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Updated: Jun 4, 2026

An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
Published on: January 27, 2010
Breast milk hydrocodone and hydromorphone levels in mothers using hydrocodone for postpartum pain
Jason B Sauberan1, Philip O Anderson, James R Lane
1From the Department of Pharmacy and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego Medical Center, San Diego, California; the Pediatric Pharmacology Research Unit, University of California, San Diego, San Diego, California; and the Department of Pediatrics, Division of Neonatology, School of Medicine, University of California, San Diego, California.
Objective:
To estimate the extent of passage of hydrocodone and its active metabolite, hydromorphone, into breast milk.
Methods:
This is a pharmacokinetic study of 30 postpartum women receiving hydrocodone bitartrate for postpartum pain in the inpatient setting. Mothers donated timed breast milk samples for the analysis of hydrocodone and hydromorphone.
Results:
Fully breastfed neonates received 1.6% (range 0.2%-9%) of the maternal weight-adjusted hydrocodone bitartrate dosage. When combined with hydromorphone, the total median opiate dosage from breast milk is 0.7% of a therapeutic dosage for older infants. Most mothers excreted little to no hydromorphone into breast milk.
Conclusion:
Standard postpartum dosages of hydrocodone bitartrate appear to be acceptable to use in women nursing newborns. Prolonged use of high dosages is not advisable.
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