Dihydrocodeine in Pregnancy and Breastfeeding
Dihydrocodeine is generally avoided during pregnancy and breastfeeding unless a doctor decides the benefit clearly outweighs the risk.
During pregnancy
- First trimester: avoided where possible. Limited human data, but opioids are not associated with major birth defects when used briefly.
- Second trimester: short courses for acute pain are sometimes prescribed if non-opioid options have failed.
- Third trimester: avoided. Regular use late in pregnancy can cause neonatal opioid withdrawal — the baby is born physically dependent.
- During labour: dihydrocodeine is not used in labour because it can slow the baby’s breathing at birth.
Always tell your midwife or obstetrician if you are taking any opioid, including a one-off dose.
During breastfeeding
Dihydrocodeine passes into breast milk in small amounts. Single occasional doses are generally considered low-risk for healthy full-term babies. Regular use is avoided because:
- It can make the baby very sleepy
- It can suppress the baby’s breathing (rare but reported)
- It can reduce the baby’s feeding
If you must take dihydrocodeine while breastfeeding, take it at the lowest effective dose for the shortest time, take it immediately after a feed (so the next feed has the lowest milk levels), and watch your baby for unusual sleepiness, poor feeding or breathing changes.
See also
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