Why cant you take codeine while breastfeeding?

The Risks of Codeine Use While Breastfeeding
The use of codeine during breastfeeding has become a contentious topic due to significant health risks posed to infants. Medical authorities, including the FDA, have issued strong warnings against the use of codeine by breastfeeding mothers, primarily due to the potential for serious adverse reactions in infants.
Serious Health Risks for Infants
When a breastfeeding mother takes codeine, the drug is metabolized into morphine, which can then be passed into breast milk. This poses a risk of excessive drowsiness, difficulty breastfeeding, and even severe respiratory issues in infants, which can lead to fatal outcomes. The FDA has highlighted these dangers, emphasizing that the risks associated with codeine use in breastfeeding women outweigh the benefits.
Infants are particularly vulnerable to the effects of opioids, as their central nervous systems are still developing. Even small doses of codeine can lead to central nervous system depression, which manifests as lethargy or difficulty in breathing. The symptoms of opioid exposure in infants can take several days to appear, often surfacing around four days after the mother begins using codeine.
Metabolism Variability and Increased Risks
Another critical factor is the variability in how individuals metabolize codeine. Some women are classified as “ultrarapid metabolizers,” meaning they convert codeine to morphine at a much higher rate than average. This can result in dangerously high levels of morphine in their breast milk, significantly increasing the risk of overdose in their infants. The consequences of such exposure can be dire, as evidenced by tragic cases where infants have suffered fatal morphine poisoning.
Guidelines and Recommendations
Given these risks, health organizations recommend that breastfeeding mothers avoid codeine altogether. If pain management is necessary, alternative medications that are safer for breastfeeding should be considered. In cases where codeine is prescribed, mothers are advised to monitor their infants closely for any signs of drowsiness or respiratory distress.
While some sources suggest that short-term use of codeine might be acceptable under strict conditions—such as abstaining from breastfeeding for a few hours after taking the medication—this approach is not always practical or safe. The overarching consensus remains that the potential for harm is too great to justify the use of codeine during breastfeeding.
Conclusion
In summary, the use of codeine while breastfeeding poses significant risks to infants, including severe respiratory issues and potential overdose. The variability in maternal metabolism further complicates the situation, making it imperative for breastfeeding mothers to seek safer alternatives for pain management. The health and safety of the infant should always be the priority, leading to a clear recommendation against the use of codeine in breastfeeding women.

What is the safest opioid in breastfeeding?

Buprenorphine can be used with caution in breastfeeding for pain, but infant monitoring is still required. Morphine is preferred.

Which painkiller should be avoided during breastfeeding?

Codeine and dihydrocodeine are weak opioids that are available over the counter in combination with other medications described above. Codeine is not recommended when you are breastfeeding.

Can codeine affect a baby?

Codeine used around the time of delivery can affect the baby for a while after birth, meaning that they may need to be looked after in a neonatal unit. The baby may be ‘jittery’, have feeding problems, and initially need some help with breathing.

Who cannot take codeine?

It should not be used in children younger than 12 years of age. Safety and efficacy have not been established. Codeine sulfate tablets should not be used to relieve pain after surgery removal of tonsils or adenoids in any children 12 to 18 years of age.

Can a breastfeeding mom take codeine?

The labels for over-the-counter (OTC) products containing codeine have recently been updated to advise against codeine use in breastfeeding except on medical advice. The doses of codeine available in some OTC preparations are considered sufficient to cause morphine toxicity in breastfed infants.

What is the strongest painkiller while breastfeeding?

Aspirin is generally not recommended for treatment of pain during breastfeeding. If paracetamol and a NSAID does not effectively control your pain, opiate painkillers for example, morphine sulphate or Oramorph, can also be taken.

How long does codeine stay in your breastmilk?

Using the half life of codeine as 3 hours – it takes 15 hours for a dose to be regarded as no longer in breastmilk.

What are the side effects of codeine in infants?

Effects in infants
Following maternal use of codeine, there have been several reports of serious side-effects. These include bradycardia, respiratory depression, sedation, apnoea, cyanosis. Lethargy, drowsiness and poor feeding have also been reported.

Which drug is usually avoided with breastfeeding?

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 opioid is codeine?

Codeine is an opioid drug closely related to morphine and, like morphine, is derived from opium poppies. Codeine can cause opioid tolerance, dependence, addiction, poisoning and in high doses, death.