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Taking Codeine While Breast-Feeding May Harm Infant
Date:8/25/2008

almost half of all babies are delivered by either Caesarean section or episiotomy.

Given that the American Academy of Pediatrics recommends codeine as "compatible" with breast-feeding, and given that an estimated 80 percent of North American mothers breast-feed, Madadi and her colleagues calculate that upwards of 40 percent of all new mothers may be breast-feeding while consuming codeine for post-delivery pain.

Among that group, the researchers noted that between 1 percent and 10 percent of mothers with white European ancestry appear to have the risky genetic variant that causes morphine overproduction. Prior research indicates that the figure might be higher for other ethnicities.

Madadi noted that the current research effort was launched following the death of a Canadian infant due to the excessive ingestion -- following 12 days of breast-feeding -- of codeine-produced morphine.

In that instance, the mother, who was prescribed codeine-containing painkillers following an episiotomy, was later found to have the problematic genotype.

To explore the issue, the research team analyzed DNA samples collected from 72 mothers across Canada who consumed post-delivery codeine between 2004 and 2007. All the women also participated in a telephone survey to gauge the health of the mother and the central nervous system of the child -- both before, during and after codeine consumption.

Nearly one-quarter of the infants exhibited some central nervous system depression -- manifested by reduced alertness -- while breast-feeding during maternal codeine ingestion.

Among this group, mothers were found to have consumed, on average, almost 60 percent more codeine than mothers with healthy babies. This led the team to conclude, in fact, that excessive codeine consumption while breast-feeding can compromise a baby's health, whether or not the mother is one of the relatively few affected by a genetic predisposition to over
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Taking Codeine While Breast-Feeding May Harm Infant
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