AANA journal course: update for nurse anesthetists--"is it okay to breast feed my baby after anesthesia?" A scientific basis for an informed response.

Many breast-feeding women are exposed to anesthetic drugs. The question of breast feeding following an anesthetic is a highly relevant issue in part because it is desirable to allow breast feeding to resume quickly while minimizing the potential for drug-related infant morbidity. The physiology of breast milk production and the factors influencing the transfer of drugs into breast milk is reviewed. Generally there is incomplete or sparse information on the potential effects upon the suckling infant. Despite this, certain reasonable conclusions and recommendations can be developed. Among these include a substantive risk with high-dose and long-standing therapies, particular vulnerability in the premature neonate or when a mother is receiving multidose therapy, and consideration of temporarily interrupting the feeding schedule where sufficient doubt exists. Overall, the importance of breast feeding must be carefully considered in light of the potential for side effects in each maternal/child scenario.