Vein Treatments - Are they safe while BFing?

[AmyGirl]

Is it safe to go through vein treatments while breastfeeding? I'm starting these soon and the doctor says it is fine, but I'm still a bit nervous for my baby.

[cpride]

Dear AmyGirl,

Three common sclerosing agents are used during local treatments for varicose veins. Saline is a normal component of our bodies thus poses minimal risk to the breastfed infant. Glycerin is virtually non-toxic and is found in the human body also. Another agent often used is polidocanol. The adverse effects of using polidocanol are mainly local. One time treatment poses minimal risk to the breastfed infant. There are no adequate or well-controlled studies or case reports for the use of polidocanol during breastfeeding, but the half-life(time it takes for half of the drug to be eliminated from the body) is short at 1.5 hours. Waiting 1.5 to 3 hours before returning to breastfeeding would eliminate most risk. If your physician plans to use a different medication, please call us at the InfantRisk Center. We are open Monday through Friday, 8 to 5, CDT. Our phone number is 806-352-2519.

Sincerely,
Cindy Pride, MSN, CPNP
TTUHSC InfantRisk Center

[AmyGirl]

Is Lidocaine safe? They are telling me that I have to pump and dump for 24 hours after each procedure and I really don't want to do that as I have to pump and dump all week at work and I need my nights and weekends to get my supply back to normal.

[AmyGirl]

STS is used instead of Polidocanol, is this safe?

[cpride]

Dear AmyGirl,

Lidocaine is used as a local anesthetic. The half-life is one and one-half hours so waiting three hours should eliminate most risk. Lidocaine should never be applied to the nipple where the infant would suckle due to the risk of causing seizures and low heart rate. There are no data available on the transfer of sodium tetradecyl sulfate (STS) into human milk and no studies done in nursing women. This product could be hazardous if introduced in the infant through breastmilk. Therefore, extreme caution is recommended with its use in a lactating mother. Use only if the potential benefit to mother outweighs the potential risks to the infant. If this medication is unavoidable, Dr. Hale would recommend pumping and discarding for 24 hours after the procedure. You may want to talk with your physician about one of the other agents that was previously discussed (saline, glycerin or polidocanol) to see if one of those would be suitable for your condition.

Sincerely,
Cindy Pride, MSN, CPNP
TTUHSC InfantRisk Center