Taking Fentanyl While Breastfeeding: What You Need to Know

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Breastfeeding can help set the stage for an infant’s lifelong physical and mental health, enhancing their cognitive function, boosting their resistance to sickness and disease, and even increasing their lifespan. However, while breastfeeding comes with a number of benefits, it can also carry some serious risks. Many substances mothers consume can pass through their breast milk to their infant, including medications and illicit drugs. One substance that can be particularly damaging to infants when passed through breast milk is fentanyl. Among the strongest opioids available on the market today, fentanyl is a synthetic pain reliever typically used to address severe pain following major surgery or during cancer treatment. In cases of misuse, fentanyl is taken recreationally, either by mixing it with other opioids or injecting, smoking, snorting or swallowing it in its pure form. Like most opioids, fentanyl is extremely addictive. If you’re a mother who plans to breastfeed, it’s important to be aware of the risks that fentanyl could pose to your infant. Whether you’re taking the fentanyl for medical or recreational purposes, the substance could have considerable short-term and long-term negative effects on your child.
Fentanyl is one of the most potent painkillers available today. As such, it’s also among the most deadly. According to the United States Drug Enforcement Administration (DEA), just two milligrams of fentanyl is enough to prove lethal for most non-opioid dependent individuals. Because of its high potency and addictive properties, this substance has the potential to cause addiction or overdose in nearly anyone who takes it. The drug only becomes more dangerous when it’s consumed by mothers.

Like most opioid medications, trace amounts of fentanyl can pass from mother to baby through breast milk. While some research has been conducted to assess fentanyl’s risk to breastfeeding infants, the results of these studies have largely been mixed and controversial. One showed that the infants of mothers who received epidural fentanyl during delivery demonstrated a delay in their first suckling, with the delay increasing with increased dose. According to Drugs.com, other studies have suggested that it’s safe for mothers to use fentanyl in small, physician-monitored doses during labor or for a brief period of time postpartum. It is never safe to take fentanyl recreationally and breastfeed, because the amount and potency of the fentanyl ingested can vary dramatically from dose to dose.

When it comes to breastfeeding, it’s best to err on the side of caution. Newborn infants are sensitive to even small doses of opioids, and the effects of fentanyl on newborns hasn’t been studied extensively. When taking any amount of fentanyl for any reason, it’s crucial that mothers consult with a doctor before breastfeeding their infants. Once a mother’s milk comes in, it’s best to control pain with nonnarcotic analgesics that pose no harm to infants, or to limit the mother’s intake of fentanyl to only a few days at a low dosage with close infant monitoring

Taking Fentanyl While Breastfeeding: What You Need to Know
The length of time that fentanyl stays in the body can vary depending on several factors. Some of these include age, body chemistry, amount ingested and length of use. The form fentanyl is consumed in can also impact how long it stays in the body. For example, Actiq, a prescription lozenge form of the medication, can take anywhere from 25 to 75 hours to be fully eliminated from the body. Other forms may leave the body faster or more slowly. According to one study, certain metabolites of fentanyl were detectable in urine in all patients studied after 48 hours. In four of the seven patients studied, fentanyl metabolites were present after 96 hours. If you’re using prescription fentanyl, consult with your doctor for more information about how long it typically takes for the specific form of the medication you’re using to leave the body.
Breastfeeding carries a number of lifelong mental and physical benefits for infants. However, these benefits can be overshadowed by significant risks if mothers use certain medications or illicit drugs during breastfeeding, including fentanyl.  

While fentanyl’s effect on babies hasn’t been studied extensively, some possible side effects of infant ingestion include:

  • Difficulty feeding
  • Trouble breathing
  • Limpness
  • Drowsiness

If a baby shows any of the above symptoms after breastfeeding from a mother who has recently consumed fentanyl, contact a physician immediately.

Because fentanyl is an extremely potent substance, it’s imperative that mothers seek other methods of pain relief while breastfeeding, to protect both their own health and the health of their child. However, this can be difficult, especially when dealing with post-delivery pain. Nearly 31 percent of women who undergo vaginal delivery and 91 percent who undergo cesarean delivery are prescribed opioids for post-birth pain management, according to a study conducted by the American Society of Anesthesiologists (ASA).

However, as awareness of the United States’ opioid epidemic increases, many doctors are utilizing other, safer methods of pain relief. Drugs.com suggests that Acetaminophen and Ibuprofen may be safe, over-the-counter alternatives to opioids. Some physicians are turning to anesthetics like bupivacaine for cesarean delivery-related pain, though this medication may also pose a small risk to infants. If you’d like to use these or other non-opioid post-delivery pain management methods, consult with your health care provider.

For mothers who took fentanyl for an extended amount of time before or during pregnancy, discontinuing use can be more complicated. This is particularly true if fentanyl addiction is present. In these situations, it’s crucial that the mother consult her health care provider before beginning or discontinuing fentanyl use. Halting use abruptly could cause severe withdrawal symptoms, including seizures or overdose. In these cases, gradually diminishing fentanyl dose and bottle feeding until fentanyl use is discontinued may be best for the health of both mother and baby. If the mother has a fentanyl use disorder, a professional rehab program may also be necessary.

Are you a new mother who struggles with fentanyl addiction, or know one who does? Fentanyl addiction can feel impossible to overcome, but with the right rehab program, you can begin the recovery process. It all starts with a phone call. Reach out to The Recovery Village today for more information.

Taking Fentanyl While Breastfeeding: What You Need to Know
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