Opioid painkillers used by breastfeeding mothers ‘safe’ for babies, study shows

Study finds no association between maternal opioid prescription after delivery and harm to babies

A study published in the BMJ has found that there is no association between maternal opioid prescription after delivery and adverse infant outcomes (Getty Images/iStockphoto)

Opioid painkillers perscribed to breastfeeding women do not harm babies through breast milk, new research shows.

A study published in the BMJ has found there is no association between maternal opioid prescription after delivery and harm to infants.

Current NHS advice states women should not take codeine if they are breastfeeding, while other opioids, such as dihydrocodeine or tramadol, can be used “at the lowest effective dose for the shortest duration” but that “risks to the baby” should be discussed before prescription.

The study, which used hospital data from 865,691 mother and newborn baby pairs in Ontario, Canada over an eight-year period, found that infants of mothers who were prescribed an opioid were no more likely to be admitted to hospital during the next 30 days for any reason than infants of mothers who were not prescribed an opioid.

Around 10 per cent of the mothers included in the data were prescribed an opioid painkiller in the week after giving birth, mostly after a caesarean section.

Oxycodone was taken by 42 per cent of mothers in the study, while codeine was taken by 20 per cent and morphine by 19 per cent.

The research claimed “concerns about opioid toxicity in breastfed infants seem to be unsubstantiated.”

Current NHS advice states that women should not take codeine if they are breastfeeding (Getty Images/iStockphoto)

The study endorsed “caution in short-term postpartum opioid use in selected mothers” but added “clinicians and parents should be reassured that infants are at low risk of harm.”

The research also says that “theoretical risks to infants associated with opioid use” overshadow the risk untreated pain poses to new mothers, which can cause post-natal depression and can affect infant bonding.

Professor of clinical toxicology Nicholas Bateman of the University of Edinburgh said codeine was prescribed to many new mothers to manage pain, but the practice changed in 2006 after a high profile case of an infant’s death in association with a codeine-paracetamol product in Canada.

Professor Bateman said: “Occasional reports of drowsiness in breastfed infants associated with maternal codeine are still published, leaving mothers and their clinicians with important questions about the safety of opioid analgesia after childbirth.”

The study found infants of mothers who were prescribed an opioid were marginally more likely to be taken to an emergency department in the subsequent 30 days, but no infant deaths were found.