Is Lidocaine compatible with breastfeeding? Do we have alternatives for Lidocaine?

Lidocaine

March 22, 2018 (Very Low Risk)

Compatible with breastfeeding no matter the multiple ways it can be used: anesthetic, anti-arrhythmic, or anti-epileptic drug.

Excreted into breast milk in non-significant amount with no side effects on breastfed infants from treated mothers.

As a topical anesthetic (dermatologic, dental-stomatologic, ophtalmotologic and otologic preparations) it has an almost nil systemic absorption. Avoid using it on the nipple, but if necessary do it after the breast feed, wipe it out and rinse with water before the next feed,

An euptectic mixture with added Prilocaine (EMLA) is used for dermatologic anesthesia. There is an increased risk of Methemoglobinemia when applied on large surfaces or taken by mouth.

Intrapartum anesthesia may delay the onset of phase II of Lactogenesis or milk coming-in.

The American Academy of Pediatrics rates it usually compatible with Breastfeeding.

Alternatives

We do not have alternatives for Lidocaine since it is relatively safe.

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Lignocaine

Writings

  • Λιδοκαΐνη (Greek)
  • ليدوكائين (Arabic)
  • Лидокаин (Cyrillic)
  • 利多卡因 (Chinese)
  • リドカイン (Japanese)
  • C14 H22 N2 O (Molecular formula)
  • 2-Diethylaminoaceto-2′,6′-xylidide (Chemical name)
  • C01BB01; C05AD01; D04AB01; N01BB02; R02AD02; S01HA07; S02DA01 (ATC Code/s)

Drug trade names

References

  1. Reece-Stremtan Sarah, Campos Matilde, Kokajko Lauren, and The Academy of Breastfeeding Medicine. Breastfeeding Medicine. ABM Clinical Protocol #15: Analgesia and Anesthesia for the Breastfeeding Mother, Revised 2017. Breastfeeding Medicine. 2017 Full text (link to original source) Full text (in our servers)
  2. PDR.net EMLA Drug Summary 2014 Full text (in our servers)
  3. Lind JN, Perrine CG, Li R. Relationship between Use of Labor Pain Medications and Delayed Onset of Lactation. J Hum Lact. 2014Abstract
  4. Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014Abstract
  5. Fouladi RF, Navali N, Abbassi A. Pre-incisional, post-incisional and combined pre- and post-incisional local wound infiltrations with lidocaine in elective caesarean section delivery: a randomised clinical trial. J Obstet Gynaecol. 2013Abstract
  6. Babwah TJ, Nunes P, Maharaj RG. An unexpected temporary suppression of lactation after a local corticosteroid injection for tenosynovitis. Eur J Gen Pract. 2013Abstract
  7. Jürgens TP, Schaefer C, May A. Treatment of cluster headache in pregnancy and lactation. Cephalalgia. 2009Abstract
  8. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology. 2006Abstract Full text (link to original source) Full text (in our servers)
  9. Howie WO, McMullen PC. Breastfeeding problems following anesthetic administration. J Perinat Educ. 2006Abstract Full text (link to original source) Full text (in our servers)
  10. Bailey DN, Briggs JR. The binding of acetaminophen, lidocaine, and valproic acid to human milk. Am J Clin Pathol. 2004Abstract
  11. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  12. Tan HL, Lie KI. Treatment of tachyarrhythmias during pregnancy and lactation. Eur Heart J. 2001Abstract Full text (link to original source) Full text (in our servers)
  13. Touma S, Jackson JB. Lidocaine and prilocaine toxicity in a patient receiving treatment for mollusca contagiosa. J Am Acad Dermatol. 2001Abstract
  14. Giuliani M, Grossi GB, Pileri M, Lajolo C, Casparrini G. Could local anesthesia while breast-feeding be harmful to infants? J Pediatr Gastroenterol Nutr. 2001Abstract
  15. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001Abstract Full text (link to original source) Full text (in our servers)
  16. Dryden RM, Lo MW. Breast milk lidocaine levels in tumescent liposuction. Plast Reconstr Surg. 2000Abstract
  17. Essink-Tebbes CM, Wuis EW, Liem KD, van Dongen RT, Hekster YA. Safety of lidocaine-prilocaine cream application four times a day in premature neonates: a pilot study. Eur J Pediatr. 1999Abstract
  18. Ortega D, Viviand X, Lorec AM, Gamerre M, Martin C, Bruguerolle B. Excretion of lidocaine and bupivacaine in breast milk following epidural anesthesia for cesarean delivery. Acta Anaesthesiol Scand. 1999Abstract
  19. Vickers ER, Marzbani N, Gerzina TM, McLean C, Punnia-Moorthy A, Mather L. Pharmacokinetics of EMLA cream 5% application to oral mucosa. Anesth Prog. 1997Abstract
  20. Lebedevs TH, Wojnar-Horton RE, Yapp P, Roberts MJ, Dusci LJ, Hackett LP, Ilett K. Excretion of lignocaine and its metabolite monoethylglycinexylidide in breast milk following its use in a dental procedure. A case report. J Clin Periodontol. 1993Abstract
  21. Harrison RF, Brennan M. Evaluation of two local anaesthetic sprays for the relief of post-episiotomy pain. Curr Med Res Opin. 1987Abstract
  22. Zeisler JA, Gaarder TD, De Mesquita SA. Lidocaine excretion in breast milk. Drug Intell Clin Pharm. 1986Abstract
  23. Nau H. Clinical pharmacokinetics in pregnancy and perinatology. I. Placental transfer and fetal side effects of local anaesthetic agents. Dev Pharmacol Ther. 1985Abstract