title: Morphine excretion in breast milk and resultant exposure of a nursing infant.
abstract: We report the case of an infant who was breastfed while his mother was receiving low doses of morphine. Morphine concentration in his serum was in the analgesic range (4 ng/ml), while concentrations in the milk varied substantially in three samples collected within 2 hours (10, 100, 12 ng/ml). The calculated dose that the infant must have received to achieve the observed serum concentration had to be between 0.8 to 12% of maternal dose, based on reference literature values of clearance and bioavailability. The current perception that maternal morphine exposure is safe for the breastfed infant is based on a 50 year old data which were determined by an analytical method 1000 fold less sensitive than the present HPLC, thus leading to a likely erroneous conclusion.
authors.affiliation: Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario.
authors.forename: I
authors.initials: I
authors.lastname: Robieux
authors.forename: G
authors.initials: G
authors.lastname: Koren
authors.forename: H
authors.initials: H
authors.lastname: Vandenbergh
authors.forename: J
authors.initials: J
authors.lastname: Schneiderman
mesh_terms: D000328:Adult; D001682:Biological Availability; D001942:Breast Feeding; D002851:Chromatography, High Pressure Liquid; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008895:Milk, Human / Q000737:chemistry*; D009020:Morphine / Q000032:analysis* / Q000097:blood / Q000493:pharmacokinetics; D011237:Predictive Value of Tests
chemical_list: D009020:Morphine