Background

T here is little rigorous information in the scientific literature about anesthesia or procedural sedation in breastfeeding mothers. Recommendations in this area typically focus on pharmacologic properties of anesthetic agents, limited studies of milk levels, and rare infant effects. In addition to medication concerns, additional perioperative considerations may impact a breastfeeding dyad's continued breastfeeding success when a mother undergoes anesthesia or sedation. Despite the lack of controlled studies regarding outcomes of breastfeeding in mothers receiving anesthesia, multiple review articles conclude that most mothers may safely breastfeed immediately following anesthesia. 1–8 (IV)(Quality of evidence [levels of evidence IA, IB, IIA, IIB, III, and IV] is based on levels of evidence used for the National Guidelines Clearing House and is noted in parentheses.) 9 Most recommendations for breastfeeding in the perioperative setting come from expert opinion rather than from extensive studies or trials. Up-to-date information on specific medications can be found on the United States National Library of Medicine website LactMed, 10 with additional resources listed in Table 1.