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

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 journal › Review article › peer-review

165 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 language	English
Pages (from-to)	33-35
Number of pages	3
Journal	Canadian Family Physician
Volume	53
Issue number	1
State	Published - Jan 2007
Externally published	Yes

Cite this

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

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.",

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AU - Cairns, James

AU - Chitayat, David

AU - Gaedigk, Andrea

AU - Leeder, J. Steven

AU - Teitelbaum, Ronni

AU - Karaskov, Tatyana

AU - Aleksa, Katarina

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AB - 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.

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

Abstract

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