Last update May 14, 2024
Compatible
We do not have alternatives for Propofol since it is relatively safe.
Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.
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Main tradenames from several countries containing Propofol in its composition:
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e-lactancia is a resource recommended by Academy of Breastfeeding Medicine - 2015 of United States of America
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It is a short-acting anesthetic that is administered intravenously for the induction and maintenance of general anesthesia and for sedation. It is an authorized medication for use in infants older than 1 month.
Its pharmacokinetic data (high percentage of protein binding and very large volume of distribution) explain the negligible passage into colostrum or breast milk observed. (Stuttmann 2010, Birkholz 2009, Nitsun 2006, Dailland 1989, Schmitt 1987)
No side-effects were observed in breastfed infants of mothers who were administered this medication. (Stuttmann 2010)
Propofol causes a transient and brief increase in prolactin levels (Murakawa 1998). The use of Propofol and Ketamine as post-cesarean analgesia shortened the time of the first breast feeding. (Jaafarpour 2017)
Its null oral bioavailability makes it difficult for it to pass to the infant plasma from ingested breast milk. (Dailland 1989)
90 minutes after extubation, no amounts of propofol are detected in the milk (Stuttmann 2010). The mother may breastfeed the baby as soon as she is recovered from anesthesia. No need to express and discard breast milk. (Reece 2017, Schaefer 2015, ASGE 2012, Nitsun 2006, Dailland 1989)
Propofol can turn urine green. Cases of transient (1 to 4 days) green or bluish-green discoloration of breast milk have been reported after administration of propofol (Bulut 2021, Prescriber 2021, Rainone 2018, Birkholz 2009). Two mothers have reported to us, one in 2020 and one in 2024, that after sedation with propofol, the milk they expressed had a bluish color. Possibly this is more frequent than what has been reported, since it is only observed when the mother expresses milk. It would not be necessary to discard this milk as the culture was negative and propofol was not found in the breastmilk. (Bulut 2021, Rainone 2018)
Several medical societies and expert authors consider the use of this medication possible during breastfeeding. (Hale, Briggs 2015, Howie 2006, Mahadevan 2006, Lee 1993)