Breast Milk Opioids and Neonatal Apnea

Sir.—Based on their timing and apparently benign outcome, Duffty and Bryan1have suggested that the cause of episodes of apnea occurring in full-term infants in the first week of life is related to events in the perinatal period. We reviewed one year's experience (July 1, 1984, to June 30, 1985) with full-term infants referred for episodes of apnea, bradycardia, and/or cyanosis that occurred in the first week of life, concentrating on perinatal factors. Data presented herein suggest that infant exposure to prescribed opioids in breast milk might be a causative factor. Patients and Methods.—Selection criteria were as follows: (1) the infant was born at full term (≥37 weeks); (2) the first episode of apnea (>20 s), bradycardia (rate