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  • Writer's pictureDr. Harold Pierre

Can I Breastfeed While Taking Suboxone?

Updated: Jan 11

Can I Breastfeed While Taking Buprenorphine?

According to evidence-based medicine, breastfeeding while taking buprenorphine is fine. This is a conversation you must have with your addiction medicine provider, your obstetrician, and your baby's neonatologist. However, be prepared for challenges. Holmes et al (2017) stated that, "Perhaps the greatest barrier to breastfeeding for women with opioid dependence is the inaccurate and inconsistent information they receive from different sources, including health care professionals." In this article, I will present a comprehensive guide for mothers and provide the information they need to discuss with their baby's physician.

Young woman breastfeeding her baby in nursery

Is it safe to breastfeed while taking Suboxone (Buprenorphine/Naloxone)?

Recovering from opioid addiction while caring for a newborn is challenging. If you’re taking Suboxone or buprenorphine, you may worry whether it’s safe to breastfeed. The main concern about using Suboxone while breastfeeding is that small amounts of the drug may pass into breastmilk. However, numerous studies have found that buprenorphine (the active ingredient in Suboxone) is excreted into breastmilk in extremely low concentrations, even when mothers are taking high doses of the medication.

Both buprenorphine and naloxone have poor oral bioavailability, meaning very little of the amount ingested is actually absorbed into the baby's system. Research shows buprenorphine causes no adverse effects on growth, development, or health outcomes for breastfed infants. No negative impacts on factors like IQ, cognition, or brain development have been demonstrated.

The medical consensus is that buprenorphine is one of the safest choices for mothers undergoing medication-assisted treatment for an opioid use disorder. Knowlegeble healthcare providers overwhelmingly agree that the benefits of breastfeeding substantially outweigh any potential risks from minimal buprenorphine exposure through milk.

Buprenorphine enables mothers to effectively manage opioid addiction while providing optimal nutrition to their babies through nursing. With proper medical guidance, breastfeeding while taking Suboxone is considered safe and is strongly encouraged.

Why Breastfeeding a Baby with Neonatal Abstinence Syndrome is Important?

For infants born with neonatal abstinence syndrome (NAS), breastfeeding provides significant benefits and is strongly recommended by pediatricians and healthcare organizations.

Research indicates that breastfed infants with NAS experience less severe withdrawal symptoms compared to formula-fed babies. Human milk helps stabilize babies going through opioid withdrawal and enables them to pass through this difficult period with fewer complications.

The skin-to-skin contact and comfort from nursing helps soothe NAS babies during a distressing and uncertain time. The bonding and security of breastfeeding enables babies to get through withdrawal with less medication and shorter hospital stays.

Breastfeeding an infant with NAS provides the optimal nutrition and hydration to help them withdraw safely. Nursing is also shown to support better bonding between mothers and babies with NAS, which has lifelong mental health benefits.

Is Buprenorphine Safe for Breastfeeding Mothers?

There are numerous reasons why breastfeeding is highly encouraged for mothers undergoing medication-assisted treatment for opioid addiction:

  • Breastfeeding promotes critical bonding between mother and child. This has profound emotional benefits, especially for mothers overcoming substance use disorders.

  • Nursing helps suppress fertility and delays the return of menstrual cycles after birth. This can prevent unplanned pregnancies which could derail addiction recovery.

  • Breastfeeding releases oxytocin and other calming hormones that lower stress and anxiety. This helps stabilize moods and may prevent potential relapse triggers.

  • Staying close to their baby motivates mothers to adhere closely to treatment plans in the vulnerable postpartum period. This keeps new mothers engaged in the recovery process.

  • The routine of breastfeeding provides mothers with a sense of purpose during the significant life transition into parenthood and sobriety.

Ultimately, breastfeeding supports better recovery outcomes for mothers battling addiction. Healthcare providers unanimously agree that mothers using Suboxone or buprenorphine for opioid disorders should be encouraged and supported in breastfeeding, barring any contraindications.

What are the Potential Risks of Breastfeeding While on Buprenorphine?

While considered safe in most cases, there are some potential risks to weigh when making the personal decision to breastfeed while taking Suboxone or buprenorphine:

  • Stopping Suboxone in order to breastfeed may lead some mothers to relapse into opioid misuse. This can result in impaired functioning and difficulty caring for an infant. Discontinuing medication-assisted treatment is not recommended.

