A Case of Toxic Breast-feeding?. Issue 1 (January 2019)

• Record Type: Journal Article
• Authors: Schultz, Megan L.; Kostic, Mark; Kharasch, Sigmund
• Is Part Of: Pediatric emergency care. Volume 35:Issue 1(2019)
• Publication Date: 2019-01
• Subjects: breast-feeding -- hydromorphone -- opioid toxicity -- urine toxicology screening; Pediatric emergencies -- Periodicals; 618.92002505
• DOI: 10.1097/PEC.0000000000001009
• Languages: English
• ISSNs: 0749-5161

Abstract

Abstract : Abstract: Opiates are frequently prescribed postpartum for pain relief after cesarean delivery, episiotomies, and headaches. It is estimated that greater than 30% of breast-feeding mothers in the United States are prescribed opiates for pain relief associated with childbirth. Many opiates are readily transferred to human milk, although life-threatening events are rare. We report a 6-day-old breast-feeding infant whose mother was taking hydromorphone for pain relief from a cesarean delivery and whose clinical course was suggestive of opiate toxicity. This case emphasizes the importance of thorough medication history taking in postpartum breast-feeding mothers whose infants may present with symptoms of opiate toxicity. Semisynthetic opiates are frequently not detected on emergency department urine toxicology screens. The pertinent literature is reviewed.