Last update: May 19, 2021

(General Anesthesia)

Very Low Risk for breastfeeding


Safe. Compatible.
Minimal risk for breastfeeding and infant.

Most anesthetics are excreted in small concentrations in breast milk and/or are very rapidly eliminated, which allows breastfeeding as soon as the mother is awake, alert, and fit and able to hold her baby (Mitchell 2020, Oliveira 2019, Fischer 2019, Reece 2017, Cobb 2015, Dalal 2014, Kranke 2011, Sønderskov 2011, Dahl 2011, Nitsun 2006, Lang 2003, Borgatta 1997, Lee 1993).

The small amount of colostrum obtained by the newborn in the first few feedings makes waiting to breastfeed after a caesarean section even more superfluous (Rathmell 1997).

Use of narcotics and benzodiazepines should be minimized, instead short-acting anesthetics and regional anesthesia should be used whenever possible for caesarean sections or surgical interventions in nursing mothers (Dalal 2014).

Regarding epidural anesthesia, general anesthesia in case of caesarean section delays the start of breastfeeding and reduces its frequency and duration (Kocaöz 2019, Alus 2014, Kutlucan 2014, Sener 2003, Lie 1988).

Early initiation of maternal feeding after awakening from anesthesia improves conditions for breastfeeding (Al-Takroni 1999).

Increased prolactin levels have been found during anesthesia (Lawrence 2016 p65, Morgan 1976).


See below the information of this related group:

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Group

(General Anesthesia) belongs to this group or family:

References

  1. Mitchell J, Jones W, Winkley E, Kinsella SM. Guideline on anaesthesia and sedation in breastfeeding women 2020: Guideline from the Association of Anaesthetists. Anaesthesia. 2020 Nov;75(11):1482-1493. Abstract
  2. Fischer A, Ortner C, Hartmann T, Jochberger S, Klein KU. [Which medications are safe while breastfeeding? : A synopsis for the anesthetist, obstetrician and pediatrician]. Wien Med Wochenschr. 2019 Mar;169(3-4):45-55. Abstract
  3. Oliveira MRE, Santos MG, Aude DA, Lima RME, Módolo NSP, Navarro LH. [Should maternal anesthesia delay breastfeeding? A systematic review of the literature]. Rev Bras Anestesiol. 2019 Mar - Apr;69(2):184-196. Abstract
  4. Kocaöz FŞ, Destegül D, Kocaöz S. Comparison of the breastfeeding outcomes and self-efficacy in the early postpartum period of women who had given birth by cesarean under general or spinal anesthesia. J Matern Fetal Neonatal Med. 2019 Jul 10:1-5. Abstract
  5. Reece-Stremtan Sarah, Campos Matilde, Kokajko Lauren, and The Academy of Breastfeeding Medicine. Breastfeeding Medicine. ABM Clinical Protocol #15: Analgesia and Anesthesia for the Breastfeeding Mother, Revised 2017. Breastfeed Med. 2017 Nov;12(9):500-506. Full text (link to original source) Full text (in our servers)
  6. Lawrence RA, Lawrence RM. Breastfeeding. A guide for the medical profession. Eighth Edition. Philadelphia: Elsevier; 2016
  7. Cobb B, Liu R, Valentine E, Onuoha O. Breastfeeding after Anesthesia: A Review for Anesthesia Providers Regarding the Transfer of Medications into Breast Milk. Transl Perioper Pain Med. 2015;1(2):1-7. Abstract Full text (link to original source) Full text (in our servers)
  8. Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, Third Edition. 2015
  9. Alus Tokat M, Serçekuş P, Yenal K, Okumuş H. Early Postpartum Breast-Feeding Outcomes and Breast-Feeding Self-Efficacy in Turkish Mothers Undergoing Vaginal Birth or Cesarean Birth With Different Types of Anesthesia. Int J Nurs Knowl. 2014 Abstract
  10. Dalal PG, Bosak J, Berlin C. Safety of the breast-feeding infant after maternal anesthesia. Paediatr Anaesth. 2014 Abstract
  11. Kutlucan L, Seker İS, Demiraran Y, Ersoy Ö, Karagöz İ, Sezen G, Köse SA. Effects of different anesthesia protocols on lactation in the postpartum period. J Turk Ger Gynecol Assoc. 2014 Dec 1;15(4):233-8. Abstract
  12. Kranke P, Frambach T, Schelling P, Wirbelauer J, Schaefer C, Stamer U. [Anaesthesia and breast-feeding: should breast-feeding be discouraged?]. Anasthesiol Intensivmed Notfallmed Schmerzther. 2011 Abstract
  13. Sønderskov ML, Albrechtsen CK, Bille AB, Henneberg S, Afshari A. [Most anaesthetics can be used without damaging effects of the breastfed child]. Ugeskr Laeger. 2011 Abstract
  14. Dahl JB. [Infants can be breastfed immediately after general anesthesia of the mother]. Ugeskr Laeger. 2011 Abstract
  15. Glader EL, Spigset O. [Should breast feeding mothers dispose of their milk after anesthesia?]. Lakartidningen. 2009 Abstract
  16. Nitsun M, Szokol JW, Saleh HJ, Murphy GS, Vender JS, Luong L, Raikoff K, Avram MJ. Pharmacokinetics of midazolam, propofol, and fentanyl transfer to human breast milk. Clin Pharmacol Ther. 2006 Abstract
  17. Sener EB, Guldogus F, Karakaya D, Baris S, Kocamanoglu S, Tur A. Comparison of neonatal effects of epidural and general anesthesia for cesarean section. Gynecol Obstet Invest. 2003 Abstract
  18. Lang C, Geldner G, Wulf H. [Anesthesia in the breast feeding period. Excretion of anesthetic agents and adjuvants into breast milk and potential pharmacological side-effects on the suckling infant]. Anaesthesist. 2003 Abstract
  19. Al-Takroni AM, Parvathi CK, Mendis KB, Hassan S, Qunaibi AM. Early oral intake after caesarean section performed under general anaesthesia. J Obstet Gynaecol. 1999 Abstract
  20. Borgatta L, Jenny RW, Gruss L, Ong C, Barad D. Clinical significance of methohexital, meperidine, and diazepam in breast milk. J Clin Pharmacol. 1997 Mar;37(3):186-92. Abstract
  21. Rathmell JP, Viscomi CM, Ashburn MA. Management of nonobstetric pain during pregnancy and lactation. Anesth Analg. 1997 Nov;85(5):1074-87. Review. No abstract available. Abstract
  22. Lee JJ, Rubin AP. Breast feeding and anaesthesia. Anaesthesia. 1993 Jul;48(7):616-25. Review. Abstract Full text (link to original source) Full text (in our servers)
  23. Lie B, Juul J. Effect of epidural vs. general anesthesia on breastfeeding. Acta Obstet Gynecol Scand. 1988 Abstract
  24. Morgan L, Barrett A, Beswick F, Hollway T, Raggatt PR. Prolactin concentrations during anaesthesia. Br Med J. 1976 Abstract Full text (link to original source)

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