High Dose Fentanyl

[mmilla]

Fentanyl

Dear Linda,
It is still quite high since she is getting it around the clock.
Thanks,
Maria Milla, MD
InfantRisk Center

[linda]

Hi Maria
I'm very sorry, the bolus dose was written in error. It is actually 30mcg. Would you please review this question.
Thanks,
Linda

[mmilla]

High Dose Fentanyl

Dear Linda,
This dose (1 gram/day plus bolus doses) is risky and can heavily sedate the baby putting him or her at risk for apnea. We recommend that this baby be put on donor milk (if possible) or on formula. The mom's milk should be pumped and discarded in order to maintain her supply so she can resume breastfeeding once she is off the drip. I hope this is helpful.
Maria Milla, MD
InfantRisk Center

[linda]

A mother would like to breastfeed her 4 week old baby. The baby was term with no problems. The mother is in intensive care with a condition which is unrelated to the birth, and is on 50mcg of Fentanyl per hour. She also has the occasional bolus of 30mg of Fentanyl. She has been on this regime for 2 days and it is to continue for a unspecified length of time. I have read of Fentanyl's low oral bioavailability on your website, however, the doctors in ICU are concerned about these high doses affecting the baby.

Thanks very much,
Linda