
Let's take another brief look at the way Subutex works in your body before deciding whether or not to consider breastfeeding as an option.
Subutex is designed to taken sublingually (under the tongue). It is absorbed into the body through the blood vessels under the tongue. If it is swallowed, the digestive system breaks it down before it has a chance to be absorbed and enter the blood stream.
In theory (remember - there just hasn't been the studies yet), when a baby swallows breast milk that has been tainted with Subutex, it should be broken down in the gut before it enters the baby's bloodstream. Any amount that does reach the bloodstream should surely be tiny
Therefore, following this line of thought, many Doctor's are now giving their unofficial approval to breastfeed your baby. That's right -it's up to you to make an informed decision with your Doctor.


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