Opioids ‘no risk to babies’ for new mums

Women should not be denied opioid painkillers after childbirth as the drugs do not harm babies through breast milk, research shows.

Doctors are currently advised to avoid prescribing many opioids to women who are breastfeeding.

However, a major Canadian study revealed that concerns the drugs pose a risk to babies are unfounded, meaning that they can be safely prescribed to help new mothers in pain. Researchers looked at hospital data from 865,691 mother and newborn baby pairs in Ontario over an eight-year period. About 10 per cent of these were prescribed an opioid painkiller in the week after giving birth, mostly after a caesarean.

Medical records revealed that babies born to mothers prescribed opioids were no more likely to need hospital treatment during the next 30 days, and there were no infant deaths. The study, published in the BMJ, said “concerns about opioid toxicity in breastfed infants seem to be unsubstantiated”.

It said caution is still required when prescribing opioids, which can be addictive if used long-term, but that “clinicians and parents should be reassured that infants are at low risk of harm”.

English guidelines currently state that women should not take codeine if they are breastfeeding. Other opioids, such as dihydrocodeine or tramadol, can be used “at the lowest effective dose for the shortest duration” but “risks to the baby” should be discussed before they are prescribed.

However, the new study says that from now on, doctors should focus on the risks to mothers “rather than infants”.