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Editorial

Is maternal opioid use hazardous to breast-fed infants?

&
Pages 1-14 | Received 01 Jul 2011, Accepted 21 Oct 2011, Published online: 13 Dec 2011

References

  • American Academy of Pediatrics, Work Group on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics 1997; 100: 1035–1039.
  • Ito S, Lee A. Drug excretion into breast milk – overview. Adv Drug Deliv Rev 2003; 55:617–627.
  • American Academy of Pediatrics, Committee on Drugs. The transfer of drugs and other chemicals into human milk. Pediatrics 2001; 108:776–789.
  • Ryan AS, Wenjun Z, Acosta A. Breastfeeding continues to increase into the new millennium. Pediatrics 2002; 110:1103–1109.
  • Wight NE. Maternal medications and breastfeeding. Cal J Health-Sys Pharm 2007; 19:5–17.
  • Bohnert ASB, Valenstein M, Bair MJ, Ganoczy D, McCarthy JF, Ilgen MA, Blow FC. Association between opioid prescribing patterns and opioid overdose-related deaths. J Am Med Assoc 2011; 305:1315–21.
  • Kuehn BM. Safety plan for opioids meets resistance: opioid-linked deaths continue to soar. J Am Med Assoc 2010; 303:495–497.
  • Kuehn BM. Opioid prescriptions soar: increase in legitimate use as well as abuse. J Am Med Assoc 2007; 297:249–251.
  • Volkow ND, McLellan TA, Cotto JH, Karithanom M, Weiss SR. Characteristics of opioid prescriptions in 2009. J Am Med Assoc 2011; 305:1299–1301.
  • The Use of Medicines in the United States: review of 2010. IMS Institute for Healthcare Informatics. http://www.imshealth.com/deployedfiles/imshealth/Global/Content/IMS%20Institute/Static%20File/IHII_UseOfMed_report.pdf. Accessed 23 April 2011.
  • Matheson I. Drugs taken by mothers in the puerperium. Br Med J (Clin Res Ed) 1985; 290:1588–1589.
  • Passmore CM, McElnay JC, D’Arcy PF. Drugs taken by mothers in the puerperium: inpatient survey in Northern Ireland. Br Med J 1984; 289:1593–1596.
  • Collaborative group on drug use in pregnancy. Medication during pregnancy: an intercontinental cooperative study. Int J Gynecol Obstet 1992; 39:185–196.
  • Freed GL, Clark SJ, Sorenson J, Lohr JA, Cefalo R, Curtis P. National assessment of physicians’ breast-feeding knowledge, attitudes, training, and experience. J Am Med Assoc 1995; 273:472–476.
  • Ito S. Drug therapy for breast-feeding women. New Engl J Med 2000; 343:118–126.
  • Anderson PO, Pochop SL, Manoguerra AS. Adverse drug reactions in breastfed infants: less than imagined. Clin Pediatr 2003; 42:325–340.
  • Smith JW. Codeine-induced bradycardia in a breast-fed infant [abstract]. Clin Res 1982; 30:259a.
  • Davis JM, Bhutani VK. Neonatal apnea and maternal codeine use [abstract]. Pediatr Res 1985; 19(4 pt 2):170a.
  • Naumburg EG, Meny RG. Breast milk opioids and neonatal apnea. Am J Dis Child 1988; 142:11–12.
  • Ito S, Koren G, Einarson TR. Maternal non-compliance with antibiotics during breastfeeding. Ann Pharmacother 1993; 27:40–42.
  • Madadi P, Shirazi F, Walter FG, Koren G. Establishing causality of CNS depression in breastfed infants following maternal codeine use. Pediatr Drugs 2008; 10:399–404.
  • Koren G, Cairns J, Chitayat G, Leeder SJ. Pharmacogenetics of morphine poisoning in a breast fed neonate of a codeine-prescribed mother. Lancet 2006; 368:704.
  • Levine B, Moore KA, Aronica-Pollak P, Fowler DF. Oxycodone intoxication in an infant: accidental or intentional exposures? J Forensic Sci 2004; 49:1358–1360.
  • Bodley V, Powers D. Long-term treatment of a breastfeeding mother with fluconazole-resolved nipple pain caused by yeast: a case study. J Hum Lact 1997; 13:307–311.
  • Meyer D, Tobias JD. Adverse effects following the inadvertent administration of opioids to infants and children. Clin Pediatr 2005; 44:499–503.
