Lidocaine Safety During Breastfeeding
Local anesthetics like lidocaine can be safely used in breastfeeding mothers with no need to interrupt breastfeeding. 1
Safety Profile of Lidocaine During Breastfeeding
Lidocaine, an amino amide local anesthetic, has been extensively studied in the context of breastfeeding:
- Local anesthetics may be secreted in small amounts in breast milk, but extensive investigation has shown no evidence of harm to breastfed infants 1
- The Association of Anaesthetists explicitly states that local anesthetics can be used in lactating women with no need to interrupt breastfeeding 1
- Even when lidocaine is administered parenterally for dental procedures, the amounts transferred to breast milk are minimal and considered safe for the infant 2
Pharmacokinetic Considerations
The safety of lidocaine during breastfeeding is supported by its pharmacokinetic properties:
- In studies measuring lidocaine concentrations in breast milk after dental anesthesia, the calculated daily infant dosages were extremely low (73.41 ± 38.94 μg/L/day) 2
- When used intravenously, breast milk concentrations of lidocaine reach approximately 40% of maternal serum levels, but these amounts are still considered too small to cause adverse effects in nursing infants 3
- The FDA drug label for topical lidocaine recommends consulting a healthcare professional before use during breastfeeding, but does not contraindicate its use 4
Clinical Recommendations
When using lidocaine in breastfeeding mothers:
- No waiting period is required before resuming breastfeeding after lidocaine administration 1
- For dental procedures requiring local anesthesia with lidocaine, mothers can safely continue breastfeeding 2
- For topical lidocaine applications, follow standard precautions regarding application site and duration of use 4
Common Pitfalls and Considerations
- Unlike some medications that require caution during breastfeeding (such as tramadol or oxycodone), local anesthetics including lidocaine do not require special monitoring of the infant 1
- The benefits of uninterrupted breastfeeding generally outweigh any theoretical risks of lidocaine exposure through breast milk 5, 6
- When making decisions about medication use during lactation, healthcare providers should consider that most medicines, including lidocaine, can be used safely at recommended doses 7
In conclusion, the evidence strongly supports that lidocaine administration to breastfeeding mothers, whether for local anesthesia during procedures or for other indications, is compatible with continued breastfeeding without interruption or special precautions.