Last update May 6, 2022
Very Low Risk
Medication which is compatible with breastfeeding in its multiple applications: local anesthetic (dermatological, dental), antiarrhythmic and epidural anesthesia.
It is excreted in breastmilk in insignificant quantities (Galderma 2012, Giuliani 2001, Dryden 2000, Ortega 1999, Lebedevs 1993, Zeisler 1986) and no problems have been observed in infants whose mothers were taking it. (Ortega 1999)
There is controversy about whether or not neuraxial analgesia during labor can affect the initiation and success of lactation. (Heesen 2021, see analgesia epidural)
As a TOPICAL ANESTHETIC (dermatological, stomatological-dental, ophthalmological and otological preparations) it has virtually no systemic absorption (Reece 2017, Cobb 2015, Harrison 1987). Do not apply to the breast or, if necessary, apply after a feed and clean thoroughly with water before the next one.
With prilocaine it forms a eutectic mixture (EMLA) which is useful for dermatological anesthesia. Application over large areas or orally can cause methemoglobinemia. (PDR 2014, Touma 2001, Essink 1999, Vickers 1997)
Local infiltration of lidocaine and epinephrine in the incision area of a caesarean section, before and after the incision was associated with earlier first breastfeeding. (Tharwat 2016, Fouladi 2013).
The manufacturer (Galderma 2012) and several medical associations and expert consensus consider the use of this medication to be safe during breastfeeding. (Reece 2017, Cobb 2015, Butler 2014, Jürgens 2009, Schaefer 2007 p632, Howie 2006, Mahadevan 2006, Giuliani 2001, Tan 2001)
American Academy of Pediatrics: medication usually compatible with breastfeeding. (AAP 2001)
List of WHO essential medicines: compatible with breastfeeding. (WHO / UNICEF 2002)
We do not have alternatives for Lidocaine since it is relatively safe.
Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.
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