Halothane and Breastfeeding

Summary of use during lactation

Halothane is no longer available in the United States. There is no published experience with the therapeutic use of halothane as an anesthetic during breastfeeding, but trace amounts were found in the milk of a practicing anesthesiologist who had administered halothane in the operating room. Various recommendations have been made regarding breastfeeding after halothane anesthesia, from discarding the first pumping after recovery to discarding breastmilk for 24 to 48 hours after the surgical procedure.[1,2] Although withholding breastfeeding for 24 h is probably unnecessary, a short-acting anesthetic is preferred. In one study, breastfeeding before general anesthesia induction reduced requirements of sevoflurane and propofol compared to those of nursing mothers whose breastfeeding was withheld or nonnursing women.[3] It is possible that requirements for other anesthetic agents would be affected similarly.

Drug levels in milk and infant serum

Maternal Levels. Foremilk samples taken on two occasions from a practicing anesthesiologist after administering halothane anesthesia in the operating room contained from 630 mcg/L to 2.1 mg/L (0.63-2.1 ppm) of halothane.[1] These values were higher than air samples from the operating room, but may be underestimates because of sampling techniques. 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.

Effects on lactation and breastmilk

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

Alternative drugs to consider

Desflurane, Enflurane, Isoflurane, Sevoflurane

References

1. CotéCJ KeneppNB ReedSB Trace concentrations of halothane in human breast milk. Br J Anaesth 1976 48 541 3 986147
2. HaleTW Anesthetic medications in breastfeeding mothers. J Hum Lact 1999 15 185 94 10578796 PubMed
3. BhaskaraB DayanandaVP KannanS Effect of breastfeeding on haemodynamics and consumption of propofol and sevoflurane: A state entropy guided comparative study. Indian J Anaesth 2016 60 180 6 27053781 PubMed