Breastfeeding After Lidocaine and Steroid Injections for De Quervain's Tenosynovitis
Yes, a woman can safely continue breastfeeding after receiving lidocaine and steroid injections for De Quervain's tenosynovitis. There is no need to interrupt breastfeeding or discard breast milk following these injections.
Safety of Lidocaine During Breastfeeding
- Lidocaine is considered compatible with breastfeeding as it has poor oral bioavailability and minimal transfer into breast milk 1
- Local anesthetics can be used in lactating women with no need to interrupt breastfeeding 1
- The FDA drug label for lidocaine does not specifically contraindicate its use during breastfeeding, though it notes caution should be exercised 2
Safety of Corticosteroids During Breastfeeding
- The American Academy of Pediatrics considers oral steroids to be compatible with breastfeeding 1
- Corticosteroid injections are generally considered safe during lactation 1
- For steroid injections, breastfeeding can continue as normal without the need to express and discard breast milk 1
Potential Temporary Effects on Lactation
- There is a rare possibility of temporary suppression of lactation following corticosteroid injections 3
- One case report documented temporary suppression of lactation for approximately 36 hours after an injection of methylprednisolone acetate for De Quervain's tenosynovitis in a breastfeeding woman, with spontaneous resumption of normal milk production by 90 hours post-injection 3
- This effect appears to be dose-dependent and may be more likely with injections in high-activity areas like the wrist 3
Clinical Evidence for Treatment of De Quervain's in Breastfeeding Women
- A randomized controlled trial specifically including pregnant and lactating women found corticosteroid injections to be highly effective for De Quervain's tenosynovitis with no reported adverse effects on breastfeeding 4
- In this study, all patients receiving steroid injection achieved complete pain relief compared to none in the splinting group 5
- Corticosteroid injections have shown 65-98.75% success rates in treating De Quervain's tenosynovitis in general populations 6, 7
Recommendations for Breastfeeding Women Receiving These Injections
- Breastfeeding should be encouraged to continue normally following the procedure 1
- There is no need to express and discard breast milk ("pump and dump") after receiving these injections 1
- As a precaution, mothers might consider expressing and storing some breast milk prior to the procedure in case of the rare occurrence of temporary lactation suppression 3
- If using higher doses of corticosteroids, monitor the infant for any unusual drowsiness, though this is unlikely with localized injections 1
Conclusion
The evidence strongly supports that women can safely continue breastfeeding after receiving lidocaine and steroid injections for De Quervain's tenosynovitis. The benefits of treating the mother's condition while maintaining breastfeeding outweigh any theoretical risks to the infant.