Question

I am a breastfeeding mother and i want to know if it is safe to use dl-Ketamine? Is dl-Ketamine safe for nursing mother and child? Does dl-Ketamine extracts into breast milk? Does dl-Ketamine has any long term or short term side effects on infants? Can dl-Ketamine influence milk supply or can dl-Ketamine decrease milk supply in lactating mothers?

dl-Ketamine lactation summary

dl-Ketamine usage has low risk in breastfeeding
  • DrLact safety Score for dl-Ketamine is 3 out of 8 which is considered Low Risk as per our analyses.
  • A safety Score of 3 indicates that usage of dl-Ketamine may cause some minor side effects in breastfed baby.
  • Our study of different scientific research indicates that dl-Ketamine may cause moderate to no side effects in lactating mother.
  • Most of scientific studies and research papers declaring usage of dl-Ketamine low risk in breastfeeding are based on normal dosage and may not hold true for higher dosage.
  • While using dl-Ketamine We suggest monitoring child for possible reactions. It is also important to understand that side effects vary largely based on age of breastfed child and time of medication in addition to dosage.
  • Score calculated using the DrLact safety Version 1.2 model, this score ranges from 0 to 8 and measures overall safety of drug in lactation. Scores are primarily calculated using publicly available case studies, research papers, other scientific journals and publically available data.

Answer by Dr. Ru: About dl-Ketamine usage in lactation

It may be a cause of hallucinatory/psychotic reactions in the mother within the next 24 hours after usage. (Close follow-up is mandatory).

Answer by DrLact: About dl-Ketamine usage in lactation

Breastmilk levels of dl-Ketamine have not been measured after administration to humans. Minimal data indicated that dl-Ketamine use in nursing mothers may not affect the breastfed infant or lactation. Until more data are available, dl-Ketamine should only be used with careful monitoring during breastfeeding. Alternate agents are preferred.

dl-Ketamine Side Effects in Breastfeeding

Four mothers who received epidural analgesia with lidocaine and bupivacaine for cesarean section also received general anesthesia with dl-Ketamine and midazolam (dosages not specified). Their infants were either breastfed or received their mother's breastmilk by bottle. No adverse effects were reported in the infants.[1]

dl-Ketamine Possible Effects in Breastfeeding

A pregnant woman sustained 28% body surface area burns near term. She underwent an emergency cesarean section on her due date under dl-Ketamine anesthesia. Although the infant required vigorous resuscitation, the infant began breastfeeding immediately. The infant had transient jaundice that resolved in a few days.[2] A study compared women undergoing cesarean section who received either placebo or S-dl-Ketamine 0.5 mg/kg intramuscularly, followed by a continuous infusion of 2 mcg/kg/minute for 12 hours. This low dose was used to enhance analgesia and reduce residual pain rather than to provide anesthesia. All women received intraspinal bupivacaine 8 to10 mg and sufentanil 5 mcg for analgesia, as well as midazolam 0.02 mg/kg intravenously before the S-dl-Ketamine or placebo injection. Postoperatively, patients received patient-controlled intravenous morphine for 24 hours, followed by acetaminophen, oral ketorolac and a single dose of ondansetron 8 mg intravenously as needed. Of the 56 patients enrolled in the study (28 in each group), 13 in each group were contacted at 3 years postpartum. Patients who received placebo reported breastfeeding for an average of 10.5 months and those who received S-dl-Ketamine reported breastfeeding for an average of 8 months; however, the difference was not statistically significant.[3] A randomized, double-blind study compared the effects of intravenous propofol 0.25 mg/kg, dl-Ketamine 0.25 mg/kg, dl-Ketamine 25 mg plus propofol 25 mg, and saline placebo for pain control in mothers post-cesarean section in mothers post-cesarean section. A single dose was given immediately after clamping of the umbilical cord. The time to the first breastfeeding was 58 minutes in those who received placebo, 31.9 minutes with dl-Ketamine and 25.8 minutes with propofol plus dl-Ketamine. The time was significantly shorter than the other groups with the combination.[4]

Alternate Drugs

Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. We do not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.