Breastfeeding, Surgery, and Anesthesia: A Guide for Mothers
Breastfeeding, Surgery, and Anesthesia: A Guide for Mothers
Breastfeeding provides essential nutrition and immune support to your baby, and most modern anesthetics and perioperative medications are compatible with breastfeeding. For mothers facing surgery, concerns about anesthesia and medications are natural. Recent guidelines from the American Society of Anesthesiologists and the Academy of Breastfeeding Medicine confirm that breastfeeding can generally be resumed as soon as you are awake and alert, without the need to discard milk.
With careful planning and clear communication with your healthcare team, you can confidently continue breastfeeding throughout your surgical experience and beyond.
Preparing for Surgery as a Breastfeeding Mother
Pre-surgery planning is essential. By communicating your breastfeeding goals with your surgical team, you can ensure that they make accommodations to support your needs. Please see our article: how to talk to your healthcare provider about medications and breastfeeding . The Mayo Clinic has developed this module which is a greate too to educate mothers on caring for themselves during surgery.
- For most procedures, patients must continue to take clear liquids by mouth until 2 hours prior to the procedure to provide adequate hydration. The specific number of hours might be different for different surgeries or facilities, always check with your surgical team to find out what they require for your procedure.
- Ask your medical team if they have breast pumps available, or if you need to bring your own. Hand expression is another option if necessary. Hand expression is a good skill to learn: How To Hand Express
- Feed or Pump Right Before Surgery: This reduces the chance of needing to pump during or shortly after surgery, extending the amount of time during and after surgery you and your team have before the next milk expression.
- Discuss Preoperative and Intraoperative Support: For longer surgeries, your care team can discuss options like intraoperative milk expression to keep you comfortable. If your care team hasn’t done this before, let them know about the information we have in our articles for healthcare providers.
Intraoperative Support for Breastfeeding Mothers
Some hospitals now offer lactation support in the operating room, with protocols to ensure comfort and support for breastfeeding mothers link to more info for the perioperative team. If your surgery might exceed typical feeding or pumping intervals, discuss options with your team.
Scheduled Milk Expression: Pumping at specific intervals can prevent engorgement and maintain supply.
Breast Accessibility and Positioning: Many hospitals allow cotton (No metal, no synthetics that would conduct energy in the case of a code) nursing bras to be worn during surgery to maintain comfort.
With safe medication choices, it is usually possible to manage pain and other symptoms without affecting your breastfeeding goals. During your preoperative appointment, consult with the anesthesia team to discuss breastfeeding considerations and ensure safe breastfeeding practices are maintained. Many anesthetic agents and common pain medications are compatible with breastfeeding. Compatibility of anesthetic medications with breastfeeding allows for immediate resumption of breastfeeding, supporting maternal and infant health. See: Anesthesia for Patients Who Are Breastfeeding.
Postoperative Recovery and Resuming Breastfeeding
Once surgery is complete, mothers are encouraged to resume hydration and normal nutrition as early as possible. Maintaining hydration and nutrition can support a smooth recovery and steady milk supply.
Anesthesia is designed to work fast and leave your body quickly—once you’re awake, these drugs are mostly gone. Medications get into (and out of!) milk from your blood supply. When the drugs are gone from your body, they are also gone from your milk!
Most mothers can resume breastfeeding as soon as they feel alert. Mothers who have premature infants or medically fragile infants need to be more cautious, although breastfeeding is still compatible in most situations. Talk to your healthcare provider about what drugs were used during your procedure and if they are compatible with breastfeeding. Each medication is different. Some meds can temporarily reduce milk supply, even if they are compatible with breastfeeding (steroids).
Pain can interfere with a positive breastfeeding experience and shouldn't be ignored. For pain control, mothers should prioritize non-medication methods and scheduled non-opioid options (like ibuprofen or acetaminophen) as the first approach to minimize the need for potentially sedating medications. If opioid medications (like hydrocodone or morphine) become necessary, the lowest effective dose should be used for the shortest possible duration. Waiting 4-12 hours after receiving pain medications or providing infants with half of your milk and half previously pumped milk or formula may be another option to limit the infant's exposure to medications.
Though the risk of side effects in the breastfed infant is rare, we always suggest you watch for signs of drowsiness or unusual reactions in your infant when a mother is taking sedating medications.
Supporting You Every Step of the Way
With the right support and resources, lactating patients can confidently undergo surgery without compromising their breastfeeding goals.
For additional support, you can look up the compatibility of over 4,000 medications 24/7 with our app for breastfeeding moms: MommyMeds. You may also contact the InfantRisk Center (806-352-2519) from 8 am to 3 pm CST Monday through Friday or consult with your lactation specialist for guidance.
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