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

Obstet Gynecol. 2011 Mar;117(3):611-617. doi: 10.1097/AOG.0b013e31820ca504.


Objective: To estimate the extent of passage of hydrocodone and its active metabolite, hydromorphone, into breast milk.

Methods: This is a pharmacokinetic study of 30 postpartum women receiving hydrocodone bitartrate for postpartum pain in the inpatient setting. Mothers donated timed breast milk samples for the analysis of hydrocodone and hydromorphone.

Results: Fully breastfed neonates received 1.6% (range 0.2%-9%) of the maternal weight-adjusted hydrocodone bitartrate dosage. When combined with hydromorphone, the total median opiate dosage from breast milk is 0.7% of a therapeutic dosage for older infants. Most mothers excreted little to no hydromorphone into breast milk.

Conclusion: Standard postpartum dosages of hydrocodone bitartrate appear to be acceptable to use in women nursing newborns. Prolonged use of high dosages is not advisable.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetaminophen / therapeutic use
  • Adolescent
  • Adult
  • Analgesics, Non-Narcotic / therapeutic use
  • Analgesics, Opioid / analysis
  • Analgesics, Opioid / pharmacokinetics*
  • Analgesics, Opioid / therapeutic use
  • Female
  • Humans
  • Hydrocodone / analysis
  • Hydrocodone / pharmacokinetics*
  • Hydrocodone / therapeutic use
  • Hydromorphone / analysis
  • Hydromorphone / pharmacokinetics*
  • Hydromorphone / therapeutic use
  • Milk, Human / chemistry*
  • Pain / drug therapy
  • Postpartum Period
  • Pregnancy
  • Young Adult


  • Analgesics, Non-Narcotic
  • Analgesics, Opioid
  • Acetaminophen
  • Hydrocodone
  • Hydromorphone