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
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