  • West PL, McKeown NJ, Hendrickson RG. Methadone overdose in a breast-feeding toddler. Clin Toxicol 2009; 47:721.
  • Smialek JE, Monforte JR, Aronow R, Spitz WU. Methadone deaths in children. A continuing problem. J Am Med Assoc 1977; 238:2516–2517.
  • Lawrence RA, Lawrence RM. Breastfeeding. A Guide for the Medical Profession. 7th ed. St. Louis, MI: Elsevier Mosby; 2011: 40–61, 98–116, 860–866.
  • Berlin CM, Briggs GC. Drugs and chemicals in human milk. Sem Fet Neonat Med 2005; 10:149–159.
  • Fleisheker JC, McNamara PJ. In vivo evaluation in the lactating rabbit of a model for xenobiotic distribution into breast milk. J Pharmacol Exp Ther 1988; 244:919–924.
  • Spigset O, Hagg S. Analgesics and breast-feeding. Safety considerations. Paediatr Drugs 2000; 2:223–238.
  • Ferris AM, Jensen RG. Lipids in human milk: a review. J Pediatr Gastroenterol Nutr 1984; 3:108–122.
  • Prentice A, Prentice AM, Lamb WH. Mastitis in rural Gambian mothers and the protection of the breast by milk antimicrobial factors. Trans R Soc Trop Med Hyg 1985; 79:90–95.
  • Anderson PO. Drug use during breast-feeding. Clin Pharm 1991; 10:594–624.
  • Smith HS. Opioid metabolism. Mayo Clin Proc 2009; 84:613–624.
  • Kearns GL, Abdel-Rahman SM, Alander SW, Blowey DL, Leeder JS, Kauffman RE. Developmental pharmacology – drug disposition, action, and therapy in infants and children. N Engl J Med 2003; 349:1157–1167.
  • Willman S, Edginton AN, Coboeken K, Ahr G, Lippert J. Risk to the breast-fed neonate from codeine treatment to the mother: a quantitative mechanistic modeling study. Clin Pharmacol Ther 2009; 86:634–643.
  • Lacroix D, Sonnier M, Moncion A, Cheron G, Cresteil T. Expression of CYP3A in the human liver—evidence that the shift between CYP3A7 and CYP3A4 occurs immediately after birth. Eur J Biochem 1997; 247:625–634.
  • Sonnier M, Cresteil T. Delayed ontogenesis of CYP1A2 in the human liver. Eur J Biochem 1998; 251:893–898.
  • Treluyer JM, Jacqz-Aigrain E, Alvarez F, Cresteil T. Expression of CYP2D6 in developing human liver. Eur J Biochem 1991; 202: 583–588.
  • Vieira I, Sonnier M, Cresteil T. Developmental expression of CYP2E1 in the human liver. Hypermethylation control of gene expression during the neonatal period. Eur J Biochem 1996; 238:476–483.
  • Blake MJ, Gaedigk A, Pearce RE, Bomgaars LR, Christensen ML, Stowe C, . Ontogeny of dextromethorphan O- and N-demethylation in the first year of life. Clin Pharmacol Ther 2007; 81(4):510–516.
  • McRorie TI, Lynn AM, Nespeca MK, Opheim KE, Slattery JT. The maturation of morphine clearance and metabolism. Am J Dis Child 1992; 146:972–976.
  • Arant BS Jr. Developmental patterns of renal functional maturation compared in the human neonate. J Pediatr 1978; 92:705–712.
  • Leake RD, Trygstad CW. Glomerular filtration rate during the period of adaptation to extrauterine life. Pediatr Res 1977; 11:959–962.
  • Choonara I, Lawrence A, Michalkiewicz A, Bowha A, Ratcliffe J. Morphine metabolism in neonates and infants. Br J Clin Pharmacol 1992; 34:434–437.
  • Coller JK, Christrup LL, Somogyi AA. Role of active metabolites in the use of opioids. Eur J Clin Pharmacol 2009; 65:121–139.
  • Lindemalm S, Nydert P, Svensson JO, Stahle L, Sarman I. Transfer of buprenorphine into breast milk and calculation of infant drug dose. J Human Lact 2009; 25:199–205.
  • Kraft WK, Gibson E, Dysart K, Damle VS, Larusso JL, Greenspan JS, . Sublingual buprenorphine for treatment of neonatal abstinence syndrome: a randomized trial. Pediatrics 2008; 122:e601–e607.
