Viscous Lidocaine and Maalox Safety During Breastfeeding

General Safety Recommendations

The Association of Anaesthetists states that local anesthetics, including lidocaine, can be used in lactating women with no need to interrupt breastfeeding, as they are lipid soluble and may be secreted in small amounts in breast milk, but extensive investigation has shown no evidence of harm 1, 2, 3
No waiting period is required before resuming breastfeeding after lidocaine administration, as the drug has been extensively studied during labor analgesia and obstetric anesthesia with no evidence of neonatal harm from direct placental transfer 1, 2, 3

For infants less than 6 weeks of age (corrected for gestation), exercise extra caution with any medication due to immature hepatic and renal function, though this concern is far more relevant for systemically absorbed drugs than for topical lidocaine or non-absorbed antacids 4
Monitor the infant for unusual drowsiness or feeding difficulties only if using multiple medications or if the infant shows any concerning symptoms 4

The American Academy of Pediatrics does not have a direct statement in the article, however, paracetamol (acetaminophen) and ibuprofen are explicitly compatible with breastfeeding and can be used without interruption, as they have been extensively studied and pose no risk to breastfed infants 5