Brief Answer:
very less possibility of withdrawal in baby

Detailed Answer:
Hello,

Thanks for writing to us.

I can understand your concern for your granddaughter.

2 mg dose of suboxone is not high dose.

Some case reports are there showing no withdrawal in neonate after birth at such dose.

At this dose effect of suboxone on growth of fetus is very less.

However data suggests that suboxone is category C drug in pregnancy. So better to continue regular follow up with gynecologist and ultrasound check up.

Generally most of the gynecologists do not prefer to stop suboxone if it is alreay continued since long and female becomes pregnant considering risk of miscarriage.

For better outcome she should be shifted to buprenorphine without naloxone.As naloxone is more harmful to fetus.I think mostly suboxone contains buprenorphine as well as naloxone.
Alternative is methdone also instead of suboxone as it is overall less harmful then suboxone.

Neonatal withdrawal generally seen between 1st to 8th day of birth. She and doctor should be watchful for the same after birth though less possibility of withdrawal.

CPS- Child protection service will be involved or not that depends on local laws. If she has valid prescription of suboxone I think no CPS.

I have tried my best to answer your query. Still I would like to mention that Best information regarding your doubts can be provided by her treating gynecologist as doctor can guide according to past history, physical examination and local laws.

Hope I have answered your query, I will be happy to help further.

Regards,
Dr.Chintan Solanki.

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