Summary
Breastfeeding is acknowledged widely as one of the most effective ways to ensure the health and well-being of both child and birth parent. Historically, advice given to patients who required an anaesthetic while breastfeeding was variable and inconsistent, sometimes resulting in the interruption of feeding for ≥ 24 h, or expressing and discarding breastmilk because of concerns regarding the possible adverse effects secondary to medicines passing into the breastmilk. This can be a contributory factor in the early cessation of breastfeeding. Peri-operative decisions can normally be made on the basis of pharmacokinetic data rather than on the precautionary principle.
Results Any patient with a child aged < 2 y should routinely be asked if they are breastfeeding or expressing breastmilk during their pre-operative assessment for a procedure involving anaesthesia or sedation. Anaesthetic, sedative and analgesic medicines are transferred to breastmilk in only very small amounts. For almost all medicines used peri-operatively, there is no evidence of adverse effects on the breastfed child. Patients should be advised that discarding of breastmilk after anaesthesia (`pumping and dumping´) is not necessary and that `sleep and keep´ is now recommended.