Breastfeeding is safe after anaesthesia, according to new guidelines

on 11 August 2020

New guidance published by the Association of Anaesthesia says that it is safe for women to breastfeed as soon as they are alert following an anaesthesia.

The guidance, published in the journal Anaesthesia, say there is no need to discard any breastmilk due to fears of contamination as evidence shows that anaesthetic and non-opioid painkiller drugs are transferred to breastmilk in “very small amounts”, says the authors who include Dr Mike Kinsella from the Safety Committee at the Association of Anaesthetists based at St Michael’s Hospital in Bristol.

However, the guidance says that drugs such as opioids and benzodiazepines should be used with caution, especially after multiple doses and in babies up to 6 weeks old (corrected for gestational age): “In this situation, the infant should be observed for signs of abnormal drowsiness and respiratory depression, especially if the woman is also showing signs of sedation.”

Guidance also states that codeine should not be used by breastfeeding women following concerns of some infants becoming sedated which is related to differences in metabolism.

It is recommended that any women with an infant aged 2 years or younger should routinely be asked if they are breastfeeding during their preoperative assessment, so that it can be explained to them that breastfeeding will be safe after their surgery.

“Where possible, day surgery is preferable to avoid disrupting normal routines. A woman having day surgery should have a responsible adult stay with her for the first 24 hours. She should be cautious with co-sleeping, or sleeping while feeding the infant in a chair, as she may not be as responsive as normal.”

Overall, the guidelines say that anaesthesia and sedation in breastfeeding women require little alteration, but “supportive care for the women in the peri-operative period, and accurate advice, will ensure minimal disruption to this important part of childcare.”

Anaesthesia and sedation in breastfeeding 2020 guidelines can be found here.