Hi Denise and All,

MS Contin is a formulation of morphine which is slow release - this means
that it works for 12 hours instead of the more normal 3-4 hours for regular
morphine (oral or injected).

I would expect that symptoms of withdrawal will be present but cannot state
that they will with certainty. I would think that a total daily dose of 360
mg of morphine would guarantee problems with the infants dependency.  I have
not had the experience of working with mum/baby dyads with this type of
problem but I would imagine there is a facility in your state (I must admit
I am not sure where WA is and am assuming it is WA somewhere in the US
rather than Western Australia) with experience with mothers who are using
narcotics. The details of the situation are clearly different and the
approach may need to be different but my feeling would be there would be
value in approaching nursing and medical staff with experience in these
matters.

I would expect that relatively few narcotic dependant mothers breastfeed,
because of all the reasons we already know about and probably some active
discouragement in an attempt to decrease the problems associated with
overdose in the babies. I certainly know of at least one infant in Sydney
who overdosed as a result of his mothers drug use and breastfeeding
 anecdotal but shown at post-mortem). There were a lot of very disturbed
emergency nurses at the time (I was working in emergency although
fortunately was not present when the baby was brought in).

I must admit I find the combination of 2 different narcotic analgesics
rather curious. As a general proposition one would have 2 morphine
derivatives (ie MS Contin and oral morphine) where from my book dilaudid
would appear to be a synthetic. I stand to be corrected on that. It is
generally felt to be easier to work with the effects of one drug and then
work out appropriate dosages of same than to use 2 different drugs.



Hope this helps,

Phillip Sheard, RN, Generalist Community Nurse and Father to Alex, nearly 7
and Elena 3.

From Sydney, Oz - Cool and Clear today





> -----Original Message-----
> From: Lactation Information and Discussion
> [mailto:[log in to unmask]]On Behalf Of Denise Stuart
> Sent: Monday, June 28, 1999 12:41 AM
> To: [log in to unmask]
> Subject: MS Cotin
>
>
> I am sorry about the blank post a couple of days ago.  My
> daughter accidently hit the reply key.
> I have a mom who is due in August that has been dealing with
> kidney stones and gall bladder stones for much of this pregnancy.
>  She has been hospitalized twice and is now on MS Cotin 130mg in
> AM, 100mg at mid day and 130mg at night along with Dilaudid prn
> (not sure which dosage she takes).  We are very concerned about
> this baby having withdrawl symptoms (mom, too).  I can't find
> much about the "Cotin" part of this drug to know how much the
> baby is actually getting and if this acts much like other pain
> meds in regard to mom taking up much of the drug because her body
> is in so much pain and baby not getting as much.  I have gone
> over what symptoms we will be looking for, how she will manage
> her milk supply if the baby does have problems breastfeeding and
> the possibility of the baby being withdrawn by giving withdrawing
> doses of Morphine even after discharge as well as them both going
> thru withdrawal together by the decreasing doses in her
> breastmilk.  Does anyone know more about this drug and what to expect?
> TIA
> Denise Stuart
> Kent,WA
> <[log in to unmask]>
>
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