This sheet is about exposure to lidocaine in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.

What is lidocaine?

Lidocaine is a local anesthetic. Local anesthetics are used to numb areas of the body for short periods of time. Lidocaine has been used as an injection (given by shot), intravenously (by I.V.) and topically (rubbed on the body). Lidocaine can be found in some over-the-counter pain-relieving creams and patches. Lidocaine I.V. has also been used to treat ventricular arrhythmia (abnormal heart rhythm). Injected lidocaine has also be used in some medical or dental procedures or as a therapeutic nerve block to numb a part of the body and relieve pain. Lidocaine is sometimes injected into spinal fluid or the space around the spinal cord (‘epidural’) to provide pain relief during labor or for a surgical delivery (‘cesarian section’).

Lidocaine is also found in a topical cream called EMLA®. EMLA® cream also contains the medication prilocaine. For more information on prilocaine, please see the MotherToBaby fact sheet at: https://mothertobaby.org/fact-sheets/prilocaine.

I take lidocaine. Can it make it harder for me to get pregnant?

Studies have not been done to see if lidocaine could make it harder to get pregnant. An experimental animal study did not find that lidocaine would affect fertility (ability to get pregnant).

Does taking lidocaine increase the chance for miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not been done to see if lidocaine increases the chance for miscarriage.

Does taking lidocaine increase the chance of birth defects?

Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. One study involving lidocaine as a local anesthetic did not find a higher chance for birth defects. Also, human case reports and experimental animal studies do not suggest that lidocaine would significantly increase the chance of birth defects.

Does taking lidocaine in pregnancy increase the chance of other pregnancy related problems?

There are a few case reports of side effects in newborns of pregnant persons who received lidocaine at the time of delivery. The infants in these case reports needed treatment for symptoms that included low muscle tone (“floppy”), dilated pupils, difficulty breathing, apnea, and/or seizures. There are also case reports without health concerns in the newborn when lidocaine was used at the time of delivery.

Does taking lidocaine in pregnancy affect future behavior or learning for the child?

Studies have not been done to see if lidocaine can cause behavior or learning issues for the child.

Breastfeeding while taking lidocaine:

Lidocaine can get into breastmilk at low levels. However, when swallowed, it is not well absorbed by the baby. Breastfeeding after receiving lidocaine is unlikely to cause problems for a nursing child. Be sure to talk to your healthcare provider about all your breastfeeding questions.

If a male takes lidocaine, could it affect fertility (ability to get partner pregnant) or increase the chance of birth defects?

Studies have not been done to see if lidocaine could affect fertility. In general, exposures that fathers or sperm donors have are unlikely to increase the risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.

Selected References:

• Abboud TK, et al. 1983. Lack of adverse neonatal neurobehavioral effects of lidocaine. Anesth Analg; 62:473-5. [PubMed: 6837959]
• Abboud TK, et al. 1984. Continuous infusion epidural analgesia in parturients receiving bupivacaine, chloroprocaine, or lidocaine - maternal, fetal, and neonatal effects. Anesth Analg; 63:421-8. [PubMed: 6703368]
• Actavis Pharma, Inc. 2019. Lidocaine and Prilocaine Cream Drug Label. Available at: https://dailymed​.nlm​.nih.gov/dailymed/drugInfo​.cfm?setid=1972d657-2d5a-4697-bba9-80caffc2f2d7
• Demeulemeester V, et al. 2018. Transplacental lidocaine intoxication. J Neonatal-Perinatal Med; 11:439-441. [PubMed: 30149475]
• Dryden RM, Lo MW. 2000. Breast milk lidocaine levels in tumescent liposuction. Plast Reconstr Surg; 105:2267-8. [PubMed: 10839430]
• Favero V, et al. 2021. Pregnancy and Dentistry: A Literature Review on Risk Management during Dental Surgical Procedures. Dent J (Basel). 9(4):46. [PMC free article: PMC8072957] [PubMed: 33921608]
• Fujinaga M, Mazze RI. 1986. Reproductive and teratogenic effects of lidocaine in Sprague-Dawley rats. Anesthesiology. 65:626-632. [PubMed: 3789434]
• Heinonen OP. et al. 1977. Birth Defects and Drugs in Pregnancy. Publishing Sci Group, Littleton, MA.
• Kuhnert BR, et al. 1984. Effects of maternal epidural anesthesia on neonatal behavior. Anesth Analg; 63:301-8. [PubMed: 6703346]
• Kuhnert BR, et al. 1986. Lidocaine disposition in mother, fetus, and neonate after spinal anesthesia. Anesth Analg 65:139-44. [PubMed: 3942301]
• Lebedevs TH, et al. 1993. Excretion of lignocaine and its metabolite monoethylglycinexylidide in breast milk following its use in a dental procedure. A case report. J Clin Periodontol 20: 606-8. [PubMed: 8408724]
• Ortega D, et al. 1999. Excretion of lidocaine and bupivacaine in breast milk following epidural anesthesia for cesarean delivery. Acta Anaesthesiol Scand; 43:394-7. [PubMed: 10225071]
• Silveira MPT, et al. 2020. Breastfeeding and risk classification of medications used during hospitalization for delivery: 2015 Pelotas Birth Cohort. Rev Bras Epidemiol. 23:e200026. [PubMed: 32401919]
• Watson PD, Ott MA. 1982. Lidocaine and mepivacaine in cord blood. Ped Pharm; 2:341-348. [PubMed: 6927130]
• Zeisler JA, et al. 1986. Lidocaine excretion in breast milk. Drug Intell Clin Pharm; 20:691-3. [PubMed: 3757781]

“OTIS/MotherToBaby encourages inclusive and person-centered language. While our name still contains a reference to mothers, we are updating our resources with more inclusive terms. Use of the term mother or maternal refers to a person who is pregnant. Use of the term father or paternal refers to a person who contributes sperm.