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See Latest ArticlesGuidelines for maternal codeine use during breastfeeding
Canadian Family Physician, 11/13/09
Madadi P et al. – Codeine is widely used for postpartum pain, mostly in combination with acetaminophen. Tylenol No. 3 is the most common codeine–acetaminophen combination in clinical use. Recent research from Motherisk suggests that codeine might not be safe for all breastfed infants, as in a minority of cases it might cause CNS depression and apnea. A minority of mothers might convert more codeine to morphine in their bodies, putting their babies at risk of side effects or even death. Infants appear to be more sensitive to the effects of narcotic opioids, such as morphine, than older children or adults...As the postpartum length of hospital stay has decreased in Canada, the onus for providing a safe and effective analgesic for maternal outpatient use has increased. The strategy of replacing codeine with another opioid analgesic is troublesome in the absence of safety data and clinical experience. However, if codeine is to remain the first–line treatment of postpartum pain, practitioners, as well as patients, should be educated on its risks.
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