Breastfeeding Mums Warned About Pain Killers

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Breastfeeding mums warned about painkillers
By medical reporter Sophie Scott

Updated Fri Jul 1, 2011 11:17am AEST

Dr Gavin Pattullo says breastfeeding mothers and young children should limit their use of codeine (stock.xchng - the leading free stock photography site Carin Araujo, file photo)

Mothers who breastfeed are being cautioned to limit their use of painkillers containing codeine to four days.

The warning is being discussed at a meeting of anaesthetists in Sydney.

Medications that contain codeine such as Panadeine are widely used, but Dr Gavin Pattullo says breastfeeding mothers and young children should limit their use.

"This is because codeine needs to be metabolised by the liver into morphine to offer pain relief and this liver conversion process is very unpredictable," he said.

"Some patients' livers produce large amounts of morphine after taking codeine, causing drowsiness, while others fail to produce any morphine at all."

Dr Pattullo says for breastfeeding mothers, a large dose of morphine could make its way into the baby and result in the baby's death by overdose.

"While new mums shouldn't be unnecessarily alarmed, they need to be aware that codeine-containing painkillers in certain circumstances can cause harm," Dr Pattullo said.

"New mothers should limit their use of codeine-containing painkillers to no more than four days and, if they feel drowsy while taking this medication, cease its use and have their baby examined by a doctor for signs of drowsiness."

Breastfeeding mothers should see a doctor if their baby gets sleepy while taking the painkillers.

Tags: health, reproduction-and-contraception, breast-feeding, breastfeeding, australia, nsw, sydney-2000

First posted Fri Jul 1, 2011 11:08am AEST

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I saw this today too.

Codeine scares the bejeebers out of me. I won't take it while BFing, and I definitely wouldn't take it while pregnant, despite an ER doctor's insistence. Actually, mate,I want the pain to go away because it's fixed, not because it's masked.

Codeine literally makes me sick so I don't take it unless I have a good 4 hours to sleep off the effects - which defeats the purpose really :rofl:

I have always chosen good ole, does nothing for anything, panadol. But I think what BF/EBM mothers need to remember ANYTHING they take can be transfered to their babies through BM. Why take the risks?!

Nae x

i think at times, you just gotta do what you gotta do. harm minimisation is crucial in everything. i still BF DD, and i take codeine based meds. panadol does nothing for a fractured skull, dislocated wrist etc. i need to be able to function to take care of DD - yes, a small amount of the medication might get to her through my milk, but it's a risk i have to take if i am to be able to care for her. i try to take meds as little as possible, and if i've recently taken them i won't feed her (i try to take them after a feed so that i have several hours to metabolise them before feeding again)

i don't think codeine is necessarily a scary medication - but maybe i feel that way because i have pretty much no relief from panadol, and codeine doesn't knock me on my backside like it does for friends. i look at the benefits (being able to function, take care of DD, stay at work and actually have an income for our family) vs the potential risks (her getting byproducts in my milk) and i do what is in our best interests at the time

I was offered Codeine on day 2 post C-section due to excruciating referred pain in my shoulder. I only took it for 2 days, but the panadol wasn't cutting it at the time and I could barely function with my shoulder until I had the codeine. So I think sometimes it is a necessary evil, but its good to know that no more than 4 days is recommended and I used it less than that.

I hope women don't stop BFing and swap to FF because they read this article and freak out because they have been on codeine...

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i think at times, you just gotta do what you gotta do. harm minimisation is crucial in everything. i still BF DD, and i take codeine based meds. panadol does nothing for a fractured skull, dislocated wrist etc. i need to be able to function to take care of DD - yes, a small amount of the medication might get to her through my milk, but it's a risk i have to take if i am to be able to care for her. i try to take meds as little as possible, and if i've recently taken them i won't feed her (i try to take them after a feed so that i have several hours to metabolise them before feeding again)

i don't think codeine is necessarily a scary medication - but maybe i feel that way because i have pretty much no relief from panadol, and codeine doesn't knock me on my backside like it does for friends. i look at the benefits (being able to function, take care of DD, stay at work and actually have an income for our family) vs the potential risks (her getting byproducts in my milk) and i do what is in our best interests at the time

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Ya know that's why I find it scary. I react like Nae, and yet you react like you do, and there's no test to tell you which way you're gonna go... so I think the warning is wise for BFing mums

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I hope women don't stop BFing and swap to FF because they read this article and freak out because they have been on codeine...

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Agreed! It's always good to be aware of these things. Codeine isn't something anyone sould take unless they really need to, breastfeeding or otherwise.

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Ya know that's why I find it scary. I react like Nae, and yet you react like you do, and there's no test to tell you which way you're gonna go... so I think the warning is wise for BFing mums

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i agree the warning is wise - but i think it is - i dunno - almost irresponsible to put a four day warning on it - if someone is going to react strongly to it, it's going to happen, as it does with Nae, straight away. some people can't function after taking it, some, like me, have no negative functioning reaction kwim? if someone's liver is going to metabolise the drugs to morphine and have a strong reaction straight away, chances are it's going to be in higher doses in their milk whether they've taken it once, or for four days kwim?

FWIW - when i was DD's ONLY source of nutrition, i didn't take anything at all. i was at home, if i had pain that i couldn't manage doing normal daily activities with her, i'd take her to bed. i suffer migraines and also have a wrist that dislocates itself - having DD has put a lot more strain on that joint while i'm holding her etc - so i took us off to bed so i didn't have to hold her weight on that arm at all. generally now, as i am deemed "secondary" carer for DD, if i'm home and the pain becomes too much, again, i take myself to bed - so i only take pain killers when i have to be out and about and really have no choice

i guess it's like anything - you need to be responsible - if you have pain that needs treating, you work out the most appropriate pain relief for you, for the minimal impact for yourself and your baby.

Wow I get completely high on codeine. I used to take it when I was 19 for bad period pain and I wondered why I kept nearly crashing the car when I was menstruating until I put 2&2 together. But I never knew my liver was converting it to morphine!! No wonder!

I would never take it while Bfing, but I have to say I find Panadol quite effective.

Sent from my Desire HD

I find codeine has a drying effect for me, so I don't take it while bfing in case it impacts my supply. Same as I avoid drug and natural cold remedies that also dry my sinuses, etc out.

I broke my foot while still bring DD and got by with normal anti-inflammatories, ice, elevation, compression and resting it. I didn't think codeine was even an option while bfing, so shows I was wrong! It certainly wasn't offered to me once I told the drs I was still bfing my toddler.

I have absolutely no reaction to it whatsoever apart from pain relief. I had it post c/s both times and was never given any warning. It would be good to know prior though especially for people who do know that they have a negative reaction.

I was having it at night last week - it stops you cough. I figured that it was worth it to not cough my lungs out for 12 hours overnight while dealing with a feverish baby who was also coughing and didn't need me waking him up every 10 minutes. I actually got sleep and so did he, so it worked.

Now if this cold would actually GO AWAY I'd be happy, this is almost 2 weeks now and I'm still coughing a bit, the baby is very green but at least everyone is over their fevers. If I was working I would have had to take a solid 2 weeks sick leave from this one and its just a cold :(

Wow, I never knew about the liver converting it to morphine. Seriously though, I always wondered why people would say codeine knocks them out when I take panadeine and don't feel an inkling of drowsiness, think there must be something wrong with my body, it converts it into constipation rather than morphine :lol: That's enough to limit my intake.