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Tramadol and breastfeeding my 7 month old

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  • Tramadol and breastfeeding my 7 month old

    I am breastfeeding my 7 month old and have been prescribed Tramadol for chronic back pain (I had surgery 15 years ago) - It is immensely beneficial but I am concerned about my infant. There have been no short-term issues. He is feeding and sleeping just as he was prior to starting the medication. I am more concerned with long-term consequences. Neurological/Developmental issues, for example. I have read the current information you provide on Infantrisk about Tramadol but was curious about the specific percent that transfers to my milk and if there was any information on long-term consequences. My baby is a healthy 18 pounds and meeting all developmental milestones. I am prescribed 50-100mg every 6 hours but take at the most 100 mg/day, split into two doses.

  • #2
    Additional question

    I am also curious why Tramadol used to be an L2 and is now L3. I believe that is what I have noted recently but please correct me if I am wrong.

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    • #3
      Hi, thanks for your post.

      Tramadol is not indicated for use in children/babies, so information on toxic or developmental effects is limited. The studies that have been done on breastfeeding have echoed your own experience: no short-term adverse events. Specific studies of long-term exposure have not been done. However, I can see nothing about this drug that suggests the potential to alter neurological development. I'll keep an eye out for new information that may be published in the future.

      About 1-3% of your tramadol dose reaches the baby via the breastmilk.

      The change in tramadol's safety rating followed from an FDA warning about codeine (see link at the bottom). Tramadol uses a related metabolic pathway and we felt that there was the potential for a similar situation with this drug. I want to emphasize, however, that the codeine situation is quite rare and that tramadol carries an inherently lower risk of respiratory depression in the first place. If you have already successfully breastfed on this drug without noticing a change in your baby's wakefulness, then you are probably not one of the women discussed in the FDA's statement.

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

      -James Abbey, MD

      http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProvi ders/ucm054717.htm

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