Breast milk hydrocodone and hydromorphone levels in mothers using hydrocodone for postpartum pain.

摘要

We agree with Dr. Koren that our phar-macokinetic study cannot completely assure the safety of the use of hydrocodone in nursing mothers. Much larger numbers of patients and detailed observations of their full-term neonates would be an excellent future study to better answer the question regarding neonatal safety. We appreciate the opportunity to re-emphasize the final paragraph in our article, which recommends the use of nonopioids as the first choice for postpar-tum analgesia and that hydrocodone be given in limited doses and for short courses only when the nonopioid analge- sia is inadequate. As we state, even this cautious approach does not absolve the health care team from monitoring the mother and neonate.