HicDraconis — I have had the genetic testing as part of a research study when I was living in America, and it confirmed that I am an ultra rapid metabolizer for several classes of drugs, including codeine and other opiates. I have fairly severe chronic back pain as the result of a car accident and subsequent botched surgery. I take strong painkillers to function on a daily basis, although I reduced it to a weaker opiate during pregnancy and coped by staying on bed rest for most of it. In general pregnancy is much more medicalized in America, so like most women there I saw an OB for routine pregnancy appointments. Then because of my medication and the fact that I was 39, I was also regularly seen by a maternal-fetal medicine specialist. I had a planned c-section so an anesthetist and neonatologist were both involved in the birth — in America this is routine for all sections. In the hospital the baby was examined by three different pedicatricians for routine checkups— again routine, as they work on a rota and I was in for 3 days. While in hospital I was also seen by at least two breastfeeding consultants to help get BFing started and establish the correct latch. After we came home, I took the baby to our usual pediatrician on the normal schedule, which was quite frequent in the first six weeks and tapered down thereafter. (There are no health visitors in America , everyone just sees the pediatrician.)
Each and every one of these professionals was well aware of my situation. It was discussed of course, and a close eye was kept on the baby, but there were no objections. I was also prescribed hydrocodone/acetaminophen for the post c-section pain, which I took for about 10 days and then went back to my regular medication. Of course with a newborn you can’t schedule BFing so I just fed on demand. I was extremely concerned about the baby of course, but he was perfect. He put on weight quickly and was happy and responsive. Unfortunately once I actually had to function and care for my family, I couldn’t manage my pain with meds that were safe for BFing, so in consultation with my doctors I decided to stop BFing and go back on my pre-pregnancy meds.
I’m telling you my experience because I thought you might find it interesting as a clinician and because there may be others reading who have been through similar, but despite my own experiences you are right that I shouldn’t have told OP it was fine. I’m not a doctor and even if I was I shouldn’t give out medical advice on an anonymous message board. If something ever happened to a baby because of what I said I would never forgive myself. So OP, please try to see a doctor, and don’t rely on my anecdotal experience. For all you know I could be making this all up. (I’m not, but still.)
I do think, though, that people who haven’t experienced severe unremitting pain can’t understand what it feels like. Some PPs told OP to take it but only if she really needs it — and I thought, DUH, did they think she was taking it for a mild passing ache?? It was clear from her OP that she is a caring mum, and no caring mum would consider popping pills during BFing if it wasn’t absolutely necessary. If you haven’t been in that position it’s hard to understand.
On a different note, OP if you are still reading, can I gently suggest that now might be a good time to consider giving up breastfeeding? You’ve done an amazing job getting this far and I’m frankly in awe, but the fact is that BFing is NOT easy on your back. I don’t judge extended BFing at all, but at this point the benefit to your child is very small, and it may very well be outweighed by your need to care for yourself. Running after a toddler is hard work! You need to make sure you are in the best possible position to meet your child’s needs and those needs change over time. I sympathize with your situation and wish you the best of luck.