  • Concheiro M, Jones HE, Johnson RE, Choo R, Shakleya DM, Huestis MA. Maternal buprenorphine dose, placenta buprenorphine, and metabolite concentrations and neonatal outcomes. Ther Drug Monit 2010; 32:206–215.
  • Dewey KG, Finley DA, Lonnerdal B. Breast milk volume and composition during late lactation (7–20 months). J Pediatr Gastroenterol Nutr 1984; 3:713–720.
  • Mandel D, Lubetzky R, Dollberg S, Barak S, Mimouni FB. Fat and energy contents of expressed human breast milk in prolonged lactation. Pediatrics 2005; 116:e432–e435.
  • Larnkjaer A, Schack-Nielsen L, Michaelsen KF. Fat content in human milk according to duration and lactation. Pediatrics 2006; 117:988–989.
  • AAP publications reaffirmed and retired. Pediatrics 2010; 126:404.
  • Bateman DN, Eddleston M, Sandilands E. Codeine and breastfeeding. Lancet 2008; 372(9639):625.
  • Darbari DS, van Schaik RH, Capparelli EV, Rana S, McCarter R, van den Anker J. UGT2B7 promoter variant −840G > A contributes to the variability in hepatic clearance of morphine in patients with sickle cell disease. Am J Hematol 2008; 83:200–202.
  • Duguay Y, Baar C, Skorpen F, Guillemette C. A novel functional polymorphism in the uridine diphosphate-glucuronosyltransferase 2B7 promoter with significant impact on promoter activity. Clin Pharmacol Ther 2004; 75:223–233.
  • Green MD, King CD, Mojarrabi B, Mackenzie PI, Tephly TR. Glucuronidation of amines and other xenobiotics catalyzed by expressed human UDP-glucuronosyltransferease 1A3. Drug Metab Dispos 1998; 26:507–512.
  • Penson RT, Joel SP, Clark S, Gloyne A, Slevin ML. Limited phase I study of morphine-3-glucuronide. J Pharm Sci 2001; 90:1810–1816.
  • Smith MT. Neurotoxicity effects of morphine and hydromorphone: evidence implicating the 3-glucuronide metabolites. Clin Exp Pharmacol Physiol 2000; 27:524–528.
  • Robieux I, Koren G, Vandenbergh H, Schneiderman J. Morphine excretion in breast milk and resultant exposure of a nursing infant. J Toxicol Clin Toxicol 1990; 28:365–370.
  • Feilberg VL, Rosenborg D, Broen Christensen C, Mogensen JV. Excretion of morphine in human breast milk. Acta Anaesth Scand 1989; 33:426–428.
  • Wittels B, Scott DT, Sinatra RS. Exogenous opioids in human breast milk and acute neonatal neurobehavior: a preliminary study. Anesthesiology 1990; 73:864–869.
  • Oberlander TF, Robeson P, Ward V, Huckin RS, Kamani A, Harpur A, McDonald W. Prenatal and breast milk morphine exposure following maternal intrathecal morphine treatment. J Human Lact 2000; 16:137–142.
  • Baka NE, Bayoumeu F, Boutroy MJ, Laxenaire MC. Colostrum morphine concentrations during postcesarean intravenous patient-controlled analgesia. Anesth Analg 2002; 94:184–187.
  • Lemberg KK, Kontinen VK, Siiskonen AO, Vijakka KM, Yli-Kauhaluoma JT, Korpi ER, Kalso EA. Antinociception by spinal and systemic oxycodone: why does the route make a difference? Anesthesiology 2006; 105:801–812.
  • Pelkonen O, Turpeinen M, Hakkola J, Honkakoski P, Hukkanen J, Raunio H. Inhibition and induction of human cytochrome P450 enzymes: current status. Arch Toxicol 2008; 82:667–715.
  • Samer CF, Daali Y, Wagner M, Hopfgartner G, Eap CB, Rebsamen MC, . Genetic polymorphisms and drug interactions modulating CYP2D6 and CYP3A activities have a major effect on oxycodone analgesic efficacy and safety. Br J Pharmacol 2010; 160:919–930.
  • Foster A, Mobley E, Wang Z. Complicated pain management in a CYP450 2D6 poor metabolizer. Pain Pract 2007; 7:352–356.
  • Marx CM, Pucino F, Carlson JD, Driscoll JW, Ruddock V. Oxycodone excretion in human milk in the puerperium [abstract]. Drug Intell Clin Pharm 1986; 20:474.
