Is Isoflurane Safe in Breastfeeding

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

There is no published experience with isoflurane during breastfeeding. Because the serum half-life of isoflurane in the mother is short and the drug is not expected to be absorbed by the infant, no waiting period or discarding of milk is required.[1] Breastfeeding can be resumed as soon as the mother has recovered sufficiently from general anesthesia to nurse. When a combination of anesthetic agents is used for a procedure, follow the recommendations for the most problematic medication used during the procedure. 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.[2] It is possible that requirements for other anesthetic agents would be affected similarly.

A randomized, but nonblinded, study in women undergoing cesarean section compared epidural anesthesia with bupivacaine to general anesthesia with intravenous thiopental 4 mg/kg and succinylcholine 1.5 mg/kg for induction followed by nitrous oxide and isoflurane. The time to the first breastfeed was significantly shorter (107 vs 228 minutes) with the epidural anesthesia than with general anesthesia. This difference was probably caused by the anesthesia's effects on the infant, because the Apgar and neurologic and adaptive scores were significantly lower in the general anesthesia group of infants.[3]