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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 …
Competing interests None.