Opioid use in the breastfeeding mother is a topic that carries a degree of controversy, with some experts reporting that short-term maternal use is usually safe [ 1 ] and others citing clear risks in ultrarapid metabolizers, in particular [ 2 ]. The decision to prescribe opioids in new mothers is fraught with unique considerations and caution against risks, given that the medications may directly impact the neonate or infant. The authors concluded that while oxycodone does accumulate in breast milk, the benefits of maternal comfort and successful initiation of breastfeeding appear to outweigh the minimal risks to neonates, though they called for careful monitoring for signs of opioid exposure, such as sedation, poor attachment, gastrointestinal symptoms, and respiratory depression [ 3 ]. In earlier publications, authors recommended against oxycodone use in breast feeding due to lack of studies on safety considerations such as excretion and repeated dosing [ 4 , 5 ]. Opioid therapy for chronic pain falls squarely under this umbrella as repeated dosing is a certainty.
Breast-feeding and medications: What's safe? - Mayo Clinic
Yes, nearly all pain and fever-relieving medications are safe. Acetaminophen Tylenol and other brands is the safest medication for relieving pain and fever, since only a tiny amount enters the breastmilk. Ibuprofen is also considered safe. Narcotic analgesics codeine, Demerol, and morphine are safe to take while breastfeeding, yet they should be used with caution. Of the three, morphine has been shown to have the least effect on infants. Breathing difficulties have been reported in newborns whose mothers received codeine-containing analgesics after delivery, and some babies may become sleepy and less eager to nurse following Demerol injections in their mothers.