Last update: March 22, 2018

Lidocaine

Very Low Risk for breastfeeding


Safe. Compatible.
Not risky for breastfeeding or infant.

Compatible with breastfeeding no matter the multiple ways it can be used: anesthetic, anti-arrhythmic, or anti-epileptic drug.

Excreted into breast milk in non-significant amount with no side effects on breastfed infants from treated mothers.

As a topical anesthetic (dermatologic, dental-stomatologic, ophtalmotologic and otologic preparations) it has an almost nil systemic absorption. Avoid using it on the nipple, but if necessary do it after the breast feed, wipe it out and rinse with water before the next feed,

An euptectic mixture with added Prilocaine (EMLA) is used for dermatologic anesthesia. There is an increased risk of Methemoglobinemia when applied on large surfaces or taken by mouth.

Intrapartum anesthesia may delay the onset of phase II of Lactogenesis or milk coming-in.

The American Academy of Pediatrics rates it usually compatible with Breastfeeding.

Alternatives

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:

Tradenames

Main tradenames from several countries containing Lidocaine in its composition:

Pharmacokinetics

Variable Value Unit
Bioavailability 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 %

References

  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. Breastfeeding Medicine. 2017 Full text (link to original source) Full text (in our servers)
  2. Lind JN, Perrine CG, Li R. Relationship between Use of Labor Pain Medications and Delayed Onset of Lactation. J Hum Lact. 2014 Abstract
  3. PDR.net EMLA Drug Summary 2014 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. Babwah TJ, Nunes P, Maharaj RG. An unexpected temporary suppression of lactation after a local corticosteroid injection for tenosynovitis. Eur J Gen Pract. 2013 Abstract
  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. Jürgens TP, Schaefer C, May A. Treatment of cluster headache in pregnancy and lactation. Cephalalgia. 2009 Abstract
  8. 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)
  9. 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)
  10. Bailey DN, Briggs JR. The binding of acetaminophen, lidocaine, and valproic acid to human milk. Am J Clin Pathol. 2004 Abstract
  11. 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)
  12. 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)
  13. 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
  14. Touma S, Jackson JB. Lidocaine and prilocaine toxicity in a patient receiving treatment for mollusca contagiosa. J Am Acad Dermatol. 2001 Abstract
  15. 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)
  16. Dryden RM, Lo MW. Breast milk lidocaine levels in tumescent liposuction. Plast Reconstr Surg. 2000 Abstract
  17. 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
  18. 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
  19. 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
  20. 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 Abstract
  21. Harrison RF, Brennan M. Evaluation of two local anaesthetic sprays for the relief of post-episiotomy pain. Curr Med Res Opin. 1987 Abstract
  22. Zeisler JA, Gaarder TD, De Mesquita SA. Lidocaine excretion in breast milk. Drug Intell Clin Pharm. 1986 Abstract
  23. Nau H. Clinical pharmacokinetics in pregnancy and perinatology. I. Placental transfer and fetal side effects of local anaesthetic agents. Dev Pharmacol Ther. 1985 Abstract

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