Last update: Jan. 10, 2015


Very Low Risk for breastfeeding

Not risky for breastfeeding or infant.

Local anesthetic agent which is used for infiltration and nerve-blocking procedures included Epidural anesthesia.

It is excreted into breast milk in non-significant amount, with no side-effect observed on breastfed infants of treated mothers. Plasma levels in those infant were undetectable.

There is controversy about the effect of drug-mediated analgesia used during the child birth (e.g. epidural injection of local anesthetics plus Fentanyl or alone) on the mature milk coming in, whether by delaying the onset of Lactogenesis phase II, or, by affecting the ability of the child for sucking.

Some studies have shown a higher risk for delay of initiation of Lactogenesis phase II (milk coming in) longer than 3 post-natal days, but without effect on loss of initial weight. On other studies, the newborn infant appears to have higher risk for delay on first latch-on, higher body temperature and irritability or somnolence. Because of the latter, it is argued that those mothers would be in need of more support on breastfeeding when they have received ante or intra partum analgesia.

However, some studies that have used Ropivacaine did not get such findings.

There is consensus on the achievement of higher milk production and higher body weight increase in the neonate with an adequate pharmacological control of pain after C-section or vaginal childbirth.


We do not have alternatives for Ropivacaine 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.


Ropivacaine belongs to this group or family:


Main tradenames from several countries containing Ropivacaine in its composition:


Variable Value Unit
Molecular weight 329 daltons
Protein Binding 94 %
VD 0,58 l/Kg
Tmax 0,7 hours
T1/2 1,8 hours
Theoretical Dose 0,004 - 0,05 mg/Kg/d


  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. Mauri PA, Contini NN, Giliberti S, Barretta F, Consonni D, Negri M, Di Benedetto I. Intrapartum Epidural Analgesia and Onset of Lactation: A Prospective Study in an Italian Birth Centre. Matern Child Health J. 2014 Abstract
  4. Zuppa A, Alighieri G, Riccardi R, Cavani M, Iafisco A, Cota F, Romagnoli C. Epidural analgesia, neonatal care and breastfeeding. Ital J Pediatr. 2014 Abstract Full text (link to original source) Full text (in our servers)
  5. Gizzo S, Di Gangi S, Saccardi C, Patrelli TS, Paccagnella G, Sansone L, Barbara F, D'Antona D, Nardelli GB. Epidural analgesia during labor: impact on delivery outcome, neonatal well-being, and early breastfeeding. Breastfeed Med. 2012 Abstract
  6. Pandya ST. Labour analgesia: Recent advances. Indian J Anaesth. 2010 Abstract
  7. Matsota PK, Markantonis SL, Fousteri MZ, Pandazi AK, Manikis DE, Christodoulopoulou TC, Loizou MM, Kostopanagiotou GG. Excretion of ropivacaine in breast milk during patient-controlled epidural analgesia after cesarean delivery. Reg Anesth Pain Med. 2009 Abstract
  8. Chen YM, Li Z, Wang AJ, Wang JM. [Effect of labor analgesia with ropivacaine on the lactation of paturients]. Zhonghua Fu Chan Ke Za Zhi. 2008 Abstract
  9. Chang ZM, Heaman MI. Epidural analgesia during labor and delivery: effects on the initiation and continuation of effective breastfeeding. J Hum Lact. 2005 Abstract
  10. McClure JH. Ropivacaine. Br J Anaesth. 1996 Abstract
  11. Lee A, Fagan D, Lamont M, Tucker GT, Halldin M, Scott DB. Disposition kinetics of ropivacaine in humans. Anesth Analg. 1989 Abstract

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e-lactancia is a resource recommended by Academy of Breastfeeding Medicine from United States of America

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