Of the oral pain meds we use most often here in the states for post-partum Moms, only Percocet (oxycodone and acetaminophen) seems to have not been implicated in problems with nursing neonates. Therer was one case report of a death, but further investigation suggests that Mom was sharing her Percocet directly with her baby. 

There have been cases of apnea, cyanosis, and bradycardia previously reported with codeine use in nursing moms (check out the codeine listing on LactMed for more information). Codeine has a three active metabolites plus the active parent compound, and hydrocodone (the fun part of Lortab)has SIX of them as well, and has also been implicated in trouble with nursing neonates. 

I think we can do two great services for these Moms when they go home from the hospital: 
1. Have them take ibuprofen on a schedule, and narcotic analgesics only "as needed."
2. Teach them what to look for, when to summon help, and what to tell them.

Laura Block, PharmD
"a nursing pharmacist"

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