EMSA

Pregnancy and Breastfeeding

RCoA Guide
Overview
Adjustments
Rota planning
Breastfeeding
Resources

At‑a‑Glance

When to notify?

Notify by 25 weeks to secure maternity leave/pay; paid time off for antenatal care applies.

Risk hot spots

Unscavenged nitrous, high‑turnover inhalational lists, prolonged standing (>3 h), manual handling, ionising radiation, certain scrubs (iodine) and infection exposures.

Breastfeeding and Anaesthesia

Modern guidance supports “sleep and keep” (no routine “pump & dump”) after GA; plan expressing breaks and storage.

Practical adjustments (by exposure)

  • Anaesthetic gases: prioritise well‑scavenged theatres; consider TIVA; avoid high‑turnover paeds/ENT facemask lists if possible.
  • Radiation: stand back; use wrap‑around lead + thyroid shield; extension lines; choose lower‑exposure lists if feasible.
  • Manual handling/standing: avoid heavy pushing/pulling; limit prolonged standing; request seating and help for transfers.
  • Infection: adhere to local IPC guidance; consider redeployment away from specific high‑risk exposures where advised.
  • Bone cement: ensure vacuum mixing/ventilation; keep distance during mixing.
  • Iodine scrubs: avoid routine povidone‑iodine during pregnancy; use alternatives as per Trust policy.

Training & rota planning

Agree a personalised plan with your ES/TPD. Many trainees step off nights in the third trimester; timing can be earlier or later based on individual need. Use KIT/SPLiT days and SuppoRTT for a confident return.

Quick links

Breastfeeding at work

  • Clinically: most anaesthetic/analgesic agents transfer to milk in very small amounts; routine “pump & dump” is not required.
  • On shift: plan expressing every 3–4 h; arrange fridge storage; schedule breaks into theatre lists.
  • Facilities: request a private room (not a toilet), power outlet, handwashing and a fridge/freezer for milk.

Tip: express‑friendly lists

  • Choose day‑case or shorter lists where breaks can be planned.
  • Flag your needs to theatre coordinator at the start of the list.
  • Carry a labelled cool bag in case fridge access is limited.

Resources & policy links

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LTFT GuideOpen