When my sister’s provider handed her a bottle of opiates just after she had her son, I was shocked. I understood that she had a C-section and was in pain. However, I didn’t realize that doctors could prescribe taking narcotics while breastfeeding. As a (now former) healthcare reporter and someone who has lost many friends to the opioid epidemic, I couldn’t help but wonder… What if my sister had a history of addiction? Did they do any screening of this before giving her narcotics? However, I quickly moved past it, having other things to think about. I decided why stress about something that’s their job – if it was not safe, they wouldn’t do it. Not everyone is so quick to dismiss this though – and there are some out there who have very strong feelings about it. So, what’s the scoop on patients taking narcotics while breastfeeding?
The Debate on Taking Narcotics While Breastfeeding | Should You Prescribe Opiates to New Mothers?
It turns out that my concerns for my sister weren’t uncommon. A survey conducted by Moms Meet found that about 9 out of 10 moms-to-be have concerns about taking pain medication during and after childbirth.
Their concerns aren’t completely unfounded, either. Any medication a new mother is taking has the potential to get into her breastmilk. The simple answer to the question, should you prescribe opiates to new mothers, is that it’s perfectly safe for the baby. Although pain medication may make the baby a little sleepy, if the new mother is taking it as prescribed, the levels won’t be dangerous. Plus, pain management is important for new mothers because pain can interfere with their hormones. So, simply put, the benefits of taking narcotics while breastfeeding (if in pain) outweigh the potential drowsiness.
The American Academy of Pediatrics tells physicians that they should weigh out the risks and benefits specific to their patient before they prescribe taking narcotics while breastfeeding.
Should you prescribe opiates to new mothers? Consider this:
- How much pain is your patient experiencing?
- Will, and if so how, could the drug affect milk production?
- What amount of the drug could get into the milk?
- How much of the medication could the infant absorb and what are the potential negative effects?
So, the baby is safe, but what about mom?
Although the baby will likely be safe, others warn that there’s something doctors should be more concerned about than the baby. In the midst of an opioid crisis, where more people than ever before are dying of overdoses, the biggest concern when it comes to taking narcotics while breastfeeding is for the new mother. New mothers are at a vulnerable moment in their lives, and some suffer from postpartum depression. Subjecting them to a highly addictive medication such as opioids can be risky, depending on the person. In fact, one study discovered that an estimated 1 in 300 women who never used narcotics beforehand could become habitual opioid users after a cesarean delivery.
What does that tell us? It tells us that most women will take their medication as needed for pain and then never touch it again. Yet, others could develop an addiction to it. This is why the American College of Obstetricians and Gynecologists suggests that when you are going to prescribe opioids to a new mom, you should educate them and their families on the health risks and potential side effects of those drugs. If you have a new mom who is worried about taking opioids or is at risk of addiction, hear her out. Don’t dismiss her concerns, especially if she admits to a history of addiction. Consider alternative pain treatments for her. She can take simple, over-the-counter anti-inflammatory drugs, such as ibuprofen or acetaminophen. Some say that warm showers and perineal exercises can help with labor pains as well as pain afterward.
What are your thoughts? Should you prescribe opiates to new mothers or how do you decide? Share with us in the comments below!