Stupid question about drugs

[Commutinghell]

I know I'm just being daft and there will be a perfectly good reason for this, but I just can't work it out. We're told not to drink alcohol or take various prescription drugs when breast feeding. Yet in labour, they administer diamorphine, which is basically heroin. And then still encourage breast feeding straight after birth. How does that add up? Doesn't that mean that the baby's first few feeds contain heroin? Am I being stupid?!

With my very limited understanding, no you are not being stupid. In fact iirc it also affect tge baby and can make them sleepy when they come out.

But probably best to wait for someone with more knowledge to come along.

It is cleared from the body a little faster than you are imagining, and that is before milk has come in (so not much volume of milk in the first feed) so in reality anything the baby gets should be minimal, and midwives do try to avoid giving it if they think that the baby will be born within a few hours.

Thanks both!

The main problem that regular heroin use causes for babies is that they are born addicted. I nurse them and it's awful to watch - they scream constantly, vomit, tremor and are extremely hard to settle. A one off dose in labour will not cause the same result. If given late in labour the baby may be born very sleepy, or rarely, fail to start breathing effectively, in which case they are given an antidote that works instantly.

I was given pethidine in labour (it was lurvely, really worked and relaxed me to the point where I fell asleep on the floor and refused to get up ) and dd was far from sleepy! I ended up with a cs so also had morphine which didn't affect dd when I fed her but made me itch unbearably all over, I won't be having it this time!

I had pethedine and hated it, it made me sick but worst of all it left me with very little memory of the birth, just a druggie fog! I had no comprehension of what was going on and would have agreed to my leg being amputated if asked. On the plus side dh said I was telling some cracking jokes and witty one liners. I wish I'd had an epidural at least that way I would have been aware. On this one I'm staying away from pethedine at all costs.

That's all really interesting, thanks for sharing your experiences. You've certainly put me off having any sort of drugs if I can help it! I was particularly interested to hear about the babies born addicted to heroin. I had heard similar things previously and I've seen adults withdrawing, it's so unpleasant. If there was any danger of my baby going through anything like that for the sake of my pain relief there's no way I'd go near it.

Seriously, your baby is not going to be born addicted to heroin just because you have pethadine in labour. I just googled it, and there is a LOT of misinformation on the internet along the lines of

pethadine=heroin= your baby will be a smack head unless you have a drug free birth

Now, some obstetricians, (including mine) think pethadine is quite outdated/ causes delivery problems (as can make the baby and you sleepy, can cause nausea etc) and prefer to go G&A and then to epidural BUT that is a completely different issue to the addiction one, which is not going to be a problem.

If you've had morphine before (eg post-operatively etc) and reacted badly to it, then tell your midwife as then you probably want to avoid pethadine. This was my situation.

Btw, it's fine to drink alcohol in moderation when you're bf. Just dont get drunk.

HTH

Commuting I think you have misread my post...the problems I describe occur from regular drug use - certainly not a one off dose in labour! I wouldn't have had it myself if I had those concerns!

And as I said, I was fine with pethidine, but I did react badly to morphine, they are different and a bad reaction to one of them doesn't mean a bad reaction to both.

Have whatever pain relief you need at the time, it wouldn't be offered if it wasn't safe. I hate the whole pressure to do it "naturally" - labour hurts!

I hope the following helps.

Diamorphine is a strong pain killer which is converted to Morphine by the body. (It is naturally occuring in opium poppies)

Pethadine is a slightly different drug. It is a man made version of morphine and has different side effects.

The dose you get of either of these in labour will hang around in your system for 3-4 hours. If given immediately before delivery your baby may be immediately sleepy/ less likely to feed but it will wear off quickly.

Having either of these drugs as a pain killer in child birth will not make your baby have a withdrawal reaction. This is only seen in babies whose mothers take drugs like morphine on a daily basis throughout their pregnancy.

Different people will experience the benefits/side effects of the drugs in different ways hence some people like them and others don't. Unfortunately the only way to find out if you get on with the drug is to have some.

Please don't worry about having pain killers in labour if you need them.