PT - JOURNAL ARTICLE AU - Parvaz Madadi AU - Gideon Koren AU - James Cairns AU - David Chitayat AU - Andrea Gaedigk AU - J. Steven Leeder AU - Ronni Teitelbaum AU - Tatyana Karaskov AU - Katarina Aleksa TI - Safety of codeine during breastfeeding DP - 2007 Jan 01 TA - Canadian Family Physician PG - 33--35 VI - 53 IP - 1 4099 - http://www.cfp.ca/content/53/1/33.short 4100 - http://www.cfp.ca/content/53/1/33.full SO - Can Fam Physician2007 Jan 01; 53 AB - QUESTION Recently a newborn died from morphine poisoning when hismother used codeine while breastfeeding. Many patients receive codeine for postlabour pain. Is it safe to prescribe codeine for nursing mothers? ANSWER When a mother is an ultrarapid metabolizer of cytochrome P450 2D6, she produces much more morphine when taking codeine than most people do. In this situation, newborns might be exposed to toxic levels of morphine when breastfeeding. Options to reduce this risk include discontinuing codeine after 2 to 3 days of use and being aware of symptoms of potential opioid toxicity in both mothers and newborns.