Judy Welborn posts on an unofficial policy in her hospital of not allowing
BF if mother is using Demerol.
This is the most bizarre perversion I have heard of to date, of the
knowledge we have of BF and Demerol.  Demerol does not relieve labor pain
(studies using visual analog scales showed mothers had just as much pain
post- as pre-Demerol injection) but it does affect infant behavior in subtle
ways lasting for days and maybe longer.  Newborns exposed to Demerol in
utero are less organized and less eager to come to the breast, which may
lead to other interventions depending on policy in the institution in
question.
Demerol used in labor has been linked with later opiate dependency in the
offspring, in research by the late Karin Nyberg, who I am proud to say I
knew, and she was very badly treated by the professional community when she
presented her findings, which have been replicated in other settings far
from where she did her landmark work.  Note that this was given in labor so
the babies were not able to be protected from it.
Despite all this, we still use the stuff, a lot, where I work.  It is the
analgesia we most often give in labor, and until recently we gave it IM post
CS, for a couple of days, as needed for incision pain.  Now we give
diclofenac and paracetamol (acetaminophen) and codeine, like that's a whole
lot better!  We have never, ever practiced any restrictions on BF due to any
of these drugs, though some of us feel that the BF gets restricted if baby
is too 'under the influence' to do coordinated rooting and latching.   Not
quite the same as having mothers express and discard their milk!
This unofficial policy needs to be discussed (and abandoned!).
Rachel Myr
Kristiansand, Norway

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