The nursing infants may be at increased risk of morphine overdose if their mothers are taking codeine, FDA said. The federal agency warns the mothers to watch their infants for increased sleepiness or other signs of overdose.
FDA's warning is prompted by a 2006 report in a medical journal about the death of a 13-day old breastfed infant who died from morphine overdose. The morphine levels in the mother's milk were abnormally high after taking small doses of codeine to treat episiotomy pain.
A genetic test showed that the mother was an ultra-rapid metabolizer of codeine, meaning woman's body converted the codeine to morphine more rapidly and completely than in other people.
Science Daily quotes an official from FDA as saying, "Our best advice to physicians prescribing codeine-containing products to nursing mothers is to prescribe the lowest dose needed for the shortest amount of time."
Once the codeine enters the mother's body, some part of the drug is metabolized to morphine. However, in some people, the metabolization of codeine is much faster and more completely than others, resulting in higher and unsafe levels of codeine in the blood and breast milk.
Codeine is commonly found in several prescription pain drugs and in some over-the-counter cough syrups and new mothers who consume this drug in any form should immediately consult a doctor if they find themselves or their baby extremely sleepy, the FDA alert warned.
