Baby Dies From Toxic Breast Milk

Codeine prescribed for postnatal pain can produce deadly concentrations of morphine in breast milk.

A lawsuit over the death of Toronto newborn Tariq Jamieson, who died as a result of opiate toxicity in his mother's breast milk, has renewed the debate over prescribing such drugs as Tylenol 3 to breastfeeding mothers.

Tariq's mother Rani was prescribed Tylenol 3 for lingering episiotomy pain. Although Tariq was initially healthy, he developed increasing lethargy after the seven-day mark, and after 11 days he was brought to a pediatrician due to concerns about his skin color and poor feeding. Two days later, Tariq died.

Tariq was found to have high blood levels of acetaminophen, and a blood concentration of morphine six times higher than would normally be considered safe in a neonate. Tylenol 3 contains both acetaminophen and codeine, which is metabolized to morphine in the body. However, not everyone metabolizes codeine at the same rate. Rani Jamieson was an ultra-rapid metabolizer of codeine to morphine, which means that the opiate built up in her breastmilk very fast.

While ultra-rapid metabolization of codeine occurs in about 1 percent of Caucasians, it occurs in as much as 30 percent of some African and Asian populations.

National Review of Medicine June 15, 2007

Dr. Mercola's Comment:

Mothers must use extreme caution when taking any drugs while breastfeeding, because those drugs could be transferred to your baby. Prescription drugs like Tylenol 3 are not the only danger. The excessive acetaminophen you can get from regular Tylenol, even without the codeine, can be extremely dangerous. Because some 5 billion over-the-counter medications are sold in the United States annually, many believe they're safe. But you, or your baby, could suffer from serious side effects and possibly die unintentionally if you don't take them with the proper care. Even environmental chemicals like rocket fuel are sadly now being found in breast milk. But nonetheless, breastfeeding is without a doubt the healthiest way to feed your baby. Breastfed infants have added protection against: Heart disease Immune system cancers such as lymphoma Bowel diseases such as Crohn's disease Juvenile rheumatoid arthritis Asthma and allergies So although this child died from breastfeeding, that in no way discounts its value as breastfeeding is not only incredibly good for your baby, it's good for moms, too!

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Another benefit of breastfeeding...

BARCELONA, Spain, Jun 15, 2007 (UPI via COMTEX) -- Breastfeeding for 13 months or more can reduce the mother's risk of developing rheumatoid arthritis, Swedish researchers reported Friday.
Comparable use of oral contraceptives or hormone replacement therapy showed no significant effect on the risk of developing rheumatoid arthritis, said Dr. Mitra Keshavarz, of Malmo Hospital University, Sweden.
The findings add to the "growing body of evidence in favor of breastfeeding and its positive health implications -- this time demonstrating its protective benefits for the mother," Keshavarz said.
The study compared information from the Swedish National Hospital Discharge and the National Cause of Death Register from 1991 to 1996.
The findings were presented at the Annual European Congress of rheumatology in Barcelona.

Pa. moms push to make breastfeeding in public a protected act

By Kim Lyons
TRIBUNE-REVIEW
Tuesday, May 8, 2007

Cheryl Bradshaw is ready -- for the snide comments, the disapproving looks, the general sense of discomfort. Even though Bradshaw, mother of three, hasn't had to defend her decision to breastfeed her kids in public, there's no law in Allegheny County that protects her and other breastfeeding moms.

"I think we have some great lactation consultants and a really active La Leche League, but Pittsburgh has a lot of old-school thinking when it comes to breastfeeding," said Bradshaw, 38.

At a rally in Harrisburg yesterday, breastfeeding mothers said Pennsylvania's unsupportive atmosphere limits their nursing. A bill sponsored by Sen. Connie Williams, a Montgomery County Democrat, would protect breastfeeding in public and ban companies from firing women who breastfeed or use a breast pump at work. It also would extend tax credits to companies with policies encouraging breastfeeding.

"I have been fortunate to have young working mothers working for me. They're terrific," Williams said. "They come back to work while they're still nursing their babies."

In the meantime, the Allegheny County Health Department is looking for this year's most breastfeeding-friendly places in Allegheny county for its 12th annual Breastfeeding Friendly Place Awards.

"The place where I'm most self-conscious, and people seem to have the biggest hangup is in restaurants," said Charissa Howe, 28, of Observatory Hill, who's nursing her 11-month-old daughter. "People seem to think it's unsanitary or something, and they'll whisper or stare at you."

Howe said breastfeeding in places like museums and parks posed the least problems.

