- Joined
- Aug 16, 2005
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Came across this new ASA statement that should simplify life for those of us that do OB.
Recommendations:
The following recommendations are suggested for lactating women requiring surgery:
1. All anesthetic and analgesic drugs transfer to breastmilk; however, only small amounts are present and in very low concentrations considered clinically insignificant.
2. Narcotics and/or their metabolites may transfer in slightly higher levels into breastmilk; therefore, steps should be taken to lower narcotic requirements by adding other analgesics when appropriate and avoiding drugs that are more likely to transfer (i.e., have a higher RID).
3. Because pain interferes with successful breastfeeding, women should not avoid pain medicines after surgery. Despite an excellent safety record, breastfeeding women who require narcotic pain medicines should always watch the baby closely for signs of sedation: difficult to wake and/or slowed breathing.
4. When possible, spinal or epidural anesthesia consisting of local anesthetic and a long-acting narcotic, should be used for cesarean delivery to reduce overall post-operative pain medication requirements.
5. Patients should resume breastfeeding as soon as possible after surgery because anesthetic drugs appear in such low levels in breastmilk. It is not recommended that patients “pump and dump.”
Statement on Resuming Breastfeeding after Anesthesia
www.asahq.org
Recommendations:
The following recommendations are suggested for lactating women requiring surgery:
1. All anesthetic and analgesic drugs transfer to breastmilk; however, only small amounts are present and in very low concentrations considered clinically insignificant.
2. Narcotics and/or their metabolites may transfer in slightly higher levels into breastmilk; therefore, steps should be taken to lower narcotic requirements by adding other analgesics when appropriate and avoiding drugs that are more likely to transfer (i.e., have a higher RID).
3. Because pain interferes with successful breastfeeding, women should not avoid pain medicines after surgery. Despite an excellent safety record, breastfeeding women who require narcotic pain medicines should always watch the baby closely for signs of sedation: difficult to wake and/or slowed breathing.
4. When possible, spinal or epidural anesthesia consisting of local anesthetic and a long-acting narcotic, should be used for cesarean delivery to reduce overall post-operative pain medication requirements.
5. Patients should resume breastfeeding as soon as possible after surgery because anesthetic drugs appear in such low levels in breastmilk. It is not recommended that patients “pump and dump.”
