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Evid Based Med 18:40-41 doi:10.1136/ebmed-2012-100777
  • Harm
  • Cohort study

Oxycodone administered as postpartum pain relief is associated with maternal report of infant central nervous system depression in breastfed infants

  1. Wibke Christina Jonas1,2
  1. 1Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institute, Stockholm, Sweden
  2. 2Department of Psychology, University of Toronto at Mississauga, 3359 Mississauga Road N, Mississauga, ON L5L1C6, Canada
  1. Correspondence to: Wibke Christina Jonas
    Department of Psychology, University of Toronto at Mississauga, 3359 Mississauga Road N, Mississauga, ON L5L1C6, Canada; Wibke.Jonas{at}ki.se

Commentary on:

Context

Despite our knowledge that codeine is excreted in breast milk, administration of codeine as a pain relief to breastfeeding mothers during the early postpartum period was considered safe until a healthy newborn died.1 The mother was an ultra-rapid metaboliser of codeine and thus, produced effectively the metabolite morphine. As a consequence, the guidelines for codeine use during breastfeeding were changed to include more caution about the possible central nervous system (CNS) depression effects on the neonate.2 As a result, many clinicians started to prescribe oxycodone, a semisynthetic opioid, instead. Little is known about the excretion of oxycodone into breast milk and the safety for newborns to mothers taking oxycodone while breastfeeding. Lam et al …

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