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Recommendations made
pediatrician - Dr. Victоr Аbdоw
Rоckville, МD, USА.


woomen

Is it allowed to take Bupivacaine during lactation?
Is it safe for a nursing mother and a child?

Local anesthetic agent which is used for infiltration and nerve-blocking procedures included Epidural anesthesia. It is excreted into breast milk in non-significant amount, with no side-effect observed on breastfed infants of treated mothers. Plasma levels in those infant were undetectable. There is controversy about the effect of drug-mediated analgesia used during the child birth (e.g. epidural injection of local anesthetics plus Fentanyl or alone) on the mature milk coming in, whether by delaying the onset of Lactogenesis phase II, or, by affecting the ability of the child for sucking. Some studies have shown a higher risk for delay of initiation of Lactogenesis phase II (milk coming in) longer than 3 post-natal days, but without effect on loss of initial weight. On other studies, the newborn infant appears to have higher risk for delay on first latch-on, higher body temperature and irritability or somnolence. Because of the latter, it is argued that those mothers would be in need of more support on breastfeeding when they have received ante or intra partum analgesia. However, other authors have failed to find the same results. There is consensus on the achievement of higher milk production and higher body weight increase in the neonate with an adequate pharmacological control of pain after C-section or vaginal childbirth.

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woomen

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Types of risk

VERY LOW RISK
It is allowed while breastfeeding. It is not dangerous for a baby. It is moderately safe. more...

LOW RISK PROBABLE
Possible presence in breast milk is allowed. Follow the doctor's recommendation. more...

HIGH RISK PROBABLE
An unsafe drug, it is necessary to assess the risks while taking. Use safer analogs. more...

VERY HIGH RISK
It is not recommended. You need to stop breastfeeding or choose a safe analog. more...

Scientific literature

The level of risk for breastfeeding is confirmed in these scientific publications:
  1. https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/15-analgesia-and-anesthesia-protocol-english.pdf
  2. http://www.ncbi.nlm.nih.gov/pubmed/24451212
  3. http://www.ncbi.nlm.nih.gov/pubmed/24953218
  4. http://www.ncbi.nlm.nih.gov/pubmed/25432659
  5. http://www.ijponline.net/content/pdf/s13052-014-0082-6.pdf
  6. http://www.ncbi.nlm.nih.gov/pubmed/25492043
  7. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4297456/pdf/13052_2014_Article_99.pdf
  8. http://www.ncbi.nlm.nih.gov/pubmed/20627690
  9. http://www.ncbi.nlm.nih.gov/pubmed/19912160
  10. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2044.2009.06136.x/epdf
  11. http://www.ncbi.nlm.nih.gov/pubmed/17134489
  12. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1702531/pdf/1746-4358-1-24.pdf
  13. http://www.ncbi.nlm.nih.gov/pubmed/17541461
  14. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595306/pdf/JPE150050.pdf
  15. http://www.ncbi.nlm.nih.gov/pubmed/15684016
  16. http://www.j-smu.com/pdf2/200501/200501114.pdf
  17. http://www.ncbi.nlm.nih.gov/pubmed/16113019
  18. http://www.ncbi.nlm.nih.gov/pubmed/12624551
  19. http://www.ncbi.nlm.nih.gov/pubmed/12774874
  20. http://whqlibdoc.who.int/hq/2002/55732.pdf
  21. http://www.ncbi.nlm.nih.gov/pubmed/11264622
  22. http://www.ncbi.nlm.nih.gov/pubmed/10225071
  23. http://www.ncbi.nlm.nih.gov/pubmed/9301399
  24. http://bja.oxfordjournals.org/content/79/1/120.full.pdf
  25. http://www.ncbi.nlm.nih.gov/pubmed/8638785
  26. http://www.ncbi.nlm.nih.gov/pubmed/8346780
  27. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2044.1993.tb07130.x/epdf
  28. http://www.ncbi.nlm.nih.gov/pubmed/3891263
  29. http://www.ncbi.nlm.nih.gov/pubmed/7387928
  30. http://www.ncbi.nlm.nih.gov/pubmed/666931

Comments  

+3 #1 Reviewer: MP, 55-64 Male on Treatment for 1 to 6 months (Patient) 2018-01-13 02:39
I have a Intrathcal Pump using 0.399 Morphine/day and 4.789mg/day of Bupivacaine. I went from 6 methadone 5mg/day. this system works great!!

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