Wednesday, August 22, 2007

FDA Warnings, Breast Feeding and Codeine

This is something I have been following for over a year now. There were several published reports of mothers taking codeine and their babies having problems.

First, let me explain how that could happen. Codeine is something called a pro-drug. That means Codeine essentially does nothing when taken. It only works by being converted to another substance in the body. In codeine's case, that substance is morphine. That's correct, codeine is really morphine.

So what happens in these new babies is due to the metabolizer status of their mothers. If dear old mom is an ultra-rapid metabolizer of codeine, then there will be higher than usual amounts of morphine in the blood, and in the breast milk.

Recently the FDA issued a warning regarding codeine consumption during breastfeeding.

"Codeine frequently is prescribed to women after giving birth for pain associated with episiotomies or caesarean sections, the Washington Post reports. In addition, codeine is a common ingredient in some forms of Tylenol and nonprescription cough syrups, the Los Angeles Times reports" from medical news today..."According to FDA, about 16% to 28% of people with North African, Ethiopian and Saudi dissent are ultra-rapid metabolizers. Labs usually charge between $500 and $1,000 for a Roche Diagnostics test that can determine how people metabolize several drugs, including codeine"

The Sherpa Says: So does this mean all nursing mothers should be genotyped for polymorphisms in their metabolizing enzymes? Not really. What should be done is 1. Less convoluted pain medications should be given 2. If mothers are taking this drug, then they need to monitor their child for signs of intoxication (slow breathing, sleepiness, failure to feed) 3. Watch the news, you are bound to find more out about personalized medicine there rather than from your MD.


NaturalNurture said...

This is another sad case of avoidable iaotrogenic harm.

If in the west we took notice of all the harm we do through our medical model of birth we would stop the silliness in an instant. That is the mothers would. The medical community on the other had may not. As they should already know already and are continuing the iatrogenisis - the number one killer in North America at 700 thousand a year.

The solution to morphine transmission in breast milk (the elixir of life) is not to stop breast feeding BUT TO STOP BUTCHERING WOMEN in the hospital under the guise of health.

30% of all women in North America give birth by c-section. Put very bluntly that is 3 our of 10 babies are yanked (causing more harm than birth) through an incision. The other 7 (rounded off) are yanked through a natural opening made larger after enduring all manner of other indignities; by episiotomy. All for ease of scheduling (golf games, surgery and staff alotment).

All in all 9 our of 10 mothers and babies in NA meet for their very precious first and most important time of life - DRUGGED!
This causes all manner of harm and obuscation of natural body processes that insure our survival and a tight dyad between baby and mom, for easy breast feeding and transition back to the world. In NA new mothers are in so much pain both phyiscally and mentally, post partum depression hits harder and paves the way to the pharmacy -the number two profit centre on the globe, only second to war!


AND start using our head and REASONING power to birth naturally.

Babies are BORN
thats for PIZZA.

Steve Murphy MD said...

Ummmm......I have mixed feelings on your comments. I feel that in high risk situations c-section is a very viable option. However, so is natural childbirth.....except the time that I had to code an newborn because she fell asleep and smothered her baby while breast there are exceptions to every idea out there.