Pain Medication

[admin-james]

This is why we changed the safety rating:
http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProvi ders/ucm054717.htm

In the vast majority of breastfeeding mothers, codeine taken in moderation and for a short duration is no problem. After a lot of deliberation, we felt that the situation described above was serious enough to warrant a change in our stance on codeine, even though it had only ever happened in a handful of patients.

Ultimately, the mother's and infant's responses to codeine should be individually determined. A thorough history of the mother's experience with medications can help predict how she and her infant will handle Tylenol #3. It may also be appropriate to begin the codeine while mother and baby are still in the hospital. At the very least, every mom d/c'd on opiates needs to be instructed what is normal sleeping and breathing behavior for neonates and what constitutes a red flag. Overt somnolence, apnea, poor feeding, or grey skin should be reported immediately.

Please call us at the InfantRisk Center if this has not completely answered your question.*(806)352-2519

-James Abbey, MD

[dasher]

Tylenol #3 #4

Due to the change of requiring triplicate perscription for vicodine, many OBs start to use Tylenol #3 in hospital and as D/C pain medicine. But Dr. Hale changed Tylenol #3 and #4 from L3 to L4 this year. What would your advise to best deal with this issue?

[admin-james]

Start with 800mg Ibuprofen every 6-8 hours. Use the hydrocodone only for breakthrough pain. Also, have a look at the first part of this article:

http://mommymeds.com/node/1001946

[NursingMom815]

What is best for baby when alleviating pain? I am not a fan of using medication unless absolutely necessary, however after surgery for an umbilical hernia, I am in need of something. I've been prescribed hydrocodone, but also have 800 mg Ibuprofen and OTC Tylenol. Which one is safest to take while breastfeeding?