An infant died this past week because his mother was breastfeeding while taking codeine for her post operative pain after her c-section. Apparently, some women have a genetic make up such that they metabolize codeine super efficiently. What happens is the codeine turns into morphine and because it is metabolized so quickly, you can overdose your baby with the drug in your system.
The genetic ability to metabolize codeine in this way is extremely rare, but when it happens it can be fatal. However, the FDA was cautious to say that codeine has been used safely for post birth pain relief for episiotomies and c-sections and that this warning does not mean women who are taking codeine should stop breastfeeding. The FDA also said it does not mean that women who need pain relief after birth need to go without. Rather, nursing mothers should watch their infants carefully if they are taking codeine to make sure that there seem to be no side effects. One key indication would be sleeping for more than three hours.
Many mothers are under the assumption that you cannot take medication while breastfeeding. This is simply not true. Medication does pass through the breast milk–in fact anything that mom ingests passes through to your breast milk–however, the general standard line of thought is that if it is a medication that the baby could have normally if he were sick, then the small amount that passes through the breast milk is acceptable.
With that said, of course breastfeeding mothers should be cautious when taking medications while breastfeeding. You should always let your doctor know that you are breastfeeding if he needs to prescribe you a medication. I also often encourage sick mommies who ask, to speak with your pediatrician about what medications are acceptable. Often your pediatrician is more knowledgeable about what you can and cannot take than is a family practitioner. If neither of them know how safe the medication is, you can look it up at Ask Dr. Sears.
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