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Related Experiment Videos

Codeine and the breastfed neonate

R G Meny, E G Naumburg, L S Alger

    Journal of Human Lactation : Official Journal of International Lactation Consultant Association
    |December 1, 1993
    PubMed
    Summary

    Codeine use in early postpartum is likely safe for nursing infants. Low levels of codeine and its metabolite, morphine, were found in breast milk and infant plasma, suggesting minimal risk.

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    Area of Science:

    • Pharmacology
    • Neonatal Medicine
    • Lactation Studies

    Background:

    • Codeine is a common postpartum analgesic.
    • Its metabolite, morphine, may cause neonatal apnea.
    • The safety of codeine during breastfeeding requires investigation.

    Purpose of the Study:

    • To quantify free codeine and morphine levels in breast milk.
    • To measure neonatal plasma levels of these compounds after maternal codeine use.
    • To assess the safety of codeine for neonates via breastfeeding.

    Main Methods:

    • Radioimmunoassay was used to determine drug levels.
    • Breast milk samples from 7 mothers were analyzed.
    • Neonatal plasma samples from 11 healthy, term infants were collected and analyzed.

    Main Results:

    • Milk codeine levels ranged from 33.8 to 314 ng/ml.
    • Milk morphine levels ranged from 1.9 to 20.5 ng/ml.
    • Infant plasma codeine and morphine levels were low (< 4.5 ng/ml and < 2.2 ng/ml, respectively).

    Conclusions:

    • Low excretion into milk and limited milk intake in early days contribute to low infant exposure.
    • Moderate codeine use (up to four 60 mg doses) in the postpartum period appears safe for nursing neonates.

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