Can opioids transfer into breast milk?

Understanding Opioid Transfer into Breast Milk
The question of whether opioids can transfer into breast milk is a significant concern for nursing mothers who require pain management. Research indicates that opioids do indeed pass into breast milk, albeit in varying amounts depending on the specific medication and the mother’s metabolism.
Pharmacokinetics of Opioids in Lactation
Pharmacokinetic principles suggest that the lower the clearance rate of a drug, the higher the potential dose that an infant may receive through breast milk. This means that opioids with lower clearance rates are more likely to accumulate in breast milk, potentially affecting the nursing infant. For instance, studies have shown that while medications like oxycodone can accumulate in breast milk, the actual levels detected in infants are often minimal.
Clinical Implications for Nursing Mothers
The clinical implications of opioid use during breastfeeding are complex. While opioids can lead to detectable levels in breast milk, the majority of breastfeeding cases involving opioid use occur without significant adverse effects on the infant. However, there are documented instances where maternal use of opioids, particularly oxycodone, has resulted in infant drowsiness and, in rare cases, severe central nervous system depression. This highlights the need for careful monitoring and consideration of the specific opioid being used.
Recommendations from Health Authorities
Health organizations, including the American Academy of Pediatrics, generally recommend that breastfeeding should be encouraged for mothers on opioid agonist therapy, such as methadone or buprenorphine, due to the minimal transfer of these medications into breast milk. However, mothers are advised to suspend breastfeeding if they relapse into illicit drug use or if there are other contraindications, such as HIV infection.
Conclusion
In summary, while opioids can transfer into breast milk, the extent of this transfer varies by drug and individual circumstances. The benefits of maternal comfort and successful breastfeeding often outweigh the risks, but it is crucial for nursing mothers to consult healthcare providers to ensure safe practices. Monitoring the infant for any signs of sedation or adverse effects is also essential to safeguard their health while managing maternal pain effectively.

What drugs don’t go into breast milk?

Table. Examples of drugs contraindicated in breastfeeding.

Drug	Comment
Iodine	High doses (>150 micrograms daily) lead to risk of infant hypothyroidism
Lithium	Breastfeeding only feasible with rigorous monitoring
Radiopharmaceuticals	Contact obstetric information service
Retinoids (oral)	Potential for serious adverse effects

What painkillers are safe while breastfeeding?

Most over-the-counter (also called OTC) medicine, like pain relievers and cold medicine, are OK to take when you’re breastfeeding. For example, OTC pain relievers like ibuprofen (Advil®) or acetaminophen (Tylenol®) are safe to use when breastfeeding.

Can you take a percocet while pregnant?

If you take opioids during pregnancy, your baby can be exposed to them in the womb and have symptoms of withdrawal after birth. In newborns, this is called neonatal abstinence syndrome or NAS. Even if you use an opioid exactly like your provider says to, it still may cause NAS in your baby.

What passes through breast milk?

Foods and drinks to avoid while breastfeeding
Caffeine passes into breastmilk, so large amounts of tea, coffee and cola drinks are best avoided. Drinking small amounts of drinks with caffeine (3 or less drinks a day) should not be a problem. Alcohol also passes into breastmilk and can affect your baby.

Can oxycodone pass in breast milk?

Oxycodone and breastfeeding
Although only small amounts of oxycodone pass into breast milk, it may still cause side effects in your baby such as breathing problems, being very sleepy, or difficulty feeding. Because of this potential risk, your doctor may recommend a different painkiller while you’re breastfeeding.

Can you breastfeed with morphine in your system?

Morphine and breastfeeding
Your doctor may also recommend a different painkiller for you to use while breastfeeding. Morphine passes into breast milk in fairly small amounts, although the amount does vary. When taken at low doses and for a short time, it is unlikely to cause side effects in your baby.

Can I take 10mg hydrocodone while breastfeeding?

Moderate dosages of hydrocodone appear acceptable during breastfeeding, but more data are needed to determine the maximum safe dosage for nursing mothers. Neonates and preterm infants may be more susceptible than older infants to adverse effects of hydrocodone and its metabolites in breast milk.

Does morphine affect baby during birth?

Opioids can help your entire body feel less pain. The opioids commonly used in childbirth include morphine and remifentanil. Morphine is usually used in the early stages of labor. If used too close to delivery, it can cause temporary breathing and heart rate problems in your baby after birth.

Can opioids get into breastmilk?

Yes. If you take opioids, your milk will have opioids in it. The amount that is in your milk depends on how much you take, which opioid you take and the amount of time that has passed since taking it. Opioids levels are at their highest in your milk 1-3 hours after taking them.

What drugs can pass through a mother’s breast milk and harm a nursing baby?

If you are breastfeeding, you should not take illegal drugs. Some drugs, such as cocaine and PCP, can make the baby high. Other drugs, such as heroin and marijuana can cause irritability, poor sleeping patterns, tremors, and vomiting. Babies can become addicted to these drugs.