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 mail to: [log in to unmask]