Last update: March 22, 2018
Not risky for breastfeeding or infant.
Topical anesthetics used for local, dental, spinal or epidural anesthesia are not a cause of important systemic absorption.
Used for pain relief from below the waistline (e.g. pain during childbirth)
The anesthetic which is locally injected is not harmful for the infant or lactation. It is usually used in association to an opioid-derivative drug like Fentanyl.
Several studies have shown an increase of instrumental deliveries and C-section rate related to fetal distress, unreal birth weight (due to fluids administered to the mother), breast plethora, with the use of Epidural Anesthesia.
There is controversy about the effect of drug-mediated analgesia used during the child birth (e.g. epidural injection of local anesthetics plus Fentanyl or alone) on the mature milk coming in, whether by delaying the onset of Lactogenesis phase II, or, by affecting the ability of the child for sucking.
Some studies have shown a higher risk for delay of initiation of Lactogenesis phase II (milk coming in) longer than 3 post-natal days, but without effect on loss of initial weight. On other studies, the newborn infant appears to have higher risk for delay on first latch-on, higher body temperature and irritability or somnolence. Because of the latter, it is argued that those mothers would be in need of more support on breastfeeding when they have received ante or intra partum analgesia.
However, other authors have failed to find the same results.
There consensus on the achievement of higher milk production and higher body weight increase in the neonate with an adequate pharmacological control of pain after C-section or vaginal childbirth.
We do not have alternatives for Local Anesthesia since it is relatively safe.
Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
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