Is morphine excretion in breast milk?

Morphine Excretion in Breast Milk: An Overview
Morphine, a potent opioid analgesic, is known to be excreted in breast milk, raising concerns about its potential effects on nursing infants. Understanding the dynamics of this excretion is crucial for breastfeeding mothers who may require pain management.
How Morphine Transfers to Breast Milk
Research indicates that morphine can indeed enter breast milk, with varying concentrations depending on the method of administration and timing. For instance, a study highlighted that when mothers received low doses of morphine, the concentration in their breast milk varied significantly, with samples showing levels of 10, 100, and 12 ng/ml within a two-hour window. This variability suggests that the timing of breastfeeding in relation to morphine administration is critical.
Moreover, the route of morphine administration plays a significant role in its concentration in breast milk. Epidural morphine, often used for post-surgical pain relief, results in minimal amounts of the drug being present in colostrum and milk. In contrast, intravenous or oral doses lead to higher levels of morphine in breast milk, particularly in the immediate postpartum period.
Implications for Nursing Infants
The presence of morphine in breast milk raises important questions about infant safety. While some studies have shown that infants can have detectable levels of morphine in their serum, these levels are often within the analgesic range, suggesting that the amounts transferred through breastfeeding may not always pose a significant risk. However, healthcare providers generally advise caution, as even small amounts of morphine can potentially affect a nursing infant, leading to sedation or other adverse effects.
Recommendations for Breastfeeding Mothers
Given the complexities surrounding morphine use during breastfeeding, it is essential for mothers to consult healthcare providers about their pain management options. Many medications, including morphine, may be compatible with breastfeeding, but individual circumstances can vary widely. The American Academy of Pediatrics emphasizes that while some medications are contraindicated, many can be safely used without necessitating the cessation of breastfeeding.
In conclusion, while morphine does excrete into breast milk, the implications for nursing infants depend on various factors, including dosage, timing, and the method of administration. Mothers should engage in open discussions with their healthcare providers to ensure both effective pain management and the safety of their infants.

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

Which opioids are secreted in breast milk?

Use of morphine and other analgesics (e.g., cannabinoids) by a breast- feeding mother, for control of chronic pain, may lead to higher levels of the drug and its metabolites in the infant [8].

Which drugs are excreted in breast milk?

• analgesics and antipyretics: short courses of paracetamol, acetylsalicylic acid, ibuprofen;
• antibiotics: ampicillin, amoxicillin, cloxacillin and other penicillins, erythromycin.
• bronchodilators (e.g. salbutamol), corticosteroids, antihistamines, antacids.

How is morphine excreted from the body?

Excretion. Around 90% of morphine taken is excreted from the body within 24 hours, mostly in the form of urine. Morphine has an elimination half-life of around 120 minutes. The drug can be stored in fat, so remains detectable for a long time after use and even after a person has died.

Is there morphine in milk?

Morphine has been found in cow and human milk at concentrations of 200 to 500 nanograms per liter. Multistep purification yields a material that has immunological, biological, pharmacological, and chemical properties identical to those of morphine.

How long does morphine stay in your breast milk?

The half-life in milk was 3 hours. Another study of women who received morphine in their epidurals assessed breast milk levels of the drug at various intervals. Morphine concentrations were highest 3.2 hours after the dose. By 24 hours, there was no detectable morphine in the milk.

Do pain killers pass through breast milk?

Almost any drug that’s present in the blood will transfer into breast milk to some extent. Most medications do so at low levels and pose no real risk to most infants.

Which of the following is not excreted in breast milk?

Insulin is not excreted into breast milk and is considered safe for use during breast-feeding.

Is morphine excreted in breast milk?

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.

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.