Do you have to pump and dump after dental anesthesia? Here are some tips about how to handle dental work and breastfeeding.
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One extremely common question in my instagram Q&A box is something like the following:
I’m getting my wisdom teeth removed, and my oral surgeon said to pump and dump for 24 hours after surgery. Is this really necessary? I’m a “just enougher” and the idea of throwing away all that milk makes me want to cry.
Advice regarding dental work and breastfeeding may be overly conservative
This is a great question, because sometimes advice from providers (not just dentists) regarding breastfeeding and medication can be overly conservative. From “Breastfeeding and Anesthesia: A Review for Anesthesia Providers Regarding the Transfer of Medications into Breast Milk“:
Doctors, nurses, and midwives often inform mothers to “pump and dump” their breast milk for 24 hours after receiving anesthesia to avoid passing medications to the infant. This advice, though cautious, is probably outdated.
The underlying reason that this happens is lack of research. It’s difficult (with all of the ethical issues involved) to conduct randomized clinical trials on breastfeeding women and their infants.
Because of this lack of research, healthcare providers may:
- Give overly conservative advice (such as to pump and dump for an extended period of time) out of concern for the infant (or out of concern with potential liability), or
- Pass along information from the drug manufacturer, which will often include language indicating it shouldn’t be used while breastfeeding (again, this may be due to liability concerns given the lack of clinical research).
So what should you do?
Does that mean you should just disregard your healthcare provider’s advice about certain medications not being safe to take while breastfeeding?
No. What I would suggest doing is calling the Infant Risk Center.
It’s a call center run by Texas Tech University, and the acting executive director is Dr. Thomas Hale, author of Medications and Mother’s Milk and the leading expert on the safety of medications during pregnancy and lactation. It’s free to call – the number is (806) 352-2519 – and they are open 8am to 5pm CT.
(Most dentists do not spend a lot of time learning about the safety of medication during lactation. The Infant Risk Center focuses on this and are the experts in this area.)
I called them when I was exclusively pumping, had a bad cold, and couldn’t sleep. I was miserable and really wanted to take NyQuil, but I wasn’t sure if it was safe or if I would need to dump my milk (and how long I would need to dump my milk for). They walked me through potential concerns, and we found a medication that would help me sleep and that I would be comfortable taking without having to dump my milk.
So back to the question about the wisdom teeth.
What I would suggest doing is calling or emailing the dental office and getting a list of all the medications you’ll be given or prescribed afterwards. (If possible, get this in writing.) Then with that list in hand, you can call the Infant Risk Center and discuss how it might affect you, your milk and your baby.
Some basics on dental anesthesia and breastfeeding
Some basics on dental anesthesia that might be helpful (though you should re-confirm this with the Infant Risk Center):
- Local anesthesia (such as novocaine or lidocaine) does not pass easily into lactating milk ducts and “can be safely used in breastfeeding mothers.”
- Nitrous oxide is compatible with breastfeeding and leaves your body within minutes after you stop breathing it in.
- Benzodiazepines/Narcotic Analgesics – Most are compatible with breastfeeding, but there are some (such as Valium) that have a longer half life and a higher milk to plasma ratio. If your doctor plans to administer a medication that is less than ideal for breastfeeding, you may be able to talk to the Infant Risk Center and then your dentist about alternative options that could be considered.
Have you been told to pump and dump after anesthesia? Share your experience with dental work and breastfeeding in the comments!
References- Cobb, B., Liu, R., Valentine, E., & Onuoha, O. (2015). Breastfeeding after Anesthesia: A Review for Anesthesia Providers Regarding the Transfer of Medications into Breast Milk. Translational perioperative and pain medicine, 1(2), 1–7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4582419/
- Griese, Maurenne, RNC, BSN. “Conscious Sedation and Breastfeeding: Recommendations for Patients.” https://kellymom.com/bf/can-i-breastfeed/meds/sedation/
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