Safety of codeine during breastfeeding: Fatal morphine poisoning in the breastfed neonate of a mother prescribed codeine

Parvaz Madadi, Gideon Koren, James Cairns, David Chitayat, Andrea Gaedigk, J. Steven Leeder, Ronni Teitelbaum, Tatyana Karaskov, Katarina Aleksa

Research output: Contribution to journalReview articlepeer-review

152 Scopus citations

Abstract

QUESTION: Recently a newborn died from morphine poisoning when his mother used codeine while breastfeeding. Many patients receive codeine for postlabour pain. Is it safe to prescribe codeine for nursing mothers? ANSWER: When a mother is an ultrarapid metabolizer of cytochrome P450 2D6, she produces much more morphine when taking codeine than most people do. In this situation, newborns might be exposed to toxic levels of morphine when breastfeeding. Options to reduce this risk include discontinuing codeine after 2 to 3 days of use and being aware of symptoms of potential opioid toxicity in both mothers and newborns.

Original languageEnglish
Pages (from-to)33-35
Number of pages3
JournalCanadian Family Physician
Volume53
Issue number1
StatePublished - Jan 2007
Externally publishedYes

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