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Research ArticleCurrent Practice

Safety of codeine during breastfeeding

Fatal morphine poisoning in the breastfed neonate of a mother prescribed codeine

Parvaz Madadi, Gideon Koren, James Cairns, David Chitayat, Andrea Gaedigk, J. Steven Leeder, Ronni Teitelbaum, Tatyana Karaskov and Katarina Aleksa
Canadian Family Physician January 2007, 53 (1) 33-35;
Parvaz Madadi
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Gideon Koren
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James Cairns
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David Chitayat
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Andrea Gaedigk
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J. Steven Leeder
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Ronni Teitelbaum
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Tatyana Karaskov
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Katarina Aleksa
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Abstract

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.

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Canadian Family Physician: 53 (1)
Canadian Family Physician
Vol. 53, Issue 1
1 Jan 2007
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Safety of codeine during breastfeeding
Parvaz Madadi, Gideon Koren, James Cairns, David Chitayat, Andrea Gaedigk, J. Steven Leeder, Ronni Teitelbaum, Tatyana Karaskov, Katarina Aleksa
Canadian Family Physician Jan 2007, 53 (1) 33-35;

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Safety of codeine during breastfeeding
Parvaz Madadi, Gideon Koren, James Cairns, David Chitayat, Andrea Gaedigk, J. Steven Leeder, Ronni Teitelbaum, Tatyana Karaskov, Katarina Aleksa
Canadian Family Physician Jan 2007, 53 (1) 33-35;
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