May 27 2022




Recommendations

Morphine is ranked among the drugs usually compatible with breastfeeding.

Regular use of this drug is limited to intrapartum and postpartum anesthesia immediately after cesarean, circumstance of little relevance to their potential influence on the infant. However, morphine may lead in some cases to neurological or cardiorespiratory depression, so that the baby should be closely monitored for signs such as drowsiness, refusal of food, apnea, cyanosis or bradycardia.

If deemed necessary the administration of morphine beyond intrapartum intervention, it is advisable to minimize the dose and complement treatment with non-narcotic analgesics. It should be noted that the elimination of morphine is slower in newborn and small infants that in older age infants.

According to data from a study of five cases, applying a maternal dose of 60 mg of morphine per day on average, an exclusively breastfed infant would receive 75 mcg/kg/day of this substance. In contrast, the therapeutic dose range at this age is 100 to 500 mcg/kg.

Another observation on five patients with a total dose of 250 mg of morphine over 96 hours in combined intravenous and oral administration, determined that an exclusively breastfed infant could ingest up 5 mcg/kg/day dose. In a group of seven women who received combined oral and intravenous morphine for 48 hours during a caesarean section, found that the ingested dose of morphine was only 2.4 mcg/kg. However, the active metabolite morphine-6-glucuronide was ingested at a much higher dose, 73 mcg/Kg/day.

Warning of the manufacturer:

Morphine is excreted in breast milk. Although no problems have been reported in humans, the effects on the infant are unknown, so your doctor will assess whether to discontinue or continue with breastfeeding.

Updated:01.03.08