Having an anaesthetic when you breastfeed

This page is designed to answer any questions you may have if you are breastfeeding at a time when you are due to undergo a surgical or diagnostic procedure that requires an anaesthetic. Please inform your surgeon and anaesthetist that you are breastfeeding, so they can consider this when planning and performing your anaesthetic and operation.

Do I have to stop breastfeeding if I need an anaesthetic?

No, breastfeeding matters to you and your child. The staff will support you in continuing to breastfeed as normally as possible around the time of your anaesthetic.

Usually, planning involves deciding whether having your child with you in the hospital is safe. If it is not safe, for instance, because of a risk of infection, the staff will support you in expressing and storing your breastmilk throughout your stay to maintain your supply.

Will medication used during my operation get into my breast milk?

Medicines used during your operation will get into the milk but only in small amounts. If you have any worries, ask your team so they can give you more details on the drugs you will receive and any known issues with them. You do not need to express and discard breastmilk (“pump and dump”) after an anaesthetic.

What medicines can affect my child?

The majority of medicines are safe and will not have any noticeable effect on your child. However, some medicines can make you sleepy, especially if you need lots of doses, and in this case the drug could build up in your breast milk and affect your child as well. If a drug makes you feel drowsy, it is more likely that it will make your child drowsy too.

What happens around the time of the operation?

You should continue to breastfeed as usual until you go to theatre; try to empty your breasts as close to having your anaesthetic as possible. You should also drink and eat until the time that you have been told to stop.

After your operation, you can breastfeed again as soon as you are back with your child, feeling awake and alert, although you may need help to start with. You should speak to a nurse who can provide you with medicine if you feel sick.

You should empty your breasts as regularly as is usual for you (either by direct feeding or expressing) in order to reduce the risk of clogged ducts, engorgement (when breasts become overly full) or infection.

How does the anaesthetist decide on the type of anaesthetic? Can I choose?

The type of operation you need often determines which anaesthetic options are available to you (local, regional, or general). Your anaesthetist will look at these options with you and, where possible consider your preferences.

Different types of anaesthetics:

Local and regional:

For some operations, an injection of a drug to numb the nerves (local anaesthetic) can be given. The injection can be given at the surgical site, at a nerve away from the site such as in the armpit or groin (regional anaesthetic), or in the back to numb the lower half of your body (spinal or epidural anaesthetic). A local or regional anaesthetic may be better if you breastfeed as you can typically eat and drink sooner, it should not affect your ability to breastfeed; and you’ll likely need fewer painkillers.

You recover quickly afterwards, and the medicines given via these routes will not affect your child.

Sedation:

This is when drugs are given to help relax you during a procedure, avoiding a full anaesthetic. It can vary from a small amount of drug to reduce anxiety (light sedation), to making you very sleepy and so that you do not remember some of the details of the procedure (deep sedation). Sedation can be given as well as local anaesthesia or on its own for various procedures. You can breastfeed as soon as you feel able to hold your child safely.

General anaesthesia:

This is when you are made unconscious (‘put to sleep’) for the procedure. You might also have a local anaesthetic or a regional anaesthetic during the operation to help you feel more comfortable afterwards. Once you are awake enough to hold your child safely, you can breastfeed or express as required.

Can I take appropriate pain relief after my procedure?

It is important that you are comfortable after your procedure, so you should make sure that you have a supply of pain relief and take them if needed.

Paracetamol is safe for both you and your child. It passes into breast milk in much lower doses than we give to treat a high temperature or teething. Take paracetamol regularly to start with after surgery.

Anti-inflammatory drugs (such as ibuprofen, diclofenac, or naproxen) are suitable for you to take and breastfeed as normal, very low levels of the drug pass into breast milk. You can take these as well as paracetamol.

Opioids (morphine, dihydrocodeine tartrate, tramadol, and oxycodone) can be used if you have severe pain. The effect of these medicines will differ in different people. Some people are very sensitive and may experience significant side effects from one or several doses. In this case, the drug may build up in the breast milk and affect the child. If the medicine is making you very sleepy or causing your child to be drowsy, stop taking it and seek advice as you may need to change to a different pain relief. If your child has signs of difficulty breathing, seek medical advice straight away. This medication, when used as needed following an operation, has been safely given to breastfeeding patients.

Codeine phosphate or tablets with codeine phosphate as an ingredient should not be taken by breastfeeding patients due to the risk of drowsiness and breathing difficulties in the breastfed child. You should be given different pain relief.

When should I stop taking pain relief after my operation?

Only use opioid (strong) pain relief for the shortest time possible following your operation. As your pain lessens, aim to reduce and stop any opioids first; then reduce and stop ibuprofen (or similar pain relief; then tail off and stop paracetamol last of all.

Can I bed share as normal following my anaesthetic?

You should not bed share with your child on the night following surgery, as you will be less aware of them than usual. It is important that you also do not fall asleep in a chair or on a sofa with them.

If possible, another adult should take care of your child overnight.

Where can I find more information about the safety of anaesthetic medications and breastfeeding?

The Breastfeeding Network have a number of leaflets on drugs in breastmilk, written by experienced pharmacists who are also trained breastfeeding supporters. Go here to access the Breastfeeding Network leaflets about drugs in breastmilk.