title: Safety of codeine during breastfeeding: fatal morphine poisoning in the breastfed neonate of a mother prescribed codeine.
abstract: Recently a newborn died from morphine poisoning when his mother used codeine while breastfeeding. Many patients receive codeine for postlabour pain. Is it safe to prescribe codeine for nursing mothers?
  
  
  
  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.
authors.forename: Parvaz
authors.initials: P
authors.lastname: Madadi
authors.forename: Gideon
authors.initials: G
authors.lastname: Koren
authors.forename: James
authors.initials: J
authors.lastname: Cairns
authors.forename: David
authors.initials: D
authors.lastname: Chitayat
authors.forename: Andrea
authors.initials: A
authors.lastname: Gaedigk
authors.forename: J Steven
authors.initials: JS
authors.lastname: Leeder
authors.forename: Ronni
authors.initials: R
authors.lastname: Teitelbaum
authors.forename: Tatyana
authors.initials: T
authors.lastname: Karaskov
authors.forename: Katarina
authors.initials: K
authors.lastname: Aleksa
mesh_terms: D000082:Acetaminophen / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000378:metabolism; D001942:Breast Feeding / Q000009:adverse effects*; D003061:Codeine / Q000009:adverse effects* / Q000378:metabolism; D019389:Cytochrome P-450 CYP2D6 / Q000235:genetics / Q000378:metabolism; D017809:Fatal Outcome; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008895:Milk, Human / Q000737:chemistry; D009020:Morphine / Q000032:analysis / Q000378:metabolism / Q000633:toxicity*; D009293:Opioid-Related Disorders / Q000150:complications / Q000235:genetics* / Q000378:metabolism
chemical_list: D000701:Analgesics, Opioid; D000082:Acetaminophen; D009020:Morphine; D019389:Cytochrome P-450 CYP2D6; D003061:Codeine