Many mothers are concerned if having dental work (i.e. fillings, root canals, etc) will affect breastfeeding. Sometimes they are told they must temporarily suspend nursing in order to take pain medications or antibiotics, or they need to wait until the anesthesia clears from their system. This, however, is not always necessary; in fact, it's almost never necessary. These guidelines are for mothers who are nursing healthy, full term babies. Babies with health problems need special considerations.

Numbing agents such as lidocaine, nor any of its derivatives commonly used as local anesthetics for dental procedures, do not affect mother's milk. Bupivacaine lasts longer than carbocaine or lidocaine, but its milk levels are still "nil" according to Dr. Thomas Hale, author of Medications & Mother's Milk.

If given Valium or demeral, as soon as mom is awake and non-sedated she can safely resume nursing. There is rarely ever a need to pump and dump. According to Dr. Hale, the amount in mom's milk after one dose would be minimal.

Antiseptic mouthwashes, such as Periogard should not pose a problem for the breastfeeding infant, as its absorption is virtually nil.

Any x-rays that need to be done can be done, there is no effect to breastmilk, and mother can breastfeed immediately after any x-ray.

As for whitening teeth, the substance used for that is a peroxide compound. Peroxides are absorbed into the tissues but then are instantly destroyed, so none ever reach mother's milk.

Reference: Medications and Mother's Milk, 1999, Thomas Hale, Ph.D., Eigth Edition

X-rays, ultrasound, mammograms, and fine-needle aspirations. These particular diagnostic tests do not affect mother's milk, so breastfeeding can continue.

Reference: The Breastfeeding Answer Book, LLL

Medications

If mother needs to take medications, there are resources to help determine if she can safely continue to nurse, if she might need to temporarily suspend breastfeeding (rare), or if it's necessary that she wean (even more rare!). A partial list of AAP approved medications can be found here.

For additional information on medications, you can ask for a "meds lookup" on the breastfeeding board at Parentsplace.com, where someone will check Dr Hale's book, Medications & Mother's Milk for the medication. You can also purchase Dr. Hale's book at most local bookstores or on the internet through Amazon or Barnes & Noble, etc.

If a mother who wants to continue nursing is told that she must stop breastfeeding due to a health concern, but there seem to be no hard or specific medical reasons to do so, she should ask for references that support the doctors suggestion that she wean. She might also want to consider getting a second, or even a third, opinion.

Surgery
If surgery is needed, in most cases breastfeeding can continue. Generally speaking all that is needed is a little preparation and support. More information on surgery and/or hospitalization can be found here: http://breastfeeding.hypermart.net/surgery.html

Vaccinations

According to the US Centers for Disease Control (1994)

http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/00025027.htm

"Neither killed nor live vaccines affect the safety of breast-feeding for mothers or infants. Breast-feeding does not adversely affect immunization and is not a contraindication for any vaccine.

Inactivated or killed vaccines do not multiply within the body. Therefore they should pose no special risk for mothers who are breast-feeding or for their infants. Although live vaccines do multiply within the mother's body, most have not been demonstrated to be excreted in breast milk."

Influenza Vaccine

"Influenza vaccine does not affect the safety of mothers who are breast-feeding or their infants. Breast-feeding does not adversely affect immune response and is not a contraindication for vaccination."

http://www.cdc.gov/ncidod/diseases/flu/fluvac.htm (updated for 1999-2000 influenza season)

The following vaccines are compatible with breastfeeding:

Cholera, diptheria, influenza, measles, oral polio, pertussis (whooping cough), rabies, rubella (German Measles), small pox, tetanus, typhoid, typhus, yellow fever, and hepatitis vaccines.