Breastfeeding and Anesthesia: What the New 2026 Guidelines Mean for Parents

If you’re breastfeeding and need surgery, a procedure, or sedation, you’ve probably heard some version of this advice before:

“You’ll need to pump and dump for 24 hours.”

The problem? That advice is outdated — and for most families, completely unnecessary.

In January 2026, the Association of Anaesthetists released updated, evidence-based guidelines on anesthesia and sedation for breastfeeding patients. These guidelines were developed by a multidisciplinary team including anesthesiologists, pharmacists, midwives, infant feeding specialists, and people with lived breastfeeding experience.

The takeaway is reassuring and clear: most people can safely continue breastfeeding without interruption after anesthesia.

Let’s break down what parents actually need to know.

The Big Shift: “Sleep and Keep,” Not Pump and Dump

One of the most important updates in the 2026 guidelines is the formal recommendation to stop routine “pump and dump” advice.

What’s recommended now:

• Breastfeed or pump right before surgery

• Resume breastfeeding as soon as you are awake, alert, and able to safely hold your baby

• No routine milk discarding is needed after anesthesia

This approach is now referred to as “sleep and keep.”

Why? Because the medications used for anesthesia and pain control:

• Transfer into breastmilk in very small amounts

• Are usually poorly absorbed by the baby’s gut

• Have short half-lives, meaning they leave the body quickly

For almost all medications used during surgery, there is no evidence of harm to the breastfed child.

Breastfeeding Is Considered the Default — Not an Afterthought

The guidelines emphasize that any patient with a child under 2 years old should be routinely asked if they are breastfeeding or expressing milk during pre-op assessments.

Importantly:

• Breastfeeding beyond age 2 is also normal and should be respected

• The goal is to support continued breastfeeding whenever possible, not disrupt it unnecessarily

Interrupting breastfeeding can increase the risk of:

• Engorgement

• Plugged ducts or mastitis

• Milk supply issues

• Feeding refusal if a baby won’t take a bottle

• Early, unwanted weaning

These risks often outweigh the theoretical (and usually nonexistent) medication risks.

What About Pain Medications?

Postoperative pain control matters — and breastfeeding parents deserve adequate relief.

Medications considered compatible with breastfeeding include:

• Paracetamol (acetaminophen)

• Ibuprofen and other NSAIDs

• Local and regional anesthetics

• Most opioids (strong pain medicines) when used carefully

Opioid guidance:

• Use the lowest effective dose for the shortest time

• Morphine or dihydrocodeine are preferred if opioids are needed

• Codeine is not recommended due to unpredictable metabolism that can cause excessive infant sedation

  
  

What This Means for Families

If you’re breastfeeding and need anesthesia:

• You likely do not need to pump and dump

• You can usually resume feeding once you’re awake and steady

• Your breastfeeding goals deserve respect and support

• Outdated advice should be questioned — kindly, but confidently

If you’re told to discard your milk “just in case,” it’s reasonable to ask:

“Is this based on current breastfeeding-specific evidence?”

Need Support Navigating Surgery While Breastfeeding?

At After Baby RNs, we help families advocate for evidence-based care — including during surgery, hospitalization, and medical procedures.

If you’re preparing for surgery or were given conflicting advice about breastfeeding and medications, we’re here to help you make sense of it and protect your feeding relationship.

💛 Breastfeeding doesn’t have to stop just because you need medical care.