To ask about co codamol when breast feeding?

[Witsendmummy]

I just just taken one 30mg/500mg co codamol and just didn't think to check if it's safe. I'm breast feeding. I'm finding contradicting info on the internet. Are they ok, if not what should I do?!

If unsure, go with no.

I was given them after I have birth but I was bottle feeding due to some nasty meds I was on. The nurse asked me before hand because she wasn't going to let me take them if I was breast feeding. I'm not sure but they wouldn't allow breast feeding mums to take them in the hospital I was in

This is a useful website for medications whilst breastfeeding.

www.e-lactancia.org

Here's the Breastfeeding Network factsheet on analgesics. BfN If you have any concerns, contact a Health Care Professional.

If you've only taken 1, it's unlikely to cause a problem but for future, it's not recommended.

Not a doctor. That's a prescription dose so assume your GP prescribed and knows you're bf?

I was prescribed 60/1g whilst breastfeeding, although I tried to time doses and avoided taking the full dose. If I recall correctly, impact on child can depend on how well the mother metabolises the drug. Hopefully a pharmacist will be along to reassure you. I think the main issues are that it could slow breathing and potentially sedate the baby so they couldn't get themselves out of trouble, so keep an eye on them, make sure they are sleeping in a safe position of course.

Don't panic, basically.

There is now evidence that it’s not safe for BF mothers but many doctors say it’s fine.

Its very tricky. I avoided and stick with Diclofenac - can you see the doctor for better advice?

That's 60mg/1g btw, so double your dose.

From experience, I had a c section and was given pure codene 30mg as pain relief whilst still in the hospital. I was BF and obviously they knew this.
Double check with your HV or even give your out of hours a call to double check

it's contra indicated as some babies react badly and can stop breathing.
I would only take it under close supervision.

Lactmed is good for info on medications. Here (should be) a link for codeine: toxnet.nlm.nih.gov/cgi-bin/sis/search2/f?./temp/~svbUtd:1:1@

Mostly seems to mention very young babies and seems to cause drowsiness, but probably in greater quantities than you took. So you're probably fine, but best not to take any more :)

And see your GP to see if they can prescribe you something else if you're concerned. There are various types of pain relievers.

I find this website really useful, I think there's a helpline too.
www.breastfeedingnetwork.org.uk/drugs-factsheets/

I was given codiene after my c section so and I was breast feeding. I had the 30mg tablets and had two at a time I was also prescribed paracetamol just not the combined ones. I’m allergic to the anti inflammatory painkillers, so couldn’t really have any others. They were prescribed by the hospital and I had no issues breast feeding.

I was prescribed it before I was feeding. I can't believe I was stupid enough to take it before checking. I have some expressed milk I can use for tonight but I can't find any info on when it'll be safe to feed again. I'm so annoyed with myself how stupid!!

I'm not a medical professional so I'm in no way qualified - I've been told these kind of drugs can take around 16 hours or less to leave your system. If you can get by tonight, drink plenty of fluids to help metabolize it and then continue in the morning I should imagine you will be fine. Call a professional if you are concerned!

In 2013 after my c section I was given that while breastfeeding newborn. In 2016 after c section they gave something different as the rules had changed due to research showing it makes babies sleepy and can effect nursing and therefore weight gain.

I'm now nursing a 18 month old and been told they don't advice as a rule but will prescribe a nursing mother if needing a stringer pain relief.

For peace of mind I would phone for advice but I think one dose will likely be ok but will depend on age of infant etc

I'll use my expressed stash tonight and pump and dump in the morning then feed. Thanks all definitely learned my lesson!!

Don't be down on yourself - you're presumably sleep-deprived AND in pain.

No it isn’t safe. I had this discussion with a doctor the other week. I had been given cocodomol with my last child for after pains but apparently it’s a big no-no now (so I got the bum pill instead!) something about there being a risk of morphine poisoning because codeine can concentrate in the breast milk. Something like that. However apparently it’s rare and not all women are capable of doing it anyway (something about some women being “ultra rapid metabolisers”).

So anyways it’s rare, but it’s a no-go now

Codine metabolises fairly quickly I think for the dose taken it will be safe to give it the overnight period and resume in the morning. Drinking plenty of fluids etc. If you want to be super over cautious you can monitor baby tomorrow to make sure there's nothing out of the ordinary but you will be fine! We all make mistakes were not judging don't worry! If your unsure refer to those websites or call a local pharmacy and they should be able to give you some good advice. I've called many times and they can help with any interactions

I was given dihydracodeine after my emcs a few months ago and the hospital were aware that I was breastfeeding...

Franticallypeaceful has the right idea. Codeine is metabolized to morphine which is what actually provides the painkilling effect.

Some people are ultra rapid metabolisers which causes them to convert codeine to morphine really quickly. These high amounts of morphine can pass into the breast milk and sedate the baby/ cause respiratory depression etc.

You can take codeine when breastfeeding but keep a close eye on baby. (From a nearly qualified pharmacist)

I was given it in hospital after giving birth and was breast feeding. They kept giving it to me for days so it wasn't just right at the outset. I had to tell them to stop.giving it to me as I wasn't in pain!

Codeine is partially metabolised to morphine in the liver. About 10% of people don’t have the enzyme for this process (CYP2D6 if you’re interested) and so codeine is ineffective for them. Another 10% (the “ultra rapid metaboliser” group) have a much more effective version and can convert a low dose of codeine into a larger amount of morphine than expected. The remaining 80% metabolise it relatively consistently such that 30mg oral codeine is equivalent to about 3mg oral morphine.

There have been deaths (rare but well publicised) in the ultra rapid metaboliser group both in patients themselves and in breast fed babies of patients who have had codeine for post operative pain relief. They have occurred after more than one dose over a period of time and were due to opioid toxicity. As we don’t know (usually) which group any one individual is in, it’s safer to put codeine into the “unsafe for breastfeeding” group of medicines.

It has a half life of around 3h - so after 12h, one sixteenth of the dose is in your system. You’re safe to feed whenever you like after one dose (bear in mind I can give 10mg of IV morphine to a breastfeeding patient as part of analgesia for surgery and it’s safe to feed as soon as you’re awake enough). It’s repeated doses and cumulative effect you need to be careful with.

Obviously with a tiny ebf newborn the risk is different than with a 9 month old who is also getting nutrition from food. When in doubt, wait 4-5 half lives (so 12-15h) after which minimal drug is in your system.

(Obstetric anaesthetist)

I did this too. Because when I was pregnant 15 years ago, it was fine.

Info now is some babies can metabolize codeine faster than others and it's no longer recommended.

Having said that, I was in agony (tmj) and I took it in desperation. Nothing happened to DS2, all was fine.

However, hopefully you can chat to gp to get something for the pain that's safe x