  • Seaton S, Reeves M, McLean S. Oxycodone as a component of multimodal analgesia for lactating mothers after Caesarean section: relationships between maternal plasma, breast milk and neonatal plasma levels. Aust N Z J Obstet Gynaecol 2007; 47:181–185.
  • Lam J, Kelly L, Ciszkowski C, LandsmeerMLA, NautaM, CarletonBC, Central nervous system depression of neonates breastfed by mothers receiving oxycodone for postpartum analgesia. J Pediatr 2011; DOI 10.1016/j.jpeds.2011.06.050 (in press).
  • Chen ZR, Irvine RJ, Somogyi AA, Bochner F. Mu receptor binding of some commonly used opioids and their metabolites. Life Sci 1991; 48:2165–2171.
  • Otton SV, Schadel M, Cheung SW, Kaplan HL, Busto UE, Sellers EM. CYP2D6 phenotype determines the metabolic conversion of hydrocodone to hydromorphone. Clin Pharmacol Ther 1993; 54: 463–472.
  • Anderson PO, Sauberan J, Lane JR, Rossi SS. Hydrocodone excretion into breastmilk: the first two reported cases. Breastfeed Med 2007; 2:10–14.
  • Sauberan JB, Anderson PO, Lane JR, Rafie S, Nguyen N, Rossi SS, Stellwagen LM. Breast milk hydrocodone and hydromorphone levels in mothers using hydrocodone for postpartum pain. Obstet Gynecol 2011; 117:611–617.
  • Edwards JE, Rudy AC, Wermeling DP, Desai N, McNamara PJ. Hydromorphone transfer into breast milk after intranasal administration. Pharmacotherapy 2003; 23:153–158.
  • Wang JS, DeVane CL. Involvement of CYP3A4, CYP2C8, and CYP2D6 in the metabolism of ®- and (S)-methadone in vitro. Drug Metab Disp 2003; 31:742–747.
  • Chabra S, Bull J. Methadone. Am J Hosp Pall Med 2008; 25:146–150.
  • Ferrari A, Rosario Coccia CP, Bertolini A, Sternieri E. Methadone-metabolism, pharmacokinetics and interactions. Pharmacol Res 2004; 50:551–559.
  • Begg EJ, Malpas TJ, Hackett LP, Ilett KF. Distribution of R- and S-methadone into human milk during multiple, medium to high oral dosing. Br J Clin Pharmacol 2001; 52:681–685.
  • McCarthy JJ, Posey BL. Methadone levels in human milk. J Hum Lact 2000; 16:115–120.
  • Kreek MJ, Schecter A, Gutjahr CL, Bowen D, Field F, Queenan J, Merkatz I. Analyses of methadone and other drugs in maternal and neonatal body fluids: use in evaluation of symptoms in a neonate of mother. Am J Drug Alcohol Abuse 1974; 1:409–419.
  • Blinick G, Inturrissi CE, Jerez E, Wallach RC. Methadone assays in pregnant women and progeny. Am J Obstet Gynecol 1975; 121: 617–621.
  • Pond SM, Kreek MJ, Tong TG, Raghunath J, Benowitz NL. Altered methadone pharmacokinetics in methadone-maintained pregnant women. J Pharmacol Exp Ther 1985; 233:1–6.
  • Wojnar-Horton RE, Kristensen JH, Yapp P, Ilett KF, Dusci LJ, Hackett LP. Methadone distribution and excretion into breast milk of clients in a methadone maintenance programme. Br J Clin Pharmacol 1997; 44:543–547.
  • Jansson LM, Choo RE, Harrow C, Velez M, Schroeder JR, Lowe R, Huestis MA. Concentrations of methadone in breast milk and plasma in the immediate perinatal period. J Hum Lact 2007; 23:184–190.
  • Jansson LM, Choo R, Velez ML, Lowe R, Huestis MA. Methadone maintenance and breastfeeding in the neonatal period. Pediatrics 2008; 121:106–114.
  • Madadi P, Ross CJD, Hayden MR, Carleton BC, Gaedigk A, Leeder JS, Koren G. Pharmacogenetics of neonatal opioid toxicity following maternal use of codeine during breastfeeding: a case-control study. Clin Pharmacol Ther 2009; 85:31–35.
  • Sistonen J, Sajantilla A, Lao O, Corander J, Barbujani G, Fuselli S. CYP2D6 worldwide genetic variation shows high frequency of altered activity variants and no continental structure. Pharmacogenet Genomics 2007; 17:93–101.
