Nitrous Oxide use while Breastfeeding

Nitrous Oxide Levels and Effects while Breastfeeding

Summary of Use during Lactation

Because the serum half-life of nitrous oxide in the mother is short and the drug is not expected to be absorbed by the infant, no waiting period or discarding of milk is required.[1][2] Breastfeeding can be resumed as soon as the mother has recovered sufficiently from general anesthesia to nurse. When a combination of anesthetic agents is used for a procedure, follow the recommendations for the most problematic medication used during the procedure.

Drug Levels

The serum half-life of nitrous oxide is less than 3 minutes, so extensive passage into milk is unlikely.[1]

Maternal Levels. Relevant published information was not found as of the revision date.

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Relevant published information was not found as of the revision date.

Possible Effects on Lactation

A randomized, but nonblinded, study in women undergoing cesarean section compared epidural anesthesia with bupivacaine to general anesthesia with intravenous thiopental 4 mg/kg and succinylcholine 1.5 mg/kg for induction followed by nitrous oxide and isoflurane. The time to the first breastfeed was significantly shorter (107 vs 228 minutes) with the epidural anesthesia than with general anesthesia. This difference was probably caused by the anesthesia's effects on the infant, because the Apgar and neurologic and adaptive scores were significantly lower in the general anesthesia group of infants. It is not known what part nitrous oxide played in this difference in outcome.[3]

References

1. Hale TW. Anesthetic medications in breastfeeding mothers. J Hum Lact. 1999 ;15:185-94. PMID: 10578796

2. Rooks JP. Safety and risks of nitrous oxide labor analgesia: a review. J Midwifery Womens Health. 2011;56:557-65. PMID: 22060215

3. Sener EB, Guldogus N, Karakaya D et al. Comparison of neonatal effects of epidural and general anesthesia for cesarean section. Gynecol Obstet Investig. 2003;55:41-55. PMID: 12624551

Nitrous Oxide Identification

Substance Name

Nitrous Oxide

CAS Registry Number

10024-97-2

Drug Class

• Anesthetics, Inhalation

Administrative Information

LactMed Record Number

612

Information from the National Library of Medicine's LactMed Database.

Last Revision Date

2013-01-24

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