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Guidelines Indicate Breastfeeding Is Safe After Maternal Anesthesia

There is no need to discard breast milk after anesthesia; opioid sparing preferred for breastfeeding moms

MONDAY, Aug. 3, 2020 (HealthDay News) — Breastfeeding is safe after anesthesia, according to guidelines issued by the Association of Anaesthetists and published online July 31 in Anaesthesia.

Joellene Mitchell, from the University Hospital Ayr in the United Kingdom, and colleagues developed guidelines to minimize interruptions to breastfeeding after surgery, including pharmacokinetic data on drugs used during anesthesia.

The authors developed recommendations that encourage breastfeeding as normal after surgery. After anesthesia, there is no need to express and discard breast milk. Data have shown anesthetic and nonopioid analgesic drugs are only transferred to breast milk in very small amounts. There was no evidence of effects on breastfed infants for almost all drugs used perioperatively. Opioids and benzodiazepines should be used with caution, especially after multiple doses and in mothers of babies aged younger than 6 weeks; infants should be observed for abnormal drowsiness and respiratory depression. Breastfeeding women should not use codeine due to concerns of excessive sedation in some infants. For breastfeeding women, opioid-sparing techniques are preferable; local and regional anesthesia are beneficial. To avoid disrupting normal routines, day surgery is preferable when possible. A woman having day surgery should have a responsible adult with her for 24 hours following surgery; care should be taken with cosleeping or sleeping while feeding the infant in a chair. Lactating women undergoing surgical and medical procedures should have access to breastfeeding support.

“Supportive care for the woman in the perioperative period, and accurate advice, will ensure minimal disruption to this important part of child care,” the authors write.

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