![]() Mean and median infant dosage of hydromorphone were 2.1 and 0.3 mcg/kg daily, respectively. Mean and median infant daily dosages of hydrocodone were 3.9 and 2.1 mcg/kg, respectively, which were equal to 2.4 and 1.6% of the weight-adjusted maternal dosage, respectively. Only 12 of the 30 women had hydromorphone detectable (>1 mcg/L) in their milk with a median milk hydromorphone concentration of 1.9 mcg/L. The mean and median milk hydrocodone concentrations were 25.9 and 14.2 mcg/L, respectively. Mean and median maternal dosages of hydrocodone base were 175 and 145 mcg/kg daily, respectively (range 44.3 to 423.2 mcg/kg daily). Milk samples were collected after lactogenesis II was judged to have occurred, usually starting on the third postpartum day. Their infants received an estimated 3.1 and 3.7% of the maternal weight-adjusted dosages, but the absolute hydrocodone dosages were 8.58 mcg/kg and 3.07 mcg/kg daily because of the differences in the dosages ingested by their mothers.Ī study of 30 postpartum women taking a hydrocodone-containing product for postpartum pain measured hydrocodone and hydromorphone in breastmilk. Her milk hydrocodone levels ranged from 5.2 to 47.2 mcg/L, beginning at day 16 postpartum. The second mother had 5 milk hydrocodone levels measured over 1.5 days while taking 5 mg doses of hydrocodone bitartrate. Her milk hydrocodone levels ranged from 8.6 to 127.3 mcg/L. One mother had 17 milk hydrocodone levels measured over 4 days while taking first 10 mg and then 5 mg of hydrocodone bitartrate as needed, beginning on day 7 postpartum. They donated samples of their pumped milk for analysis of hydrocodone. Two hospitalized mothers were taking hydrocodone and acetaminophen combination for pain and pumped their milk for their nonhospitalized infants. Hydrocodone is metabolized to 6 active metabolites, including hydromorphone.
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