Hydrocodone While Pregnant or Breastfeeding

Last Updated: February 1, 2024

Editorial Policy | Research Policy

The risks and benefits of hydrocodone while pregnant or breastfeeding should be carefully weighed before taking the drug.

About 7% of American women take opioids while pregnant. One of the most common opioids is hydrocodone. Sold on its own or in combination with acetaminophen, hydrocodone can be a helpful pain reliever. However, its use can come with risks if you are pregnant or breastfeeding. For this reason, you should carefully weigh the risks and benefits with your doctor before taking hydrocodone.

Can You Take Hydrocodone While Pregnant?

Deciding whether or not to take hydrocodone while pregnant is a complex choice that involves discussing the risks and benefits of opioids with your doctor. Although opioids can pose a risk to both mother and baby, experts agree that there are times when opioids may be appropriate and safer than other alternatives. For this reason, it’s important to discuss hydrocodone use with your doctor before taking the medication if you’re pregnant.

Risks and Side Effects of Taking Hydrocodone During Pregnancy

Taking hydrocodone during pregnancy can increase the risk of a variety of problems for your baby. These include the risk of birth defects, neonatal abstinence syndrome, poor birth outcomes and even fetal death.

Birth Defects

When taken during pregnancy, opioids are linked to a variety of birth defects. Although the exact reason for some defects is unknown, others can result from the opioids causing cell death in a fetal brain. Birth defects linked to opioids include:

  • Neural tube defects, causing problems in the baby’s brain or spine
  • Heart defects
  • Gastroschisis, a condition where the intestines come outside of the belly
  • Cleft lip and palate

Neonatal Abstinence Syndrome (NAS)

Neonatal Abstinence Syndrome (NAS) occurs when a baby is born to an opioid-dependent mother, causing the infant to become opioid-dependent due to exposure in utero. The baby then develops withdrawal syndromes after birth. Symptoms of NAS in newborns include:

  • Irritability
  • Seizures
  • Vomiting
  • Diarrhea
  • Fever
  • Poor feeding
  • High-pitched crying

Poor Birth Outcomes

Poor birth outcomes are linked to prenatal opioid use. These outcomes can be problematic on their own, but they can also be connected to additional complications like long hospital stays after the birth. Some examples of poor outcomes linked to opioids include:

  • Premature birth
  • Stunted growth in the womb 
  • Low birth weight

It is also important to note that if you are taking an opioid, suddenly stopping it can cause withdrawal symptoms that also increase the risk of poor birth outcomes like premature birth and fetal distress.

Miscarriage or Stillbirth

Opioid use during pregnancy is linked to loss of the baby. This can occur as a miscarriage before 20 weeks of pregnancy or as a stillbirth after 20 weeks. However, if you are already taking an opioid and suddenly stop, the resulting withdrawal symptoms can also put you at risk of miscarrying.

Can You Take Hydrocodone While Breastfeeding?

Although opioids should be avoided when possible while breastfeeding, you may be able to take hydrocodone in some circumstances. Experts agree that you can take hydrocodone for two to three days at a total daily dosage of no more than 30 mg as long as the baby is closely monitored for side effects. 

How To Breastfeed Safely

You can minimize risk to your baby while taking hydrocodone while breastfeeding. While your doctor will be able to give specific advice about your particular medical situation, there are things you can do to breastfeed more safely while on hydrocodone.

Take Medication Exactly as Prescribed

You should take your hydrocodone exactly as prescribed by your doctor. Never take more hydrocodone than prescribed, and never take the drug more often than it is prescribed. In addition, you should never take hydrocodone that has not been specifically prescribed to you. Following these steps will help you avoid higher-than-expected levels of hydrocodone in your breast milk.

Monitor Your Baby Closely

You should monitor your baby for signs that they are being affected by the opioid. Signs that you need to immediately call a doctor include if your baby:

  • Is sleepier than usual 
  • Has problems breastfeeding
  • Has breathing difficulties
  • Has limp muscles

Avoid Taking Additional Acetaminophen

Short-acting hydrocodone products come as a combination drug with acetaminophen to help with pain relief. In contrast, long-acting hydrocodone products do not come paired with acetaminophen.

Acetaminophen is one of the safest pain medications for breastfeeding mothers, and side effects are rare for the nursing infant. However, for your own safety, it is important to not take additional acetaminophen if your hydrocodone product also contains acetaminophen, as this can put you at risk of liver damage.

Follow a Breastfeeding Schedule

In some cases, your doctor may recommend a breastfeeding schedule and may advise you to refrain from breastfeeding for an hour or more after taking an opioid like hydrocodone. However, breastfeeding schedules are not always recommended; in some cases, the risk of skipping a feeding may outweigh the benefit. 

Because every baby is different, make sure to first ask your doctor and pediatrician if they recommend a breastfeeding schedule while you take opioids.

Help for Hydrocodone Addiction

Struggling with hydrocodone while pregnant or breastfeeding can be scary. However, help is available. At The Recovery Village Cherry Hill at Cooper, we are with you every step of the way to keep you and your baby safe. From medical detox for weaning you off hydrocodone to rehab for keeping you hydrocodone-free, we can help put you and your new family on a road to recovery. Don’t wait: contact a Recovery Advocate today.

Sources

Centers for Disease Control and Prevention. “Prescription Opioid Pain Reliever Use During Pregnancy.” July 10, 2020. Accessed April 15, 2023.

American College of Obstetricians and Gynecologists. “ACOG Statement on Opioid Use During Pregnancy.” March 16, 2016. Accessed April 15, 2023.

Proctor-Williams, Kerr &; Louw, Brenda. “Cleft Lip and/or Palate in Infants Prenatally Exposed to Opioids.” Cleft-Palate Craniofacial Journal, April 2022. Accessed April 15, 2023.

Hu, Shuxian; Sheng, Wen S.; Lokensgard, James R.; & Peterson, Phillip K. “Morphine induces apoptosis of human microglia and neurons.” Neuropharmacology, May 2022. Accessed April 15, 2023.

National Library of Medicine. “Pregnancy and Opioids.” August 27, 2018. Accessed April 15, 2023.

Centers for Disease Control and Prevention. “Treatment for Opioid Use Disorder Before, During, and After Pregnancy.” November 15, 2022. Accessed April 15, 2023.

Intermountain Healthcare. “Breastfeeding and Opioid Pain Medication.” November 2021. Accessed April 15, 2023.

Drugs and Lactation Database. “Hydrocodone.” September 19, 2022. Accessed April 15, 2023.

Drugs and Lactation Database. “Acetaminophen.” March 21, 2022. Accessed April 15, 2023.

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