Fentanyl and Breastfeeding: Is It Safe?

Last Updated: March 20, 2024

Editorial Policy | Research Policy

Fentanyl can pass into breast milk, putting your baby at risk of side effects

When you breastfeed a baby, medications often pass into your breast milk alongside the nutrients your baby needs for a healthy life. The opioid fentanyl is one such medication that appears in your breast milk. Understanding how to weigh the risks and benefits of fentanyl treatment is an important consideration before you breastfeed while taking fentanyl.

Is It Safe To Take Fentanyl While Breastfeeding?

Although it’s best to avoid medications like fentanyl that can pass into your breastmilk, you should discuss the risks and benefits of taking fentanyl with your doctor. For example, if you have severe pain and cannot not care for your baby without your prescribed fentanyl, your doctor may decide it’s safer to keep you on the medication. However, if you buy fentanyl off the street for recreational use, for example, the potential harm to your baby likely far outweighs any benefit of taking the drug.

How Long Does Fentanyl Stay in Your System? 

It is unclear how long fentanyl can stay in your breastmilk, which can complicate efforts to “pump and dump” breast milk after a fentanyl dose. However, experts know that if you receive fentanyl during childbirth, the drug can stay in the baby’s system for over 24 hours. Traces of fentanyl can also show up in your system for hours, days, weeks or months, depending on what is being tested:

  • Blood: Fentanyl can show up in blood for up to 12 hours.
  • Urine: Fentanyl can be found in urine for up to 3 days.
  • Saliva: Although specific data for fentanyl is unknown, most drugs can show up in saliva for up to 36 hours.
  • Hair: Fentanyl can show up in a 1.5-inch hair sample for around 90 days.

Factors that may influence how long fentanyl stays in your system include:

  • Fentanyl dosage form
  • Fentanyl dose
  • Frequency of fentanyl use
  • If you take fentanyl by mouth, injection or skin patch
  • Your age
  • Your body composition 
  • Your sex
  • Your medical history
  • Other medications you take
  • Your overall hydration and nutrition status

Your doctor or pharmacist can best advise you about how long fentanyl may stay in your system based on your medical history.

Risks and Side Effects of Fentanyl During Lactation

Studies have been done on infants whose mothers have taken fentanyl before breastfeeding. Some of the side effects in babies include:

  • Decreased infant interest in breastfeeding
  • Unusual sleepiness compared to before
  • Breathing difficulties
  • Limpness

If your baby shows any of these side effects of being exposed to fentanyl, you should immediately contact your doctor.

Fentanyl Alternatives for Breastfeeding Parents

If your doctor prescribes your fentanyl for pain control, you may be able to discuss the possibility of using other options. These include:

  • Topical medications like diclofenac, lidocaine or capsaicin because topical drugs have limited absorption into the body
  • Over-the-counter pain relievers like acetaminophen (Tylenol) and ibuprofen (Motrin)
  • If opioids are necessary, opioid alternatives with lower potency than fentanyl, such as codeine, hydrocodone, oxycodone, tramadol or morphine

To limit your baby’s exposure to medications, your doctor may recommend taking the lowest possible medication dose for the shortest period of time to relieve your pain.

Help for Fentanyl Addiction

If you or a loved one struggles with stopping fentanyl while breastfeeding, this may be a symptom of a fentanyl addiction. The Recovery Village Cherry Hill at Cooper can help you wean off fentanyl through our medical detox program. Following detox, our rehab program can help support you in your goals of staying off fentanyl for good. Don’t wait: contact a Recovery Advocate today to learn more about your fentanyl recovery.

Sources

Drugs and Lactation Database. “Fentanyl.” February 15, 2023. Accessed April 14, 2023.

ARUP Laboratories. “Therapeutic Drug Monitoring.” July 2022. Accessed April 14, 2023.

American College of Obstetricians and Gynecologists. “Pharmacologic Stepwise Multimodal Approach for Postpartum Pain Management.” July 2018. Accessed April 14, 2023.

ARUP Laboratories. “Drug Plasma Half-Life and Urine Detection Window.” September 2022. Accessed April 14, 2023.

LabCorp. “Drug Test Summary for Urine Oral Fluid and Hair.” Accessed April 14, 2023.

Griswold, Matthew K., et al. “A Novel Oral Fluid Assay (LC-QTOF-MS) for the Detection of Fentanyl and Clandestine Opioids in Oral Fluid After Reported Heroin Overdose.” Journal of Medical Toxicology, October 2, 2017. Accessed April 14, 2023.

Gryczynski, Jan, et al. “Hair Drug Testing Results and Self-reported Drug Use among Primary Care Patients with Moderate-risk Illicit Drug Use.” Drug and Alcohol Dependence, May 17, 2014. Accessed April 14, 2023.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.