Manslaughter by breastfeeding

[meringue33]

Did anyone else see this?

Horrific :(

www.theguardian.com/science/2014/apr/09/manslaughter-conviction-negligent-breastfeeding-mothers

[meringue33]

linky

[meditrina]

a) this is in USA
b) if your medical condtition means you need to take heavy doses of opiate painkillers, the perhaps you shouldn't be BFing

[Cookiepants]

As above if you have a medical condition/ injury that requires large doses of an opiate, formula milk is available.

As a registered nurse you would think she would be aware of the risks to her child.

Terrible story though

[thingamajig]

Did you read the article? The amount she was taking would not normally have caused any problem - in fact morphine/codeine are less harmful to a BF baby than other painkillers.

"Trace amounts of painkiller appear in the milk of women taking codeine or morphine, and a fraction (roughly 10%) ends up in the child – 2 or 3 billionths of a gram – the effects of which are negligible. No morphine-related death from breastfeeding has ever been reported in a peer-reviewed journal"

and

"Either a massive dose, 50-100 tablets of the type of morphine prescribed for the mother, was administered orally to the baby, or a genetic defect prevented the baby from metabolising the tiny amounts of morphine transmitted by breast milk."

It is an awful story, not because the poor woman was taking meds while breastfeeding, but because either she or the baby had a genetic defect that messed up metabolism. Around 60 % of SIDS cases are due to a genetic disorder - this case is more like that.

[LifeHuh]

On a quick read of the article though the author seems to be saying this is the first case recorded and levels of morphine in the baby's blood weren't consistent with the Mum's dosage. But that various other tests which might have explained how/why this happened weren't done. And if genetic factors are relevant other babies may be at risk.
He's a forensic pathologist so presumably has informed knowledge of what could have been done.
May have missed something as did read through v.fast...

[LifeHuh]

X post with thingamajig who obviously has read thoroughly!

[5madthings]

What thingamajig said its a wful and horrible that she has been imprisoned because of it. Poor woman.

[meditrina]

How the body metabolises opiates varies enormously. That is why, if the mother needs opiates, BF is contraindicated, because it is notoriously unpredictable. If a doctor OKed it, then s/he is the one who should face investigation.

[5madthings]

Yes he is a forensic pathologist and a dfence witness, sound slike many mistakes wrre made and tests not done.

[VivaLeBeaver]

That's very scary that she's been found guilty of manslaughter. For an outcome which it looks like she could have no way of predicting.

[Cookiepants]

I have seen this story from other newspapers. It seems she hid her pregnancy from her regular doc and hid her pain meds from her obs/gynae doc. I am sure she did not go about to hurt her child intentionally which is why I am about the sentence, but she is living in a developed country. She had options which would have removed the risk to her child and made sure she had the treatment she required.

[meditrina]

OTC painkillers which contain codeine contain, in UK, a statement saying they should not be taken during pg or whilst BFing. If she took them anyhow, then it is fair be held to account. (Or is advice different in US?)

But if she was taking them under medical advice (on prescription or following consultation), then the responsibility should lie with the doctors.

[meringue33]

Can you provide any more links, Cookie?

[Cookiepants]

Sorry they were proper paper papers I was reading at my mums! Just had a quick google and its on the ABC news website.

[FrontierPsychiatrist]

This article paints a different picture:

linky

Maintains that
a) she was a nurse
b) she had chronic pain
c) she took opiates long term, prescribed by GP
d) she didn't see her GP in pregnancy but continued to obtain scripts for opiates by sending her husband to collect them

and crucially,

e) she didn't disclose to her obgyn that she was taking opiates

Opiates are contraindicated when breastfeeding.

Essentially her opiate use wasn't supervised by a doctor. The baby's death could have been avoided.

This is very sad.

[meringue33]

How horrible :(
She must have been terrified they'd take her meds away - but then why not just formula feed :(
She's lost two babies as well.
I imagine she'll be on suicide watch in prison, plus in isolation for her own protection :(

[AchyFox]

Very sad and weird.

3 years to come to court and none of the relevant tests done that would in all likelihood have absolved her.

Just shows how fucked the jury system is.

[edamsavestheday]

Poor woman. And what a disgraceful miscarriage of justice. Pig-ignorant prosecution.

[cakesonatrain]

I was prescribed codeine when BFing.
I mentioned to the GP that I believed it to be risky, but he said it was fine.
I didn't take them in the end.

[TheWomanTheyCallJayne]

I was prescribed codeine in hospital after my section for a prem baby who I was expressing for.

[Patilla]

Another here prescribed codeine routinely after c section. Handed over to me while bfeeding

[Meglet]

I was told to take codiene while bf after my sections. Although they bunged me up and made me woozy so I stopped.

[TheCraicDealer]

Presumably though if you're on them long-term you'd be on a pretty high dosage as opposed to a first time prescription? Sad story.

[FriendofDorothy]

She was clearly negligent to not be honest with the health professionals who were caring for her.

However, the article clearly states that the amounts of opiates she was taking usually would not have any significant affect on the child, were it not for the genetic defect which converted codeine to morphine.

All opiates say that they are not recommended for use during pregnancy/breastfeeding, however lots and lots of them are prescribed for many reasons. For example, methadone and buprenorphine is prescribed to women who are breastfeeding and yet breastfeeding is still encouraged. Patients with chronic pain are prescribed morphine, dihydrocodeine, codeine etc and yet breastfeeding is still encouraged.

[MariaJenny]

So it was the genetic disorder, not the feeding. Not the mother's fault or is it like English law - the egg shell skull rule (if you bash someone on the head in a way that would not harm most people but the person you bash happens to have a very thin skull and they die then you bear the consequences)? It's probably the latter, I suppose