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Journal of Human Lactation
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Prenatal and Breast Milk Morphine Exposure Following Maternal Intrathecal Morphine Treatment

Tim F. Oberlander, MD, FRCPC

Division of Develop-mental Pediatrics, Sunny Hill Health Centre for Children, 3644 Slocan Street, Vancouver BC, Canada V5M 3E8 timothyo{at}interchange

Paula Robeson, RN, BN

Canadian Institute of Child Health, Ottawa, Ontario.

Val Ward, BScPT

Sunny Hill Health Centre for children at the Canadian Institute of Child Health, Ottawa, Ontario

R. Stuart Huckin, PhD

toxicology laboratory at Riverview Hospital in Coquitlam, British Columbia

A. Kamani, MD, FRCPC

Department of Anesthesiology at B.C. Women's Hospital, Vancouver

Arthur Harpur, MDCM CCFP

Department of Family Medicine at Children's and Women's Hospital, Vancouver, British Columbia

William McDonald, MD, FRCP

St. Paul's Hospital, Vancouver, British Columbia

A case of an infant who had morphine exposure during and following pregnancy while her mother was treated with intrathecal (IT) morphine is presented along with a review of the relevant literature. Successful maternal pain management was achieved during pregnancy and while breastfeeding. Minimal maternal serum and breast milk levels in the first 7 postpartum weeks were found. Also, infant sleep and arousal behavior and general development at 2 and 7 months were unremarkable, illustrating the possible safe and efficacious use of IT morphine during and following pregnancy. Further work is required to understand opioid pharmacology during breastfeeding, which will be used to develop an empirical approach to breastfeeding and morphine use.

Key Words: breast milk • intrathecal morphine • reflex sympathetic dystrophy • neonatal abstinence syndrome

Journal of Human Lactation, Vol. 16, No. 2, 137-142 (2000)
DOI: 10.1177/089033440001600210
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