Tramadol and its metabolite, O-desmethyltramadol (M1), are present in human milk. There isn't any information on the effects of the drug over the breastfed toddler or the effects in the drug on milk output. The M1 metabolite is more powerful than tramadol in mu opioid receptor binding [see Medical Pharmacology https://titusurleu.thechapblog.com/36401069/a-secret-weapon-for-cocodamol-30mg