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Codeine and breastfeeding a deadly combo for baby
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Now, I'm not one to fan fires when it comes to everything we hear is harmful to mothers and their children (unborn or among us), but I took strong notice of this article. Last Friday, the US FDA put out an advisory that mothers who breastfeed and take codeine could potentially fatally harm their babies.
If a mother takes the codeine, and it turns out she is what is referred to as a "ultra-rapid metabolizer," her body could quickly metabolize the codeine, which releases morphine (a metabolite of codeine) into her system, which could then potentially be passed on to her baby rapidly through her breastmilk.
So, you say, ok, I hear things like this all the time, with words like "could" and "potential" and "may." Well, according to the FDA as few as 1% or as many as 28% of women could be ultra-rapid metabolizers. How do you know whether or not you are one? It's impossible to know if you are without genetic testing.
And as I've said many times, I'm not expert, BUT, I can assure you that your insurance company is not going to cover you getting tested to find out if you're an ultra-rapid metabolizer.
The article suggests doctors prescribe their mother patients the lowest dosage of things that contain codeine like cough medicine and ask that patients take it the least amount of time. Others are given codeine for episiotomies. Still, the risk exists, even in small doses, so it is suggested that mothers monitor their children for signs of morphine poisoning, such as unusual sleepiness and limpness.
Hey, I have another idea--how about NOT taking anything with codeine in it? There's a thought. How about sucking it up and trying something a little less likely to poison your child? Wow--how novel! I had an episiotomy--know what i took for it? Ice packs. A lot of them. They worked like a dream and I had no pain or complications...nor did I suffer from hemorrhoids (which can occur during pregnancy or after delivery).
Sorry to get on my soapbox (whoah--give me a minute, it was a steep climb up here) but I want to just test a theory out on you.
So, remember way back when mothers weren't told to not do or take anything, or, in fact, were prescribed things by their doctors that were supposed to help them? You know, like thalidomide? Their children had all kinds of problems.
Then the current thinking changed to pregnant and nursing women not taking ANYTHING, ever. Now things are slowly creeping back--suddenly caffeine is ok. Some doctors will even allow a little alcohol consumption. And there are lists being circulated about what medicines preggos and nursing moms can take.
And, steadily, children are being born with or diagnosed with problems again. One in 166 children are diagnosed with some form of autism every day in this country, yet no one knows why it's happening.
Just seems strange to me that doctors would prescribe something like codeine to nursing mothers. Codeine is powerful stuff, and common sense would tell a person to avoid anything too strong when she's pregnant or nursing, simply for the sake and safety of her child. I would never say, oh, yeah, I'll take codeine for that nagging cough even though it's going to go straight through me and right into my breastmilk. Great idea!
Sorry. Ok, now I'm off the soapbox. Anyway, just talk to your doctor or healthcare professional if you are pregnant or nursing and you end up being prescribed codeine.
Glorious picture of mannequin breastfeeding by chispita 666.
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ReaderComments (Page 1 of 1)
8-19-2007 @ 9:13PM
Callista said...I breastfeed and taken Tylenol 1 with Codeine for my migraines. I have to, nothing else works and they are so bad that I can't properly take care of my kids. I obviously try to take it at little as possible but I need to take it.
I really hope I'm not a rapid metabolizer. My baby doesn't show any signs of being sleepy after I take the medicine so I hope not.
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8-19-2007 @ 2:05PM
Cathy said...Are you trying to draw a correlation between maternal substance use during pregnancy and Autism? My oldest child has a form of Autism and I abstained from EVERYTHING during that pregnancy. I wouldn't allow myself a tylenol or a sip of pepto-bismol. I refused to go anywhere that people might be smoking. Pick a different diagnosis for your example. Fetal alcohol syndrome, prematurity, diabetes, etc.
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8-19-2007 @ 2:12PM
Bee said...Holy crap,they gave me Tylenol with codeine for pain after my c-section and I was nursing, too. You sort of trust your hospital to know what's safe... glad I didn't take very many of them & all turned out well.
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8-19-2007 @ 3:12PM
Crystal said...When I was prego with #1, I had a TERRIBLE cold, like the worst cold I ever had in the my life. I was about 16 weeks along, and refused to take anything. Not even Tylenol. The drs in my OB's office said I was being silly, and wrote me a prescription for Robutussin with Codeine. I joked with them that I couldnt eat a deli turkey sandwich (b/c of listeria) but I could take codeine.
Well, I took it. And I got some much needed sleep. And I got better. And I had a beautiful son. With infant eczema, asthma and a laundry list of allergies....
Who knows if the two are connected? But if I had it to do all over again, I would have done it my way and suffered a little longer and taken nothing.
Reply
8-19-2007 @ 7:40PM
Eva said...Sometimes you have to weight the potential, uncertain risks to a fetus or breastfed child against the needs of the mother, and your black/white attitude won't fit all scenarios.
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8-19-2007 @ 8:53PM
jenn said...My 3-year-old son is being evaluated for PDD-NOS, which is sort of a high-functioning form of autism (although that's way oversimplifying it.) So you're saying I should feel guilty or second-guess myself or my doctor because I took pain meds after my c-section? You must have no idea how judgmental that sounds. It's media stories like this that are the reason I'm on antidepressants.
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8-19-2007 @ 9:46PM
jenn said...And another thing (I probably should just let this go, but I think this is important to note, in case there are any soon-to-be moms out there.) If you have a c-section or whatever other problem with delivery that leaves you in a lot of pain, it's best to take the pain meds that the doctor offers you. Because if you don't take something, the pain will be so bad that you won't be able to see straight, let alone sit up to nurse. And then obviously your milk won't come in, and then you won't need to worry whether your baby is being affected by the meds.
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8-20-2007 @ 2:47PM
Marylena said...My doctor and my dentist, in consultation with each other, prescribed Tylenol 3 with Codeine DURING my pregnancy because a root canal I'd had 15 years prior picked my 6th month of prenancy to go bad and require retreatment. They decided this based on years of medical practice and chose this medication because it was demonstrated safe for pregnant women.
The pain in my tooth was worse than the labor. There was no "sucking it up". Sometimes, when the pain is so bad you can't eat or sleep or think, it's best not to "suck it up" and take the meds.
My daughter is six now. She's very social and makes friends easily. Her vocabulary is advanced for her age (possibly because she never stops talking). No autism here.
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8-20-2007 @ 11:55AM
Jessica said...You are taking a very closed-minded stance.
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8-20-2007 @ 4:27PM
Heather said...No woder my son was so sleepy after feeding him. He would be faling alseep, before he was even done. I had to keep waking him every 10 min. He is still a horrible sleeper. They gave me T3's after my c-section as well.
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8-22-2007 @ 4:33PM
jen said...I was given (under consultant's orders) codeine during my pregnancy, as well as ibuprofen - because i had such a bad migraine i lost the use of my arm for a week (and still have not regained full use since). sometimes you just have to do it to function.
i avoid codeine during breastfeeding as it makes me pass out and therefore i am a danger to the baby (suffocation), let alone rapid metabolising!
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