How long between taking co comadol and breastfeeding?

[GimmeDaBoobehz]

What gap should I leave?
Should I pump and chuck as it will be in my system or will it come out after the 6/8 hours?

Thanks.
I've had wisdom teeth removal and there quite sore...
I mean the one you can get over the counter.

[Gintonic]

That's codeine and paracetamol isn't it? I was given both in hospital while breast feeding - probably best to get a professional opinion though.

I don't think there is any point in pumping and dumping, unless you need to because of engorgement - it won't make the drug leave your body any quicjer

[pancakesfortea]

I took buckets of the stuff when I was breastfeeding, including when my babies were tiny and feeding constantly. It's a bit of a blur now but I'm fairly sure the doctors ok-ed it. I had arthritis, by the way, not just a codeine habit!

[GimmeDaBoobehz]

I mean to pump the drug out once the 6/8 hours was out, if that make sense.

So if took it at 4 say, pumping at 10 to make sure it's out of my breastmilk so it can create a new supply?

[noblegiraffe]

Latest advice is that breastfeeding mothers shouldn't take codeine.

www.breastfeedingnetwork.org.uk/dibm/codeine_for_website_july_2013%20(1)%20(4).pdf

It has been routinely given before however, so you could feed and just closely observe your baby for the listed symptoms.

[Gintonic]

I don't think it works like that - the drug will be in your blood, breast milk etc until your liver breaks it down. You don't have to pump your boobs to get it out AFAIAA

[GimmeDaBoobehz]

Thanks noble.

Do they have any advice on how long it takes to come out of your system (codeine that is) I was planning to just take an initial dose to ease the pain now as it was done earlier today.

Thanks for the help.

[Gintonic]

Thanks Giraffe for the link I had no idea . I wonder what they will give instead to women who can't take NSAIDs??

[Firsttimmemummy]

Hiya I have also had my wisdom teeth out and am on paracetamol and ibuprofen only as I was told I can't take codeine while bf. Think it's quite a strong dose of paracetamol though. HTH.

[GimmeDaBoobehz]

What dose of paracetamol wer eyou recommended first

[GimmeDaBoobehz]

DD is 11mo nearly a year old so not a tiny baby thank goodness otherwise I'd say no, even if it was properly recommended.

Haven't taken anything except paracetamol and lactulose since she was born just incase

[noblegiraffe]

I don't know, sorry, but you could phone or email the breastfeeding network for advice.

www.breastfeedingnetwork.org.uk/drugs-in-breastmilk.html

[EverythingIsTicketyBoo]

I saw my GP about this the other day. He explained that the drug companies don't make enough money from paracetamol/codeine/ibuprofen etc to invest in the tests for safety in breastfeeding, it is much cheaper to advise that it may pass to the baby through the milk.

He looked into it at on balance decided the evidence for the codeine was pointing towards it being passed more though the milk than something like cocodamol (which is what he prescribed me) with the advice to watch the baby after taking and feeding her. If she was sleeping more or was drowsy then stop taking them immediately.

[sleepyhead]

How old is your baby?

They gave me diclofenac instead of cocodamol when ds2 was 2 weeks old because cocodamol is no longer recommended when you're bf a newborn.

When he was 6 months though I had severe shoulder pain and the GP was fine about giving me cocodamol even though I was still bf, as ds2 was older.

It's not completely contraindicated, just preferable for you to have something else if your baby is young.

[Firsttimmemummy]

Hi Gimme , it's 1000mg every 4 hours. Plus I can take ibuprofen inbetween if needed.

[sleepyhead]

Xpost. At 11months I doubt anyone would have a problem with you taking cocodamol and breastfeeding.

[TheScience]

This might be useful: www.breastfeedingnetwork.org.uk/dibm/codeine_for_website_july_2013%20(1)%20(4).pdf

You can contact the Breastfeeding Network to get specific advice on how long to wait etc.

[NormHonal]

I was prescribed co codamol when DS was 12mo. GP said it was safe with bfing. We did it for a few months (I wasn't on the co codamol every day and we were down to one feed a day).

18 months later, he is fine apart from having 2 heads.

[TheScience]

Cocodamol is codeine EverythingIsTicketyBoo

[Madasabox]

I was given dyhdrocodeine last year by the hospital while breastfeeding and told to take it with paracetemol if that helps

[OohOod]

Codiene can be metabolised into morphine which can make a small baby ill.
I take codiene and allow 4 hours(half life) before I feed again.

[HicDraconis]

Codeine isn't advised with breast feeding. Nothing to do with drug companies not funding investigations, but related to the genetics of the individual taking it.

Codeine is metabolised to morphine. The majority of people are normal metabolisers - so a small dose of codeine becomes a tiny dose of morphine. A few people can't metabolise it at all, so they get no pain relief from it. Another few metabolise it too well - so when they take codeine, most of it gets metabolised to morphine with all the side effects of opioid overdose (drowsiness, nausea, itching, low resp rate).

Because we don't know each individual genetic makeup, it's safer to say "don't take codeine if you're bf" than risk an ultra metaboliser taking it, metabolising it to a larger amount of morphine than expected and then having a higher concentration of morphine in breast milk than would be expected. There have been a few neonatal deaths from this. Obviously the risks are greatest in tiny newborns who are ebf and in whom the morphine dose is relatively much higher (mg/kg basis).

Tramadol has been tested and although it is excreted in breast milk, it's trace amounts. The M1 metabolite also appears in breast milk but in tiny doses. If you need a moderate opioid, I'd stick with that one.

OP, after a one off dose I wouldn't worry too much, it's repeated doses and accumulation that would concern me. But I'd still avoid taking it if possible.

[Firsttimmemummy]

Weirdly though, since we are talking about codeine metabolising into morphine;

i was prescribed oramorph while at hospital just after my c section and again when I went back for a blood patch (procedure to fix a problem with my epidural) and breastfed throughout. DD was much younger then she is now (1 week at time of blood patch) She is now 5 months. Sadly I did not get more oramorph for my wisdom teeth it is a wonder drug!

[sleepyhead]

That's interesting HicDraconis. My GP had me on cocodamol, ibuprofen & amitriptyline for acute, severe pain.

She said the next step if these weren't cutting it was tramadol, but she was very unwilling to prescribe it if I didn't stop bf.

As it turned out, the pain was greatly reduced within a week so it wasn't an issue.

It's so hard when the advice seems to differ depending who you speak to.

I had a similar problem with antibiotics when I had mastitis. Despite me having been on 2 types of IV abs when hospitalised with mastitis (because they suspected uterine infection) after ds2 was born, my GP (a different one) was really reluctant to prescribe anything other than penicillin when I got it again when he was 3 months old (I'm allergic to penicillin). I had to persuade him to check out other options, which I really shouldn't have had to do .

[ALittleFaith]

This is interesting. I had chronic pain when pregnant and was on regular codeine (30mg 4 times a day so a far amount). There were risks but I couldn't function with the pain so it was my only option. I actually weaned off it before I had DD but I saw a paediatrician who said I could definitely breastfeed on the codeine and wrote a letter to that effect! This was only last year.

OP you could ring a BF hotline for advice. If you do take it, try to feed 4 hours later when it's out of your system. It metabolises quite quickly.

[TheScience]

It looks like the advice changed in July 2013.