Lactation and Dental Guidelines with AAA

SAFE ANESTHETICS
2% Lidocaine, 1:100,000 epinephrine (Xylocaine)
0.5% Bupivacaine with 1:200,000 epinephrine (Marcaine)
4% Septocaine with 1:100,000 and 1,200,000 epinephrine (Articaine)
4% Prilocaine HCL with 1:200,000 epinephrine or without epinephrine (Citanest Forte/Citanest Plain)
3% Mepivacaine (Carbocaine)
2% Mepivacaine (Carbocaine) with 1 :20,000 Levonordefrin (NeoCobefrin)

ANESTHETIC GUIDELINES
Inject LA after the baby has been fed
Stage I hypertensive lactating patient: Use LA with 1:200,000 epinephrine
Avoid epi. in stage II Htn. patient
Defer routine dental treatment in a stage III hypertensive lactating patient

SAFE ANALGESICS
Acetaminophen (Tylenol)
Codeine + Tylenol (Tylenol # 1-3)
Hydrocodone + Tylenol (Vicodin)
Oxycodone + Tylenol (Percocet)


ANALGESIC GUIDELINES
Patient takes pain medication after breast feeding and keep a 2 hour interval with the next feed
Opioids pass through the breast milk: Use lower doses and prescribe Opioids only when absolutely needed


SAFE ANTIBIOTICS
All Penicillins
All Cephalosporins
All Macrolides
Clindamycin

ANTIBIOTIC GUIDELINES
Take antibiotic after breast feeding & keep 2 hour interval with the next feed
Minimize antibiotic use due to risk of altering the baby's intestinal flora and promoting resistant pathogens growth