Medical Procedures While Breastfeeding

  1. I Am Having Surgery and I Am Breastfeeding. What Should I Do?
    Pre-operatively:

    • Plan ahead: store breast milk ahead of time. Also see Breastfeeding and Working and Breast Milk Storage
    • Schedule your surgery early in the morning, keeping yourself hydrated before the surgery
    • Pump or breastfeed immediately before surgery
    • Identify a dedicated family member or friend to take care of the infant

    During the Surgery/Procedure:

    • When able, choose a regional or local anesthesia (i.e. epidural vs. general anesthesia)
    • Minimize narcotics (i.e. morphine, fentanyl).  Over use of narcotics during a procedure may cause infant sedation when nursing immediately post-op.

    Post-operatively:

    • Breastfeed or pump as soon as possible after the procedure
    • In general, once a mother is awake and alert enough to take care of her infant, she can breastfeed because the medications are out of her system and at low levels in the breastmilk. If your medical provider has questions they can review the ABM Clinical Protocol #15:  Analgesia and Anesthesia for the Breastfeeding Mother.
    • Find out if your infant is allowed to visit you
    • Another adult should be responsible for taking care of your infant immediately post-operatively
  2. Medications Following Procedures
    Pain killers are commonly prescribed following delivery and other medical procedures. In general avoid codeine. Start with acetaminophen and ibuprofen. If a stronger pain killer is needed then oxycodone is considered generally compatible with breastfeeding. Doses should be limited to 30 mg per day. For example, vicodin 5/325 has 5 mg of oxycodone and 325 mg of acetaminophen.  If taken 1 tablet 4 times per day the daily dose would be 20 mg per day. If mother needs stronger pain killers both she and the baby should be monitored closely and cared for by another adult. The compatibility of other medications with breastfeeding can be checked here or call the Infant Risk Call Center at 806-352-2519.

  3. I Am Having an MRI or CT Scan With Contrast, Can I Continue Breastfeeding?
    • Yes, you can conitinue to breastfeed.  You do not need to pump and dump if you are having an MRI or CT scan with iodinated or gadolinium based contrast material.
    • The American College of Radiology report notes the levels in breastmilk of iodinated and gadolinium based contrast material is very low immediately following the procedure (< 1%) of the contrast material being completely cleared within 24 hours. If you want to be extremely cautious the most you would have to pump and dump would be 24 hours.
    • Based on the available data it is recommended that a mother can continue breastfeeding immediately following the procedure. Click here for the full statement.
    • If you are having a nuclear medicine test such as a PET scan, please contact your doctor to discuss the specifics.
  4. My Breastfeeding Infant Is Undergoing Surgery. What Should I Do?
    • Often before a procedure it is recommended to be NPO (nothing by mouth).
      • 2 hrs before a procedure clear liquids are allowed (water, apple juice, pedialyte)
      • 4 hrs before a procedure breast milk is allowed
    • Plan to breastfeed 4 hours before the scheduled procedure
    • Pump or hand express while your infant is NPO to prevent engorgement and protect your milk supply.  Find out ahead of time where you will be able to do this and where you can store your expressed milk or bring a small cooler with you.
    • Ask to be able to see your infant immediately (before they offer a bottle) and breastfeed in the recovery unit as soon as your infant shows interest
    • If staying overnight confirm there will be accommodations for mother to stay with their infant.
    • If your health care provider needs further information reference ABM Clinical Protocol #25:  Recommendations for Pre-procedural Fasting for the Breastfed Infant
  5. I Am Having a Dental Procedure, Can I Continue to Breastfeed?
    • It is generally accepted that a one-time use of a local anesthetic is compatible with breastfeeding.
    • Milk concentrations of lidocane, a common local anesthetic are low.  Furthermore, the drug is not absorbed well by the infant if any was excreted into the breast milk.  Not all local anesthetics have been studied with breastfeeding, but typically they have a short half-life, and therefore are out of the system quickly.  One-time use is generally viewed as compatible with breastfeeding in the healthy infant.
  6. I Am Having a Procedure With Local Anesthesia, Can I Continue To Breastfeed
    • Like dental procedures, skin biopsies or other procedures with local anesthesia typically involve one-time use of local anesthesia, which is generally accepted as compatible with breastfeeding.