Has anyone heard or read about this?
Kimberly Durdin-James, IBCLC


CANADA: Some mothers who take codeine after birth can have toxic breast milk

Wed May 10, 2006 02:47 EDT

TORONTO (CP) _ Some mothers who are given a common painkiller after giving 
birth can convert the drug into morphine, making their breast milk toxic, 
according to a case to be presented today at a medical meeting in Toronto.

The case describes a newborn who died from a morphine overdose caused by 
ingesting breast milk, said the director of the Hospital for Sick Children's 
Motherisk Program.

The baby boy's death is the first documented fatality of its kind.

The deadly conversion happens in mothers with multiple copies of a certain 
gene that transforms codeine into morphine.

The drug is commonly given after childbirth to treat pain from caesarean 
sections and other surgery.

An estimated 150,000 women a year receive codeine following childbirth.

In the case to be presented, the mother was given a mixture of codeine and 
acetaminophen last spring after an episiotomy, a surgical procedure used to 
enlarge the vaginal opening before childbirth, said Dr. Gideon Koren, 
director of the Hospital for Sick Children's Motherisk Program.

She took the drug for two weeks, not knowing she had multiple copies of the 
gene, which rapidly metabolizes the drug, Koren said.

As the first-time mother nursed her son, he became very sleepy and 
lethargic. Her doctor told her to wait to see what happened, Koren said, 
adding most doctors don't know about the problem.

By the 12th day, the boy had grey skin. He died at home the day after.

Doctors originally thought he died of sudden infant death syndrome, but 
toxicology tests revealed a surprise _ morphine levels that were at the high 
end of fatal.

About 1 per cent of Caucasians are estimated to have multiple copies of the 
gene, compared with 30 per cent of Ethiopians and 10 per cent of Southern 
Europeans.

``The fact that codeine is taken by so many women and some have this gene 
duplication makes it a serious situation,'' Koren said.

He is to present his findings to the Canadian Therapeutic Congress, a 
meeting of doctors, scientists and pharmacists who specialize in 
pharmaceuticals.

Copyright © 2006 The Associated Press

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html