I am a breastfeeding mother and i want to know if it is safe to use Dihydrocodeine? Is Dihydrocodeine safe for nursing mother and child? Does Dihydrocodeine extracts into breast milk? Does Dihydrocodeine has any long term or short term side effects on infants? Can Dihydrocodeine influence milk supply or can Dihydrocodeine decrease milk supply in lactating mothers?

Dihydrocodeine lactation summary

Dihydrocodeine usage has low risk in breastfeeding
  • DrLact safety Score for Dihydrocodeine is 3 out of 8 which is considered Low Risk as per our analyses.
  • A safety Score of 3 indicates that usage of Dihydrocodeine may cause some minor side effects in breastfed baby.
  • Our study of different scientific research indicates that Dihydrocodeine may cause moderate to no side effects in lactating mother.
  • Most of scientific studies and research papers declaring usage of Dihydrocodeine low risk in breastfeeding are based on normal dosage and may not hold true for higher dosage.
  • While using Dihydrocodeine We suggest monitoring child for possible reactions. It is also important to understand that side effects vary largely based on age of breastfed child and time of medication in addition to dosage.
  • Score calculated using the DrLact safety Version 1.2 model, this score ranges from 0 to 8 and measures overall safety of drug in lactation. Scores are primarily calculated using publicly available case studies, research papers, other scientific journals and publically available data.

Answer by Dr. Ru: About Dihydrocodeine usage in lactation

Used for pain and cough relief. As analgesic it is not more effective than Ibuprofen. The enzyme cytochrome P450-CYP2D6 catalyzes its metabolization into dehydromorphine. On date of latest update relevant data concerning breastfeeding were not found. Product with similar characteristics than Codeine but with lower oral bioavailability which would be advantageous for breastfed infants. Codeine is excreted into breast milk in non-significant amount, however, serious health problems have appeared among off-spring of mothers who are rapid metabolizers from Codeine to Morphine. Discontinue if excessive sedation appears in mother or infant, and, do not administer if such a background in mother or family is present, as there are between 1% and 29% of people who are rapid metabolizers from codeine to morphine with an excess of the gene linked to enzyme P450-CYP2D6.

Answer by DrLact: About Dihydrocodeine usage in lactation

Maternal use of oral narcotics during breastfeeding can cause infant drowsiness, central nervous system (CNS) depression and even death. Like codeine, pharmacogenetics probably plays a role in the extent of CNS depression. Newborn infants seem to be particularly sensitive to the effects of even small dosages of narcotic analgesics. Dihydrocodeine possibly caused severe respiratory depression in one newborn infant whose mother was taking the drug for cough. Once the mother's milk comes in, it is best to provide pain control with a nonnarcotic analgesic and limit maternal intake of hydromorphone to a few days at a low dosage with close infant monitoring. If the baby shows signs of increased sleepiness (more than usual), difficulty breastfeeding, breathing difficulties, or limpness, a physician should be contacted immediately. Because there is little published experience with dihydrocodine during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.

Dihydrocodeine Side Effects in Breastfeeding

A woman began taking dihydrocodeine drops for cough twice daily (5.28 mg) beginning on the first day postpartum. One day later, her breastfed infant was difficult to arouse and was not breastfeeding well. The infant had bradycardia, hypoglycemia, and an oxygen saturation of 85%. After 24 hours in the hospital, all symptoms resolved. The symptoms were possible caused by dihydrocodeine in milk.[2]

Dihydrocodeine Possible Effects in Breastfeeding

Narcotics can increase serum prolactin.[3] However, the prolactin level in a mother with established lactation may not affect her ability to breastfeed.

Alternate Drugs

Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. We do not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.