Anaesthesia during breast feeding - Which restrictions are justified

In the last years knowledge of the excretion of drugs into breast milk has increased significantly. But information concerning anesthetic and analgesic drugs seems to be dispersed and limited. This paper describes the pharmacokinetic principles of drug transfer to milk and offers a comprehensive survey for drugs used in the perianesthetic period. The necessity of anesthesia should never be a sufficient reason to quit breast-feeding. With the information given in this article the individual duration of breast-milk-free interval can be discussed. Thus it will be possible to anesthetize a breast-feeding mother with minimal risks for the child without giving up the advantages of mother milk. Through careful selection of appropriate drugs even elective operations don't need to be postponed and breastfeeding can be continued as soon as in the immediate postoperative period.