  • Vree TB, Verwey-van Wissen CP. Pharmacokinetics and metabolism of codeine in humans. Biopharm Drug Dispos 1992; 13:445–460.
  • Kwit NT, Hatcher RA. Excretion of drugs in milk. Am J Dis Child 1935; 49:900–904.
  • Findlay JW, DeAngelis RL, Welch RM, Findlay JM. Analgesic drugs in breast milk and plasma. Clin Pharmacol Ther 1981; 29:625–633.
  • Meny RG, Naumburg EG, Alger LS, Vrill-Miller JL, Brown S. Codeine and the breastfed neonate. J Hum Lact 1994; 9:237–240.
  • Ito S, Blajchman A, Stepheson M, Eliopoulos C, Koren G. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol 1993; 168:1393–1399.
  • http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm118113.htm. Accessed 13 September 2011.
  • http://www.hc-sc.gc.ca/ahc-asc/media/advisories-avis/_2008/2008_164-eng.php. Accessed 13 September 2011.
  • Peiker G, Muller B, Ihn W, Noschel H. Excretion of pethidine in mother's milk. Zentralbl Gynakol 1980; 102:537–541.
  • Quinn PG, Kuhner BR, Kaine CJ, Syracuse CD. Measurement of meperidine and normpeperidine in human breast milk by selected ion monitoring. Biomed Environ Mass Spectrom 1986; 13:133–135.
  • Borgatta L, Jenny RW, Gruss L, Ong C, Barad D. Clinical significance of methohexital, meperidine, and diazepam in breast milk. J Clin Pharmacol 1997; 37:186–192.
  • Wittels B, Glosten B, Faure EA, Moawad AH, Ismail M, Hibbard J, . Postcesarean analgesia with both epidural morphine and intravenous patient-controlled analgesia: neurobehavioral outcomes among nursing neonates. Anesth Analg 1997; 85:600–606.
  • Fliegert F, Kurth B, Gohler K. The effects of tramadol on static and dynamic pupillometry in health subjects—the relationship between pharmacodynamics, pharmacokinetics, and CYP2D6 metaboliser status. Eur J Pharmacol 2005; 61:257–266.
  • Poulsen L, Arendt-Nielsen L, Vrosen K, Sindrup SH. The hypoalgesic effect of tramadol in relation to CYP2D6. Clin Pharmacol Ther 1996; 60:636–644.
  • Ilett KF, Paech MJ, Page-Sharp M, Sy SK, Kristensen JH, Goy R, . Use of a sparse sampling study design to assess transfer of tramadol and its O-desmethyl metabolite into transitional breast milk. Br J Clin Pharmacol 2008; 65:661–666.
  • Ohtani M, Kotaki H, Sawada Y, Iga T. Comparative analysis of buprenorphine and norbuprenorphine-induced analgesic effects based on pharmacokinetic-pharmacodynamic modeling. J Pharmacol Exp Ther 1995; 272:505–510.
  • Grimm D, Pauly E, Poschl J, Linderkamp O, Skopp G. Buprenorphine and norbuprenorphine concentrations in human breast milk samples determined by liquid chromatography-tandem mass specometry. Ther Drug Monit 2005; 27:526–530.
  • Marquet P, Chevrel J, Lavignasse P, Merle L, Lachatre G. Buprenorpine withdrawal syndrome in a newborn. Clin Pharmacol Ther 1997; 62:569–571.
  • Madadi P, Moretti M, Djokanovic N, Bozzo P, Nulman I, Ito S, Koren G. Guidelines for maternal codeine use during breastfeeding. Can Fam Phys 2009; 55:1077–1078.
  • Berlin CM, Paul IM, Vesell ES. Safety issues of maternal drug therapy during breastfeeding. Clin Pharmacol Ther 2009; 85:20–22.
  • Anderson PO. Drug use during breast-feeding. Clin Pharm 1991; 10:594–624.
  • Blumenfeld YJ, Reynolds-May MF, Altman RB, El-Sayed YY. Maternal-fetal and neonatal pharmacogenomics: a review of the current literature. J Perinatol 2010; 30:571–579.
  • Osborne R, Thompson P, Joel S, Trew D, Patel N, Slevin M. The analgesic activity of morphine-6-glucuronide. Br J Clin Pharmacol 1992; 34:130–138.
  • Lalovic B, Phillips B, Risler LL, Howald W, Shen DD. Quantitative contribution of CYP2D6 and CYP3A to oxycodone metabolism in human liver and intestinal microsomes. Drug Metab Disp 2004; 32:447–454.

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