Robieux I, Koren G, Vandenbergh H, Schneiderman J
Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario.
J Toxicol Clin Toxicol. 1990;28(3):365-70. doi: 10.3109/15563659008994437.
We report the case of an infant who was breastfed while his mother was receiving low doses of morphine. Morphine concentration in his serum was in the analgesic range (4 ng/ml), while concentrations in the milk varied substantially in three samples collected within 2 hours (10, 100, 12 ng/ml). The calculated dose that the infant must have received to achieve the observed serum concentration had to be between 0.8 to 12% of maternal dose, based on reference literature values of clearance and bioavailability. The current perception that maternal morphine exposure is safe for the breastfed infant is based on a 50 year old data which were determined by an analytical method 1000 fold less sensitive than the present HPLC, thus leading to a likely erroneous conclusion.
我们报告了一例婴儿在其母亲接受低剂量吗啡治疗期间进行母乳喂养的病例。婴儿血清中的吗啡浓度处于镇痛范围内（4纳克/毫升），而在两小时内采集的三份母乳样本中的浓度差异很大（分别为10、100、12纳克/毫升）。根据清除率和生物利用度的参考文献值计算，婴儿为达到观察到的血清浓度所必须接受的剂量必定在母亲剂量的0.8%至12%之间。目前认为母亲接触吗啡对母乳喂养婴儿安全的观点是基于50年前的数据，这些数据是通过一种灵敏度比当前高效液相色谱法低1000倍的分析方法测定的，因此可能得出了错误的结论。