  • In rare cases, some babies may still exhibit mild NAS symptoms even when mothers adhere to Suboxone treatment. Doctors can provide supportive therapies to help infants through withdrawal in a healthy manner.

  • Suboxone can cause drowsiness in some users. Mothers should take precautions to ensure they are alert and positioned safely when breastfeeding.

  • Using other substances like alcohol or illicit drugs while breastfeeding can still expose babies to risk. Ongoing support treatments and recovery services help minimize these dangers.

  • Certain physical complications or other individual factors may require cessation of breastfeeding. Doctors can help determine medical compatibility.

While real, these risks can often be appropriately managed under medical supervision. The well-documented developmental, nutritional, and bonding benefits of breastfeeding will outweigh the low risks of medication exposure for most patients.

Common Tips for Safely Breastfeeding While Taking Suboxone

Mothers who plan to breastfeed while undergoing treatment with Suboxone should follow these tips to minimize any risks:

  • Discuss buprenorphine and breastfeeding with your addiction medicine specialist, pediatrician and obstetrician to make sure these tips apply to you.

  • Maintain open, honest communication with your obstetrician, pediatrician, addiction specialist, and all members of your care team. Never hesitate to ask questions or report concerns.

  • Take Suboxone at the prescribed dosage and follow administration instructions carefully. Do not double doses or skip days prior to breastfeeding.

  • Watch for excessive drowsiness and take proper precautions when holding or feeding your baby.

  • If you feel too drowsy, pump breastmilk that can be fed to the baby by a caretaker until the effects wear off. Never breastfeed when overly sedated.

  • Proactively participate in therapy, counseling groups, support meetings, and other treatments to manage your recovery and prevent relapse.

  • Follow nutritional guidelines, drink plenty of fluids, and get adequate rest to optimize breast milk production. Ask loved ones to assist with household tasks.

  • Keep a detailed log of your baby's feeding times, diaper changes, sleep patterns, and potential NAS symptoms to share with your pediatrician.

  • Consider meeting with a lactation consultant to get personalized guidance on making breastfeeding easy and successful.

Breastfeeding During Addiction Treatment is Possible

Mom breastfeeding her newborn baby boy on a hospital bed (1)

Overcoming opioid addiction during pregnancy and new motherhood is an immense challenge. But with comprehensive treatment and support services, breastfeeding while taking Suboxone is absolutely achievable.

The first step is seeking care from obstetricians and pediatricians extensively experienced in treating pregnant or postpartum women with substance use disorders. Work closely with your healthcare team to create a recovery plan tailored to your situation, including medication-assisted treatment and addiction counseling.

While difficult, with dedication and proper medical guidance, mothers can safely breastfeed while taking Suboxone. This provides the well-documented benefits of nursing to both mother and child during a critical period of development and recovery.

Key Takeaways

  • Pregnant women should continue taking Suboxone or buprenorphine under the guidance from doctors.

  • Breastfeeding while on Suboxone is safe with guidance from doctors.

  • Very little buprenorphine enters breast milk causing no harm to breastfed babies.

  • Moms who use Suboxone should keep taking it to avoid relapse.

  • Breastfeeding gives important benefits to moms in addiction treatment.

  • Nursing lowers stress hormones and postpartum depression risks.

  • Close contact with baby motivates moms to keep up treatment.

  • Moms should be honest with doctors about all substance use.

  • Join support groups and therapy to aid your addiction recovery.

Holmes, A. P., Schmidlin, H. N., & Kurzum, E. N. (2017). Breastfeeding Considerations for Mothers of Infants with Neonatal Abstinence Syndrome. Pharmacotherapy, 37(7), 861-869.

Reece-Stremtan, S., & Marinelli, K. A. (2015). ABM Clinical Protocol #21: Guidelines for Breastfeeding and Substance Use or Substance Use Disorder, Revised 2015. Breastfeeding Medicine, 10(3), 135-141.

Pritham, U. A. (2013). Breastfeeding Promotion for Management of Neonatal Abstinence Syndrome. Journal of Obstetric, Gynecologic & Neonatal Nursing, 42, 517-526.

About the author:

Dr. Harold Pierre is a board-certified anesthesiologist and addiction medicine specialist with over 20 years of experience. He is board-certified by the American Board of Anesthesiology and the American Board of Preventive Medicine.

This website is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician or another qualified medical professional. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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