Stephanie Strazisar works at Bayer, last year's workplace winner. She said she knew returning to work after the birth of her daughter wouldn't mean she'd have to stop nursing, since Bayer has six lactation rooms at its Robinson campus. The lactation rooms are quiet, private rooms with comfortable seating outlets for breast pumps.

Diana Kamyk, Bayer's manager of work life diversity, said part of the reason a lactation room was such a natural fit for Bayer is the similarity of its corporate culture to the progressive social practices of its home country of Germany.

"There have been times where it's been a little awkward, having to excuse myself from meetings," said Strazisar, 33, of Venetia. "But everyone is really supportive. It's been a win-win; I'm happy at work, and I'm just as productive a worker."

The American Academy of Pediatrics recommends babies be breastfed for at least the first year, but the early return to work presents problems -- mothers can't bring their babies to work for eight-plus hours.

Simply getting mothers to ask for a place at work to pump breast milk is a major accomplishment, said Dr. Brian Donnelly of Pediatric Alliance in McCandless.

"They need to ask for support and time and a clean, safe place to express milk," said Donnelly, who is on the Allegheny County Health Department's Breastfeeding Promotion Steering Committee. The milk can be refrigerated or frozen to feed the baby later.

The numbers show that most mothers give breastfeeding a try. According to a 2005 Centers for Disease Control survey, more than 70 percent of new moms breastfed at birth, and 39 percent still were nursing six months later. By 12 months, that number was down to 20 percent.

The survey found Pennsylvania's numbers were pretty close to the rest of the country: about 69 percent of new moms breastfed at birth. After six months, only 37.5 percent of Pennsylvania mothers still were nursing; and only 20 percent were nursing 12 months later.

At first, Shayne Blacksburg, 33, mother of 11-month-old Ari, said she felt self-conscious about nursing in public. But she's moved past that.

"I'm at the point now where I think, 'If you need to look, go ahead. You're not going to see much,'" Blacksburg said.

Material from the Associated Press was used in this report.

Kim Lyons can be reached at klyons@tribweb.com or (412) 320-7922.

AHRQ EPC breastfeeding report

April 20th, 2007 — Bekah

AHRQ EPC breastfeeding report

The Agency for Healthcare Research and Quality has released a new evidence report on breastfeeding and health outcomes. The report found evidence that breastfeeding decreases infants’ and mothers’ risk of having many short-term and chronic diseases.

There is good evidence that breastfeeding reduced infants’ risk of ear infections by up to 50 percent, serious lower respiratory tract infections by 72 percent, and a skin rash similar to eczema by 42 percent. Children with a family history of asthma who had been breastfed were 40 percent less likely to have asthma, and children who were not prone to asthma had a 27 percent reduced risk compared to those children who were not breastfed. The risk of developing type1 diabetes was reduced by about 20 percent. These benefits were seen in infants who were breastfed for three or more months. Breastfeeding also reduced the risk of type 2 diabetes by 39 percent compared to those who were not breastfed.

The report also found that breastfeeding was associated with fewer episodes of diarrhea during infancy, decreased incidence of childhood leukemia, and decreased deaths from sudden infant death syndrome. The report found no clear relationship between breastfeeding and improvement in IQ. In premature infants, breastfeeding decreased the occurrence of necrotizing enterocolitis, a serious gastrointestinal infection that often results in death.

For health outcomes in mothers, there is good evidence that women who breastfed their infants had up to a 12 percent reduced risk of type 2 diabetes for each year they breastfed. Breastfeeding decreased the risk of ovarian cancer by up to 21 percent. Breastfeeding also decreased the risk of breast cancer by up to 28 percent in those whose lifetime duration of breastfeeding was 12 months or longer. Women who did not breastfeed their infants were more likely to have postpartum depression, but unmeasured factors—such as depression that was undiagnosed prior to giving birth—may have increased the rate of depression seen in this group. Breastfeeding did not increase the risk of fractures due to osteoporosis. The effect of breastfeeding on a woman’s weight could not be determined based on the available studies.

The report was nominated and funded by the U.S. Department of Health and Human Services’ Office on Women’s Health and prepared by Stanley Ip, M.D., Joseph Lau, M.D., and colleagues at AHRQ’s Tufts-New England Medical Center Evidence-based Practice Center in Boston, Massachusetts. AHRQ’s EPCs develop evidence reports and technology assessments on topics relevant to clinical, social science/behavioral, economic, and other health care organization and delivery issues—specifically those that are common, expensive, and/or significant for the Medicare and Medicaid populations.

To access Breastfeeding and Maternal and Infant Outcomes in Developed Countries, go to: http://www.ahrq.gov/clinic/tp/brfouttp.htm.

Posted in Breastfeeding.