Breastfeeding after Anaesthesia
Further information
If you require further information please contact your anaesthetist. If you don’t know your anaesthetist’s name, contact your surgeon or procedural specialist. More information about anaesthesia and anaesthetists can be found in the patients’ section on the ASA website: www.asa.org.au
References
- Chu TC, McCallum J, Yii MF. ‘Breastfeeding after anaesthesia: a review of the pharmacological impact on children’, Anaesthesia and Intensive Care 2013, 41:35-40.
- Cobb B, Liu R, Valentine E, Onuha O. ‘Breastfeeding after anaesthesia: A review for anaesthesia providers regarding the transfer of medications into breast milk’, Translational and Perioperative Pain Medicine 2015, 1(2):1-7.
- Drugs and Lactation Database (LactMed), (2006–present) National Library of Medicine (US), Bethesda, Maryland, accessed online 22 November 2019, Available at: https://www.ncbi.nlm.nih.gov/ books/NBK501922/
You’re in good hands
Anaesthetists in Australia are highly trained medical specialists. After graduating from medical school and completing an internship, Anaesthetists will often work for three to four years as critical care resident medical officers before commencing five years of anaesthetic training. Anaesthetists receive specialist training in anaesthesia, pain management, resuscitation and the management of medical emergencies. The aims of this pamphlet are to:
- Provide you with basic information about breastfeeding after recently administered anaesthesia.
- Encourage you to ask questions of your anaesthetist.
- Reassure you about the safety of breastfeeding in the perioperative period for most patients.
In the past, there has been advice to ’pump and dump‘ for 24 hours after surgery and some women may continue to prefer to do this, however there are implications of the interruption to breastfeeding both for the baby and maternal supply. Many patients are happy to hear that this advice is conservative and probably outdated. Commonsense approaches, such as breastfeeding the infant as close to the time of the procedure as practicable and staying well hydrated, would seem reasonable. Once a mother is awake and alert after anaesthesia (or sedation) and able to safely hold her baby it is safe to breastfeed her baby. This includes after common sedation medications, antibiotics, anaesthetic and analgesic (pain relief) medications. There are around 100,000 births by caesarean section in Australia each year. Most of these mothers breastfeed their newborns safely despite undergoing either spinal, epidural or general anaesthesia for surgery and take pain relief medications post delivery. It is recommended that young babies (less than three months of age, including newborns) are initially monitored when their mothers are taking strong pain relief medications. This monitoring is for the sake of caution, and is extended to the use of strong medications called opioids. Fentanyl and other opioids are passed into breastmilk in small amounts. Care should be taken with newborns and high doses of some pain relief medications (including codeine, tramadol and oxycodone) due to the way that different people may process these medicines differently. Even these medicines are considered safe for use for the breastfeeding mother. To be as safe as possible it is suggested to monitor the baby, especially very young babies and premature infants (born earlier than 37 weeks). Premature babies may be more vulnerable to the side effects of some of these medications. There are some medicines which may be avoided in breastfeeding mothers if possible. This is because newborns may be affected and there are alternatives
