Management of minor burns in the breastfeeding patient: The current state of the literature

Dr. Michael A. J. Rooke1, A/Prof. J. E. Greenwood2, Mrs. S. Kavanagh3, Dr. Jared Campbell4

1 Adult Burns Service, Royal Adelaide Hospital, North Tce Adelaide, SA, 5000, rooke.michael@gmail.com
2 Adult Burns Service, Royal Adelaide Hospital, North Tce Adelaide, SA, 5000, John.Greenwood@sa.gov.au
3 Adult Burns Service, Royal Adelaide Hospital, North Tce Adelaide, SA, 5000, Sheila.Kavanagh@sa.gov.au
4 Implementation Science, The Joanna Briggs Institute, University of Adelaide, Adelaide, SA, 5005, jared.campbell@adelaide.edu.au

Minor burns in patients who are actively breastfeeding are a common occurrence. Often anxiety surrounding potential harm to the baby from medications and dressings used in routine burn care outweighs those concerns relating to the injury itself. In order to address these concerns we undertook a literature review to assess which aspects of minor burn management are sources of potential harm to the breastfeeding child. Three areas were investigated: anaesthetics and analgesics, common antibiotics and silver dressings. The overall quality of evidence was limited, with only five studies being identified. Recommendations from the literature included the following:

  • Analgesia should primarily be achieved using non-opioids, however low doses of morphine were considered safe.
  • Most anaesthetic agents were safe to administer, save those which were highly lipid-soluble or if large volumes of local anaesthetic were used (e.g. tumescence).
  • Mothers were safe to resume breastfeeding after anaesthesia once they were sufficiently awake to do so.
  • Most commonly used antibiotics (e.g penicillins, cephalosporins) are safe for use while breast-feeding.
  • No human studies exist regarding the safety of silver dressings in breastfeeding.

Although there are gaps within the literature, it appears that the standardised management of minor burns as performed in most Burn Centres does not pose a risk to the breast-feeding mother or her child. Operative protocols (e.g. using tumescence) may need to be adjusted on a case-by-case basis.

Key Words

Burn Care, Breastfeeding, Minor Burns

Biography

Michael Rooke is currently working as the Service Registrar for the Adult Burn Service at the Royal Adelaide Hospital. The initiative to undertake this review came from some of the concerns faced by the unit, and they aim to share their findings today to help other units better manage this particular population of patients.

About ANZBA

ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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