Original ArticleCentral Nervous System Depression of Neonates Breastfed by Mothers Receiving Oxycodone for Postpartum Analgesia
Section snippets
Methods
A retrospective study consisting of 3 cohorts (breastfeeding mother-infant pairs exposed to oxycodone, codeine, or acetaminophen only) was conducted, after obtaining research ethics board approval from the Hospital for Sick Children (Toronto, Ontario, Canada). The mother-infant pairs were recruited from the Motherisk Program at the Hospital for Sick Children, a teratology information center that counsels women with evidence-based information about the safety of using medication during pregnancy
Results
We examined the files of 1560 women inquiring about oxycodone (n = 289), codeine (n = 681), or acetaminophen only (n = 590). Of these, 533 women were available for follow up (139 in the oxycodone cohort, 210 in the codeine cohort, and 184 in the acetaminophen-only group; Figure [available at www.jpeds.com]).
In the codeine group, 65% (137/210) of mothers were taking a combination codeine-acetaminophen product, and the rest were taking codeine alone (73/210). In the oxycodone group, 52.5%
Discussion
After a fatal case in a breastfed infant exposed to codeine through breast milk,7 both the US Food and Drug Administration and Health Canada published warnings indicating that codeine use in breastfeeding may not be safe for infants.10, 11 As a result, some institutions are now replacing codeine with oxycodone for postpartum pain relief. However, Seaton et al detected oxycodone in breast milk from all mothers taking any dose of oxycodone.1 The levels of oxycodone in breast milk strongly
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2020, Handbook of Clinical NeurologyLower oxycodone dose prescription post caesarean section is associated with decreased inpatient opioid consumption
2019, International Journal of Obstetric AnesthesiaBalancing the Use of Medications While Maintaining Breastfeeding
2019, Clinics in PerinatologyBreast milk oxycodone concentrations in mothers given oxycodone for post-Caesarean delivery pain management
2024, British Journal of Clinical Pharmacology
Supported by a Post Market Drug Safety and Effectiveness Catalyst grant awarded by the Drug Safety and Effectiveness Network of the Canadian Institutes of Health Research. The authors declare no conflicts of interest.