Can you take nitrous oxide while breastfeeding?
What LactMed says
The National Library of Medicine’s own summary, quoted in full. We do not write a verdict of our own on this question, and we do not compress theirs into a label.
Because the serum half-life of nitrous oxide 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. Some evidence indicates that primiparous mothers who use inhaled nitrous oxide during labor for analgesia have better breastfeeding success than mothers who do not. If used as part of general anesthesia, breastfeeding can be resumed as soon as the mother has recovered sufficiently from 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.
Quoted from Nitrous Oxide — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised February 15, 2023.
How much nitrous oxide gets into breastmilk
The serum half-life of nitrous oxide is less than 3 minutes, so extensive passage into milk is unlikely.
Maternal Levels. Relevant published information was not found as of the revision date.
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
Relevant published information was not found as of the revision date.
Effects on milk supply
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. It is not known what part nitrous oxide played in this difference in outcome.
A retrospective database study found that primiparous women who receive a nitrous oxide-oxygen mixture for pain during delivery in addition to routine analgesia were more likely to be breastfeeding their infants at 48 hours postpartum than women who did not receive nitrous oxide. This correlation was not found when all women were included in the analysis.
In a nonrandomized, nonblinded retrospective study, 62 women who chose labor with gas analgesia with 50% nitrous oxide and oxygen were compared to a control group of 124 women who did not receive gas analgesia during labor. Most of the women in the study were primiparous. Use of other labor medications was not reported. Women who received nitrous oxide had higher rates of breastfeeding and exclusive breastfeeding than those who did not at 7 days after discharge, at 1 month postpartum, and at 3 months postpartum.
A randomized study compared intravenous meperidine 50 mg to inhaled nitrous oxide for labor analgesia. A higher percentage of mothers receiving nitrous oxide were able to breastfeed immediately after birth (95% vs 88%), but the difference was not statistically significant. There were no differences in breastfeeding rates at 24 hours after delivery or formula use.
Frequently asked questions
Can you take nitrous oxide while breastfeeding?
What the NIH's Drugs and Lactation Database says about Nitrous Oxide while breastfeeding — quoted in full. The full record is quoted on this page, and the decision is one to make with the person who prescribed it — LactMed itself states it is not a substitute for professional judgement.
Does nitrous oxide pass into breastmilk?
LactMed's measured drug levels for nitrous oxide are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking nitrous oxide?
LactMed does not frame its records that way — it reports measured drug levels in milk and what has been observed in breastfed infants, which is what this page quotes. "Pump and dump" advice for a specific drug and dose should come from your clinician or a pharmacist, not from a general rule.
More on nitrous oxide
LactMed states that the information it presents is not a substitute for professional judgement, and that you should consult your healthcare provider for breastfeeding advice related to your particular situation. Nothing on this page is medical advice.