ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Babies Can Safely Breastfeed After Their Mothers Have Local Anesthesia for a Dental Procedure
Clinical Question Are babies whose mothers have local anesthesia for dental procedures at increased risk for ingesting the anesthetic?
Clinical Bottom Line It is safe for a mother to breastfeed after having local anesthesia for a dental procedure. This is based on a clinical study showing that the amount of lidocaine in the breast milk was low. Local anesthesia is widely used in all general dental practices and accepted by patients.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 11321382 Giuliani/20017 nursing mothers between the ages of 23-39Noncontrolled clinical study
Key resultsAfter all 7 women received 2% lidocaine without adrenaline, they were instructed to get rid of their milk for 36 hours. Blood was then taken 2 hours after the lidocaine was injected and a milk sample was tested 3 and 6 hours after lidocaine was injected as well. The amount of lidocaine and MEGX, lidocaine’s primary metabolite, was measured. The study showed that if the baby were to drink 90 mL of breast milk every 3 hours after the mother was injected with lidocaine, the amount of lidocaine in the mother’s breast milk was 73.41 ± 38.94 μg/L/day and MEGX was 66.1 ± 28.5 μg/L/day. The study states that “the amount of lidocaine seems to be very small “and “an infant can tolerate much higher doses of lidocaine” (Giuliani, 2001, p.143). Even though there is a small amount of lidocaine in the mother’s breastmilk, the study makes a bold statement reminding the reader that “these anesthetics are used on a single-dose basis, thus preventing their accumulation in maternal milk” (Giuliani, 2001, p.143). The study concludes that it is safe for a mother to continue breastfeeding even after having dental treatment done in which the use of lidocaine was necessary.
Evidence Search (((breastfeed) AND local anesthesia)) AND dentistry
Comments on
The Evidence
Validity: The study starts out with 7 women who are all breastfeeding. They were all treated the same except for one. Six of the women received 3.6 mL of 2% lidocaine, and one received 4.5 mL of 2% lidocaine. All of the women were asked to discard the same amount of breast milk within the 36-hour time frame. Bias was unlikely.
Applicability The ability and safety of continuing to breastfeed an infant after the mother is anesthetized is significant. Unless because of an emergency, the mother does not get a chance to have dental work done while pregnant because of many risk factors that can cause harm to both the mother and the baby. The mother should be able to have major dental work done after giving birth. However, because breastfeeding is so important in the first few weeks of an infant’s life it is also crucial that the mother is able to continue breastfeeding her infant even after having dental work done where lidocaine was needed. This applies to all breastfeeding mothers who are in need of dental work or a deep cleaning where local anesthesia is necessary.
Specialty/Discipline (Endodontics) (General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics) (Restorative Dentistry)
Keywords local anesthesia, breast-feeding
ID# 3266
Date of submission: 08/21/2017spacer
E-mail Galateanu@livemail.uthscsa.edu
Author Octavia Andreea Galateanu
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Carol A. Nguyen
Faculty mentor/Co-author e-mail NGUYENC@uthscsa.edu
Basic Science Rationale
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