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UK NewsNewborn girl died with Tramadol in her system after doctors prescribed the painkiller to treat her mother's chronic back pain and it passed to the baby in breast milk, inquest hears

12:00  21 august  2019
12:00  21 august  2019 Source:   dailymail.co.uk

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Newborn girl died with Tramadol in her system after doctors prescribed the painkiller to treat her mother ' s chronic back pain and it passed to the baby in breast milk , inquest hears . Mother and baby were both kept in hospital for three days after the induced birth. The baby , known as Baby S

And died in her sleep on September 13, 2017 after taking the painkiller . And after taking the painkiller , died in her sleep on September 13, 2017 having left school early that day due to Kaitlin' s mother , Kelly, also told the hearing how she had been prescribed tramadol but was '99 per cent

A coroner has demanded action after a newborn baby died with Tramadol in her system after doctors gave it to her mother for her chronic back pain.

The opioid 'played a role' in her death, the inquest heard.

The mother, who has not been named, suffered chronic back pain caused by her pregnancy and was prescribed the pain killer.

As a result both her and her newborn baby, who has been referred to as Baby S, were kept in Torbay Hospital for three days after the induced birth on September 25, 2018.

The baby died at the family home in Teignmouth, Devon, just two days after being discharged.

Newborn girl died with Tramadol in her system after doctors prescribed the painkiller to treat her mother's chronic back pain and it passed to the baby in breast milk, inquest hears © Provided by Associated Newspapers Limited Newborn baby, known as Baby S, died with Tramadol in her system after doctors gave it to her mother for her chronic back pain (stock image)

Tramadol was found in her system and is believed to have been passed from breast milk.

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Newborn girl died with Tramadol in her system after doctors prescribed the painkiller to treat her mother ' s chronic back pain and it passed to the baby in breast milk , inquest hears . Mother and baby were both kept in hospital for three days after the induced birth.

Experts at her inquest say they think the drug, or withdrawal from it, 'played a role' in her death.

But the mother has claimed she was told by the hospital she would be fine to breast feed at home despite expressing concerns to them.

And after hearing from experts that there is on-going concern about Tramadol within breast milk, senior coroner Ian Arrow told the family he would be raising concern with the hospital to make sure similar tragedies could be avoided in the future.

The inquest, held in Plymouth, Devon, on Monday, heard a post mortem found no evidence of trauma or mistreatment but discovered there was a 'sub-therapeutic' amount of Tramadol which the pathologist believed may have come from the breast or bottle feeds.

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The pathologist noted that the mother had been prescribed Tramadol by the hospital for her chronic back pain and gave a cause of death as unascertained.

The mother sobbed while telling how she was not going to breast feed her daughter after being prescribed the drug, but claimed the hospital had said it would be okay to do so.

Professor Peter Fleming also attended the inquest to give his expert view as a pediatrician for 40 years.

He highlighted how Tramadol was a 'relatively new drug' and that information on its effects on babies in-utero was still 'really quite new' with some information only being published in the last year.

Newborn girl died with Tramadol in her system after doctors prescribed the painkiller to treat her mother's chronic back pain and it passed to the baby in breast milk, inquest hears © Provided by Associated Newspapers Limited Because of the mother's chronic back pain, both she and Baby S were kept in Torbay Hospital, Devon, (pictured) for three days after the induced birth on September 25, 2018. Baby S died just two days after being discharged

He said withdrawal from it usually occurs within the first 24 to 36 hours and that traces remaining were usually quite small, but it raised the question as to whether breast-feeding would have any effect and that at this stage the issue was 'unresolved'.

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Baby S's grandmother said:  'Surely the hospital should have indicated that? That the danger is the withdrawal. They didn't mention it.'

At this Prof Fleming said: 'I have concerns about the use of Tramadol. There's no absolute answer on that.'

He re-emphasised it was a fairly recently used drug for the past ten years, with it only being more widely prescribed in the 'last three to four years'.

Regarding Baby S's death he said: 'My best answer is that Tramadol played a role.

Newborn girl died with Tramadol in her system after doctors prescribed the painkiller to treat her mother's chronic back pain and it passed to the baby in breast milk, inquest hears © Provided by Associated Newspapers Limited Professor Peter Fleming told Plymouth Coroner's Court (pictured) that 'Tramadol played a role' in the baby's death

'I can't distinguish whether it's before birth or was complicated by the withdrawal later on.'

To the court itself he stated: 'I think we should be very cautious of Tramadol during pregnancy.'

Senior coroner Ian Arrow stated that he would record Baby S's death as sudden unexpected death in infancy compounded with SIDS.

Referring to the use of Tramadol, he added: 'It maybe, on the balance of probabilities, that the withdrawal may have affected [Baby S] - I can't be sure.

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'I will be writing to the hospital that this is something that needs to be carefully considered in the future.'

He told the family he hoped the inquest would give them 'a little comfort' and added: 'I can see that you cared for your daughter immensely.

'I was so sorry to hear of [Baby S's] death.'

What are opioids, such as Tramadol, and how do they work?

Opioids work by stimulating receptors in the brain that send signals to block pain and are used to treat chronic problems such as back pain. Some are available in over-the-counter medicines, such as co-codamol (codeine and paracetamol), while others, such as dihydrocodeine, Tramadol and fentanyl, are prescription-only.

Around 23 million opioids were prescribed last year in England alone.

THE CONCERNS: The side-effects of opioids include constipation (they slow down gut transit time), mood swings, sweating and lethargy. However, there are also bigger concerns about their long-term use, including the risk of dependency and the fact that the drugs become less effective, as well as accidental overdose.

Opioids are known for their potential risk of dependency, and this can occur within days, says Roger Knaggs, a professor of clinical pharmacy practice at the University of Nottingham and a member of the British Pain Society Council.

This is why codeine packaging, for instance, carries warnings that the pills should not be taken for more than three days.

Furthermore, taking them for longer can make them ineffective.

‘Doctors tend to think opioids are more effective and stronger than other painkillers, but they don’t work for many people,’ says Professor Knaggs.

‘There is evidence long-term use may make people more sensitive to pain, too, by “up-regulating” the body’s pain pathways.’

Other potential problems include accidental overdose, as opioids can depress breathing and cause death.

There were 1,985 deaths related to opioids in 2017 in England and Wales, according to the Home Office.

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