# Lidocaine--pump and dump?



## poorlittlefish (Jul 20, 2008)

At 11:30 this morning I had lidocaine injected in my back for a removal of a mole-a large excision because it was suspicious. The Dr. said to dump my next feeding and the next if I was really nervous. I will dump at my 12:30 pump but want to know about my 3pm pump. I don't want to give my baby drugs but I don't want to dump if I don't need to.

Does anyone have any experience with this?

Thanks!


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## atpeace (Apr 17, 2006)

Hmm, I had Lidocaine a few weeks before giving birth to my son for a tooth extraction (that could not wait as it was infected), and was told by the dentist that the dose will not harm the baby. Perhaps it is dose-dependent? I would probably just dump the first feeding, and not the second one...I guess it depends on how uncomfortable you are with your baby potentially being exposed to some of the drug, how much of the drug will still be in your system, how much will pass on into the milk, and how inconvenient or wasteful dumping the second pump will be (i.e. if you have low supply or other issues).

Here's one bit of info I found:
"Small amounts of lidocaine are excreted into breast milk (24). A 37-year-old, lactating woman was treated with intravenous lidocaine for acute onset ventricular arrhythmia secondary to chronic mitral valve prolapse. The woman had been nursing her 10-month-old infant up to the time of treatment. She was treated with lidocaine, 75 mg over 1 minute, followed by a continuous infusion of 2 mg/minute (23 g/kg/minute). A second 50-mg dose was given 5 minutes after the first bolus dose. The woman's serum lidocaine level 5 hours after initiation of therapy was 2 g/mL. The drug concentration in a milk sample, obtained 2 hours later when therapy was stopped, was 0.8 g/mL (40% of maternal serum). Although the infant was not allowed to nurse during and immediately following the mother's therapy, the potential for harm of the infant from exposure to lidocaine in breast milk is probably very low. The American Academy of Pediatrics considers lidocaine to be compatible with breast feeding (25)." (http://drugsafetysite.com/lidocaine/)


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## emilysmama (Jun 22, 2005)

Hmm, that seems strange to me. My lactation consultant had a physician write me a script for a compounding pharmacy. It was for a topical ointment that was the combination of lidocaine (that's like an anesthetic, right?) and something else (I think maybe double antibiotic cream?). I was supposed to rub it on my nipples, which were in excruciating pain, in between nursings, but didn't have to clean or wipe off before nursing. So my baby daughter ingested the lidocaine directly, not just through the breast milk, and several times per day. I would think that the amount your baby would get from your injection via breastmilk would be much less than what my baby got from sucking on lidocaine-laced nipples that were applied several times a day.

Said baby is now 6.5 years old and fine.


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## Midwesterner04 (Nov 19, 2009)

I realize this post is a little late, but I looked up lidocaine in the Tom Hale desk reference Medication and Mother's Milk and thought I would share what I found. It rates lidocaine as an L2 "Safer" medication that carries little risk for the breastfeeding infant (L1/"Safest" is the category that includes acetaminophen and ibuprofen). Oral bioavailability of the drug is just 35%, so the very small dose that makes it into breastmilk is not very potent. Lidocaine also has a fairly short half life of 1.8 hours, so virtually nothing reaches the milk by ten hours after the dose.

Anecdotally, many of the BF-knowledgeable midwives I know tend to use lidocaine when it is necessary to stitch up a tear after birth. I needed a couple of stitches due to my daughter's nuchal hand, and received lidocaine as local anesthesia. Neither the midwife nor an IBCLC family member who attended the birth had any concerns about breastfeeding, and the topic of pumping and dumping never came up.

OP, I hope you and your little one are doing just fine.


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## Kellyh_01 (Apr 24, 2006)

Not a problem at all. Lidocaine injected locally for minor surgical and dental procedures is absolutely fine, and is a totally different situation than lidocaine intravenously for cardiac issues.


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