Conscious Sedation and Breastfeeding:  Recommendations for Patients

As a lactation professional, I am often asked about the compatibility of breastfeeding with certain medications.  I refer to both my experience and knowledge of the drug in question as well as what the medical literature has to say about the safety of the drug for both mother and baby.

As a registered nurse working part-time for an oral surgery practice, I often administer drugs for IV conscious sedation for dental procedures, most commonly for wisdom tooth extractions.  We also offer nitrous oxide sedation and oral sedation for patients who do not wish to be as sedated as they might be for IV sedation.  

The majority of female patients we see in our clinic for IV sedation are of childbearing age.  Some of our patients are breastfeeding mothers and they often have questions about what drugs for sedation are safe in terms of:

Often times, discontinuing breastfeeding for a surgical or diagnostic procedure requiring sedation is the only alternative suggested to a nursing mother.  Discontinuing breastfeeding is typically not necessary.  

Today, many women, armed with knowledge and assertiveness, search for other ways or other practitioners who are willing to work with them as they have their procedure with sedation and continue nursing.  They know that for most medications, very little of the drug is transferred to their milk.  Additionally, very few medications have adverse effects in breastfed babies because the dose transferred to the milk is in such a low dose or it is poorly bioavailable to the infant.

Thomas Hale is one of the world's expert on Pharmacology and Lactation.  His book, Medication's and Mother's Milk, is an excellent reference for lactational pharmacology and a resource guide I use frequently.  Dr. Hale has an informative article on his website that discusses how drugs enter human milk.

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