For Pregnant Mamas on MAT

This may be one of the most important posts my pregnant mamas will read. I just want to remind y’all of my Disclaimer. I am not a doctor, nor do I claim to be. Everything I am about to tell you, is all information I have gained from my own personal experiences, as well as doing my own research.

I am now going to be giving you tips and tricks for after you deliver your baby.

As soon as we get that positive pregnancy test, most of us start wanting to do the BEST things we can do for our baby. Most women automatically think the best thing to do, is start tapering from their medication (whether it is suboxone, subutex, or methadone). But, maintenance medications are very unique. Tapering is not recommended. While you may be feeling okay during your taper, your baby can actually be going through brutal withdrawal in utero. I have known SOOO many women that have miscarried in the first trimester because they tapered.

Staying on a stable, comfortable dose is the MOST important thing you can do. This means, taking enough medication to make you feel comfortable. Don’t concentrate on the amount you are taking. Just take what makes you feel comfortable and out of withdrawal. There is a common misconception floating around the MAT community that ALL pregnant women MUST increase their dose at some time during their pregnancy. This is false. Not ALL women need to increase. Every pregnancy , every woman is different. During my first pregnancy, I felt amazing. I often took less than what I was prescribed, because I didn’t need more. I never needed to increase. The increased blood volume during pregnancy does make some women feel they need to increase. If you feel like you need to increase, do not be afraid to speak up to your doctor. But, also know that not everyone always needs to. Taking too much medication can be just as bad as taking too little.

After baby is born, delay cord clamp. This means that you do not cut the umbilical cord until it has stopped pulsating. Babies lose over 1/3 of their blood after they are born via the umbilical cord. Delay cord clamping ensures that they get all of this blood pumped back into them. Once again, it is okay to cut the cord after it has stopped pulsating. Tell your OB you would like to delay cord clamp, most are perfectly fine with that.

Skin to skin. This is probably one of the most important things you can do after your baby is born. Stripping baby down naked, and laying them on your bare chest is extremely beneficial. It helps baby regulate their body temperature and is also extremely comforting to them.

Breastfeed. Your breastmilk is literally made around your baby’s specific needs. Breastmilk is euphoric to them. Have you ever seen a nursing baby’s eyes roll into the back of their heads? They immediately relax. They get sleepy, their fists unclench, they are clearly at ease. Breastfeeding also releases natural endorphins to mom, which makes her feel better as well. Even if you are not planning on nursing, please at least give it a try for the first week. Any breastmilk is better than no breastmilk. If you absolutely can not breastfeed, pump and give it to baby in a bottle. Breastmilk has also been proven to help with stomach issues in babies and a lot of babies susceptible to NAS have upset tummies as it is.

Swaddle. I highly recommend the Love to Dream swaddle sacks. The Love to Dream sleep sacks were designed by a nursery nurse. They allow baby to keep their hands up by their face (which is a soothing mechanism), but also keep baby nice and tight. If you are not spending you time skin to skin, keep baby swaddled. Keep in mind, I recommend the Love to Dream swaddle sacks, but any swaddle will do.

Low stimulation. This means low lights, low TV volume, limit visitors. When I had my babies, the only people I allowed to visit, were my family. Passing the baby around, lots of noise, can really upset them. It is best to keep a calm, quiet environment. Take your time in the hospital to bond with your baby. You will thank me for it later 😉 I used to like to play quiet, soothing music for my babies. They seemed to always calm down once they heard the music playing.

Most hospitals are actually starting to do away with the Finnegan scoring system for scoring babies born to moms on MAT. The Finnegan scoring system is a system that scores babies on a numerical score, every few hours. There are a lot of things on the list. Inconsolable crying, sneezing, yawning, runny stools, tremors, to name a few. Some hospitals ARE still using the Finnegan scoring system, but a LOT of hospitals are starting to use the Eat, Sleep, Console system. The ESC system is basically just that. Is baby eating well? Sleeping well?? Able to be consoled? This system has really lowered the number of babies that need to be medicated due to NAS (specifically those babies born to moms on MAT medications). If you do not agree with a score, SPEAK up. You are your baby’s biggest advocate. Often times babies are scored for things that are completely normal (yawning, sneezing, etc). Do not be afraid to tell the medical staff that you do not agree with something. Ask that you nurse baby and have them score again. Most of the times, they will. I have found that the medical staff really seem to appreciate moms that are educated on what is going on with their babies.

If you are having a boy and plan on having him circumcised, ask the pediatrician to do it on the day of discharge. This will help immensely.

Last but not least, enjoy your pregnancy. I meet so many moms in my group that are just so nervous and worried. So much, that they can’t enjoy their pregnancies. They plan on a hospital stay and bank on the fact that their babies will be medicated. If you believe your baby is going to need to be medicated for NAS, your chances of that happening are greater. Relax. Enjoy your pregnancy. Take it one day at a time. If your baby needs to be medicated, then so be it. But, cross that bridge when you get there.

So far, I have had 2 babies while on buprenorphine. I had my first while on suboxone, back when there was literally no information out there. I was naive and I thought the best thing to do would be to taper. I saw a Fetal Medicine Specialist that encouraged me to stay on a stable dose. I did all of these things in this post and my daughter was absolutely perfect. She had ZERO withdrawal symptoms. None. You never would have even known I took any medication during my pregnancy unless you looked at my medical records. With my son, I took subutex. I also did all of these things in this post. He did have some mild withdrawal, but it was not enough to need medication.

I truly believe that doing these things helped. If your baby does end up needing to be medicated, remember it is only temporary. You did the right thing for yourself and for your baby by staying on your medication through your pregnancy.

If you are pregnant and reading this, Congratulations! Being a mom is one of the most challenging, exhausting, rewarding, beautiful things I have ever done with my life.

If you aren’t pregnant and reading this, please remember these things. They are important. Pass them on to a pregnant mama on MAT. They may need to hear it.

On my next blog post, I will be writing about another huge moment in my life…my car accident that occurred 4 days after the birth of my first baby. So stay tuned.

❤ Caitlin