Last week, a face book friend of mine posted a link to an article that talked about the dangers of breast feeding while taking Codeine in the postpartum period. I knew that Tylenol #3 which contains codeine is a VERY common medication given to post partum women and has been listed as safe for breast feeding mothers. I was concerned to learn that for certain mothers, those who are considered “ultra-rapid metabolizers,” ingesting codeine is potentially life threatening to their breastfeeding infant. I had an instant flashback to all of the mothers who I have given this medication to. Had I unknowingly given them something unsafe? I suppose the simply answer is yes. WOW … I sat a little dazed and then decided to do a little research on the topic.
Of course we know that anything ingested by the mother even in small amounts can be transferred to her newborn infant through her breast milk. In spite of this many drugs are considered “safe” to take during pregnancy. In fact, Codeine, the drug in question has been used “safely” for years in post partum breast feeding women. In 2007 however, after the death of a 2 week old otherwise healthy breastfeeding newborn the medical community and others began to question, “Do we really know what is safe for breast feeding women and their infants?” {This infant apparently died of a morphine overdose.}
According to a report by the FDA published in August of 2007
“Infants of nursing mothers taking codeine may have an increased risk of morphine overdose if the mother is an ultra-rapid metabolizer of codeine. When codeine enters the body and is metabolized, it changes to morphine, which relieves pain. Many factors affect codeine metabolism, including a person’s genetic make-up. Some people have a variation in a liver enzyme and may change codeine to morphine more rapidly and completely than other people. These people are ultra-rapid metabolizers and are more likely to have higher than normal levels of morphine in their blood after taking codeine. Nursing mothers taking codeine may also have higher morphine levels in their breast milk. These higher levels of morphine in breast milk may lead to life-threatening or fatal side effects in nursing babies. In most cases, it is unknown if someone is an ultra-rapid codeine metabolizer.”
This is sobering information to say the least. The most shocking thing is that while the information is new to ME… this is not NEW information. I actually found a great blog post about it from 2006.
Codeine is a VERY common drug given to women after delivery especially those who have had a cesarean section or episiotomy. Does this information mean you should never take Codeine? That’s a decision you have to make for yourself. As always, I encourage you to get information so you can make an informed decision.
In Birth and Love
Nicole
When I was pregnant with my second daughter I put my hand through a glass window and SLIT my thumb wide open, severing many nerves.
I went to the ER and told them I was pregnant (they didn’t seem to care) and I told them to only use a little numbing stuff before they sewed my thumb back together.
They prescribed me Tylenol 3 and I never filled the prescription. My daughter’s health mattered way too much to me, and even though smaller doses would have been passed through the placenta rather than how quickly and effectively through breastmilk, that’s just what I did. The benefits did NOT outweigh the risks in my eyes.
I was in excruciating, mind-numbing pain. I would lay in bed and whimper and only broke down a couple times, so I could sleep, to take regular Tylenol. I still don’t have feeling in my thumb over 2 years later.
Mothers need to be advocates for their babies. And learn to make sacrifices for them, even if it does cause us a little pain. Because we can handle it WAY BETTER than our sweet, innocent children.