In the Lancet of August 23rd 2008 there is an fascinating debate on a report from 2006 also in the Lancet ( Lancet 2006 vol 368 p 704 . In the original case report the death of a neonate was attributed to the mother taking codeine . The mother was an ultra rapid converter of codeine to morphine and the morphine passed in the breast milk to the baby. The new letter by Bateman et al challenges their conclusions suggesting that the concentration and amount of codeine and morphine in the milk could never achieve lethal amounts to the baby. The original authors reply and disagree saying that the metabolism of the baby is different from the adult and that the infant war vulnerable to small doses of morphine.
They both make good case for their point of view.
For the nutritionist the important message is that the mother is the source of the constituents of the breast mil. Care and attention should be taken about what the breast feeding mother eats and drinks and is given in non nutritional substances, drugs, alcohol etc.
The baby is very dependent and vulnerable,
Lancet 2008 vol 372 pp 625-626
Ferner 2008, Did the drug cause death? codeine and breast feeding Lancet vol 372 pp 606-7

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