If you are having surgery with general anesthesia
General anesthesia means that you will be asleep during the procedure. Share with your healthcare provider that you are breastfeeding and intend to continue breastfeeding after surgery. If you are concerned about the impact of the anesthesia and/or the separation, you can discuss postponing your surgery until your baby is older.
Many review articles have concluded that most patients may safely breastfeed healthy term or older children immediately after surgery. Once you are alert, aware, and able to hold your baby, it means the anesthetic has moved from your blood to your fat and muscle tissue to be slowly released over time.
Transfer of drugs into human milk depends on the properties of the medication. There are many drugs that are safe to use while breastfeeding. Share references below with your healthcare providers if they need more information about safe medications. Be sure to explore which medications will be prescribed for you for post-surgery pain. Most are safe for breastfeeding, but if not, it may be possible to substitute another medication if necessary.
If the nursing infant is “at-risk” such as a premature baby or a baby that experiences apnea (stops breathing temporarily from time to time), the healthcare provider may recommend refraining from breastfeeding or from giving milk you have expressed post operation for 6-12 hours following the surgery. If practical, this expressed milk may be frozen for use when the baby is older or diluted with milk expressed before administration of the anesthetic.
If possible, spinal or epidural anesthetics may be chosen instead of general anesthesia. Patients are awake during these surgeries, and can breastfeed immediately.
- Pump and save sufficient milk ahead of time so there is milk available for baby during the surgery.
- Ask the provider if surgery can be scheduled first in the day, so that there is no delay in case other surgeries run longer than expected.
- Breastfeed just before leaving home for the surgery.
- Make sure a breast pump is available when you arrive at the hospital, whether it is your own pump or one provided by the hospital. Pump just before surgery begins and again as soon as possible when you are awake and alert after surgery if baby is not there to feed. There is no reason to discard milk that is pumped just after surgery.
- If you will be staying in the hospital for a while, see if baby can stay with you, as long as there is another caregiver to assist with baby care.
- Any help you can get at home after surgery with household chores and care for other children will be really useful. If visiting people is restricted in your country, someone may be able to deliver shopping or meals to your door.
If you are having surgery with local anesthetic
Local anesthesia is when a medication is injected or applied at the site to numb the area of surgery. It is often used in dental procedures. These medications are poorly absorbed and do not transfer to human milk. Nursing may resume as soon as you feel able.
https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/15-analgesia-and-anesthesia-protocol-english.pdf. This resource is provided in English, Chinese, Croatian, Korean and Spanish
https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/15-analgesia-and-anesthesia-annotated-bibliography.pdf Bibliography of information from Academy of Breastfeeding Medicine (ABM) analgesia and anesthesia protocol in English
Breastfeeding After Anesthesia: A Review for Anesthesia Providers Regarding the Transfer of Medications into Breast Milk https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4582419/
Guideline on anaesthesia and sedation in breastfeeding women 2020 – Great Britain and Ireland https://doi.org/10.1111/anae.15179
Medications and breastfeeding information for healthcare professionals and parents:
LactMed U.S. National Library of Medicine https://toxnet.nlm.nih.gov/newtoxnet/lactmed.htm
E-Lactancia Association for Promotion and Cultural and Scientific Research of Breastfeeding, Spanish and English www.e-lactancia.org
Infant Risk Center Texas Tech University Health Sciences Center, TX USA www.infantrisk.com and +1 806-352-2519