Depth of Anesthesia
Depth of Anesthesia
Depth of Anesthesia

Are peripartum opioids safe for breastfeeding mothers?

11 months agoby David Hao, MD
Episode 39

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Episode 39

Dr. Gopika Hari and Dr. Lana Joudeh join the podcast to discuss the literature on the safety of peripartum opioid use and its implications for breastfeeding.

Featured Guests

Dr. Gopika Hari

Anesthesia Resident, MGH Anesthesia Residency Program

Graduate of Washington University School of Medicine in St. Louis, now training in anesthesia at Massachusetts General Hospital.

Dr. Lana Joudeh

Faculty Anesthesiologist, Massachusetts General Hospital

Completed her anesthesia residency at MGH, where she now serves as a faculty member.

This episode was produced as part of the Depth of Anesthesia Podcast Elective. Music by Stephen Campbell, MD.

Follow us on Instagram @DepthofAnesthesia  ·  Episode ideas or want to join the team? Email depthofanesthesia@gmail.com

References

1
Statement on Resuming Breastfeeding after Anesthesia.
American Society of Anesthesiologists. Amended October 23, 2024.
ASA Standards and Practice Parameters.
asahq.org

2
Guideline on anaesthesia and sedation in breastfeeding women 2020.
Mitchell J, Jones W, Winkley E, Kinsella SM.
Anaesthesia. 2020;75(11):1482–1493. doi:10.1111/anae.15179

3
Pharmacologic Stepwise Multimodal Approach for Postpartum Pain Management.
ACOG Clinical Consensus No. 1.
Obstet Gynecol. 2021;138(3):507–517. doi:10.1097/AOG.0000000000004517

4
Morphine excretion in breast milk and resultant exposure of a nursing infant.
Robieux I, Koren G, Vandenbergh H, Schneiderman J.
J Toxicol Clin Toxicol. 1990;28(3):365–370. doi:10.3109/15563659008994437

5
Colostrum morphine concentrations during postcesarean intravenous patient-controlled analgesia.
Baka N-E, Bayou Menu F, Boutroy M-J, Laxenaire M-C.
Anesth Analg. 2002;94(1):184–187. doi:10.1213/00000539-200201000-00035

6
Postcesarean analgesia with both epidural morphine and intravenous patient-controlled analgesia: neurobehavioral outcomes among nursing neonates.
Wittels B, Glosten B, Faure EA, et al.
Anesth Analg. 1997;85(3):600–606.

7
Central nervous system depression of neonates breastfed by mothers receiving oxycodone for postpartum analgesia.
Lam J, Kelly L, Ciszkowski C, et al.
J Pediatr. 2012;160(1):33–37.e2.

8
Oxycodone as a component of multimodal analgesia for lactating mothers after cesarean section: relationships between maternal plasma, breast milk and neonatal plasma levels.
Seaton S, Reeves M, McLean S.
Aust N Z J Obstet Gynaecol. 2007;47(3):181–185. doi:10.1111/j.1479-828X.2007.00715.x

9
Hydromorphone transfer into breast milk after intranasal administration.
Edwards JE, Rudy AC, Wermeling DP, Desai N, McNamara PJ.
Pharmacotherapy. 2003;23(2):153–158. doi:10.1592/phco.23.2.153.32081

10
The association between intrapartum opioid fentanyl and early breastfeeding: a prospective observational study.
Oommen H, Tveit TO, Eskedal LT, et al.
Acta Obstet Gynecol Scand. 2021;100(12):2294–2302. doi:10.1111/aogs.14268

11
Study of the newborn feeding behaviors and fentanyl concentration in colostrum after an analgesic dose of epidural and intravenous fentanyl in cesarean section.
Goma HM, Said RN, El-Ela AM.
Saudi Med J. 2008;29(5):678–682.

12
A randomized controlled trial of the efficacy and respiratory effects of patient-controlled intravenous remifentanil analgesia and patient-controlled epidural analgesia in laboring women.
Stocki D, Matot I, Einav S, et al.
Anesth Analg. 2014;118(3):589–597.

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Episode 39
Are peripartum opioids safe for breastfeeding mothers?