Hi All,

I have searched the archives and have found many posts with reference to the
use of demerol but not really the answer to my question.  From what I have
been reading
(Dr. Hale's book, lactnet) and from conferences that i have attended I have
learned that demerol is a poor choice for breastfeeding moms postop because
of the long half-life of the active metabolite in the infant and the chance
of neurobehavioral problems with baby.  We start with morphine pca but
sometimes change to demerol because of itching, n/v, or just poor pain
relief. Since I heard this I have talked physicians out of just switching
without any regard to possible problems with baby but now they are demanding
to see references which support this and are also are wondering what drug
would be a better choice if one needs to be switched from morphine.  Am I
making too big a thing out of it and there isn't a problem when used for the
little time we use it (24 hrs tops but mostly less than that)? One of our
anesthesiologists is aware of the article in the journal Anesthesiology by
Wittles which Dr. Hale makes reference to. He does not switch moms to
Demerol.  Any thoughts on what would be better for both mom and baby?
Thanks for your help in this matter.

Sincerely,

Jackie Proko RN, IBCLC

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