Last update: Aug. 22, 2019


Very Low Risk for breastfeeding

Safe. Compatible.
Minimal risk for breastfeeding and infant.

Medication which is compatible with breastfeeding in its multiple applications: local anesthetic, antiarrhythmic and epidural anesthesia.

It is excreted in breastmilk in insignificant quantities (Galderma 2012, Giuliani 2001, Dryden 2000, Ortega 1999, Lebedevs 1993, Zeisler 1986) and no problems have been observed in infants whose mothers were taking it (Ortega 1999).

As a topical anesthetic (dermatological, stomatological-dental, ophthalmological and otological preparations) it has virtually no systemic absorption (Reece 2017, Cobb 2015, Harrison 1987). Do not apply to the breast or, if necessary, apply after a feed and clean thoroughly with water before the next one.

With prilocaine it forms a eutectic mixture (EMLA) which is useful for dermatological anesthesia. Application over large areas or orally can cause methemoglobinemia (PDR 2014, Touma 2001, Essink 1999, Vickers 1997).

Local infiltration of lidocaine and epinephrine in the incision area of ​​a caesarean section, before and after the incision was associated with earlier first breastfeeding (Tharwat 2016, Fouladi 2013).

The manufacturer (Galderma 2012) and several medical associations and expert consensus consider the use of this medication to be safe during breastfeeding (Reece 2017, Cobb 2015, Butler 2014, Jürgens 2009, Schaefer 2007 p632, Howie 2006, Mahadevan 2006, Giuliani 2001, Tan 2001).

American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001).
List of WHO essential medicines: compatible with breastfeeding (WHO / UNICEF 2002).

See below the information of this related product:


We do not have alternatives for Lidocaine since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Lidocaine is also known as

Lidocaine in other languages or writings:


Main tradenames from several countries containing Lidocaine in its composition:


Variable Value Unit
Oral Bioavail. 35 %
Molecular weight 234 daltons
Protein Binding 66 - 70 %
VD 1,3 - 1,5 l/Kg
Tmax 0,01 (Derm: 4-10h) hours
T1/2 1,8 hours
M/P ratio 0,4 -
Theoretical Dose 0,01 - 0,12 mg/Kg/d
Relative Dose 0,8 - 4 %
Relat.Ped.Dose 0,8 - 4 %


  1. Reece-Stremtan Sarah, Campos Matilde, Kokajko Lauren, and The Academy of Breastfeeding Medicine. Breastfeeding Medicine. ABM Clinical Protocol #15: Analgesia and Anesthesia for the Breastfeeding Mother, Revised 2017. Breastfeed Med. 2017 Nov;12(9):500-506. Full text (link to original source) Full text (in our servers)
  2. Tharwat AA, Yehia AH, Wahba KA, Ali AE. Efficacy and safety of post-cesarean section incisional infiltration with lidocaine and epinephrine versus lidocaine alone in reducing postoperative pain: A randomized controlled double-blinded clinical trial. J Turk Ger Gynecol Assoc. 2016 Jan 12;17(1):1-5. Abstract Full text (link to original source) Full text (in our servers)
  3. Cobb B, Liu R, Valentine E, Onuoha O. Breastfeeding after Anesthesia: A Review for Anesthesia Providers Regarding the Transfer of Medications into Breast Milk. Transl Perioper Pain Med. 2015;1(2):1-7. Abstract Full text (link to original source) Full text (in our servers)
  4. Butler DC, Heller MM, Murase JE. Safety of dermatologic medications in pregnancy and lactation: Part II. Lactation. J Am Acad Dermatol. 2014 Mar;70(3):417.e1-10; quiz 427. Abstract
  5. EMLA. Drug Summary. 2014 Full text (in our servers)
  6. Fouladi RF, Navali N, Abbassi A. Pre-incisional, post-incisional and combined pre- and post-incisional local wound infiltrations with lidocaine in elective caesarean section delivery: a randomised clinical trial. J Obstet Gynaecol. 2013 Abstract
  7. Galderma. LIdocaine & Tetracaine (Pliagis). Drug Summary. 2012 Full text (in our servers)
  8. Jürgens TP, Schaefer C, May A. Treatment of cluster headache in pregnancy and lactation. Cephalalgia. 2009 Abstract
  9. Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, second edition. London. 2007
  10. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology. 2006 Jul;131(1):283-311. Review. Abstract Full text (link to original source) Full text (in our servers)
  11. Howie WO, McMullen PC. Breastfeeding problems following anesthetic administration. J Perinat Educ. 2006 Abstract Full text (link to original source) Full text (in our servers)
  12. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  13. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  14. Giuliani M, Grossi GB, Pileri M, Lajolo C, Casparrini G. Could local anesthesia while breast-feeding be harmful to infants? J Pediatr Gastroenterol Nutr. 2001 Abstract
  15. Touma S, Jackson JB. Lidocaine and prilocaine toxicity in a patient receiving treatment for mollusca contagiosa. J Am Acad Dermatol. 2001 Abstract
  16. Tan HL, Lie KI. Treatment of tachyarrhythmias during pregnancy and lactation. Eur Heart J. 2001 Abstract Full text (link to original source) Full text (in our servers)
  17. Dryden RM, Lo MW. Breast milk lidocaine levels in tumescent liposuction. Plast Reconstr Surg. 2000 Abstract
  18. Ortega D, Viviand X, Lorec AM, Gamerre M, Martin C, Bruguerolle B. Excretion of lidocaine and bupivacaine in breast milk following epidural anesthesia for cesarean delivery. Acta Anaesthesiol Scand. 1999 Abstract
  19. Essink-Tebbes CM, Wuis EW, Liem KD, van Dongen RT, Hekster YA. Safety of lidocaine-prilocaine cream application four times a day in premature neonates: a pilot study. Eur J Pediatr. 1999 Abstract
  20. Vickers ER, Marzbani N, Gerzina TM, McLean C, Punnia-Moorthy A, Mather L. Pharmacokinetics of EMLA cream 5% application to oral mucosa. Anesth Prog. 1997 Abstract
  21. Lebedevs TH, Wojnar-Horton RE, Yapp P, Roberts MJ, Dusci LJ, Hackett LP, Ilett K. Excretion of lignocaine and its metabolite monoethylglycinexylidide in breast milk following its use in a dental procedure. A case report. J Clin Periodontol. 1993 Sep;20(8):606-8. Abstract
  22. Harrison RF, Brennan M. Evaluation of two local anaesthetic sprays for the relief of post-episiotomy pain. Curr Med Res Opin. 1987 Abstract
  23. Zeisler JA, Gaarder TD, De Mesquita SA. Lidocaine excretion in breast milk. Drug Intell Clin Pharm. 1986 Abstract

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