Nitrous Oxide

The Basics

What is Nitrous Oxide?

Known as laughing gas or nitrous, commonly used for sedation and pain relief.

Brand names for Nitrous Oxide

Na

How Nitrous Oxide is classified

Anesthetics – Inhalation

Nitrous Oxide During Pregnancy

Nitrous Oxide pregnancy category

Category N/ANote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.

What we know about taking Nitrous Oxide while pregnant

N/A

Taking Nitrous Oxide While Breastfeeding

What are recommendations for lactation if you're taking Nitrous Oxide?

Because the serum half-life of nitrous oxide in the mother is short and the drug is not expected to be absorbed by the infant, no waiting period or discarding of milk is required.[1][2] Some evidence indicates that primiparous mothers who use inhaled nitrous oxide during labor for analgesia have better breastfeeding success than mothers who do not. If used as part of general anesthesia, breastfeeding can be resumed as soon as the mother has recovered sufficiently from anesthesia to nurse. When a combination of anesthetic agents is used for a procedure, follow the recommendations for the most problematic medication used during the procedure.

Maternal / infant drug levels

Because the serum half-life of nitrous oxide in the mother is short and the drug is not expected to be absorbed by the infant, no waiting period or discarding of milk is required.[1][2] Some evidence indicates that primiparous mothers who use inhaled nitrous oxide during labor for analgesia have better breastfeeding success than mothers who do not. If used as part of general anesthesia, breastfeeding can be resumed as soon as the mother has recovered sufficiently from anesthesia to nurse. When a combination of anesthetic agents is used for a procedure, follow the recommendations for the most problematic medication used during the procedure.

Possible effects of Nitrous Oxide on milk supply

A randomized, but nonblinded, study in women undergoing cesarean section compared epidural anesthesia with bupivacaine to general anesthesia with intravenous thiopental 4 mg/kg and succinylcholine 1.5 mg/kg for induction followed by nitrous oxide and isoflurane. The time to the first breastfeed was significantly shorter (107 vs 228 minutes) with the epidural anesthesia than with general anesthesia. This difference was probably caused by the anesthesia’s effects on the infant, because the Apgar and neurologic and adaptive scores were significantly lower in the general anesthesia group of infants. It is not known what part nitrous oxide played in this difference in outcome.[3]

A retrospective database study found that primiparous women who receive a nitrous oxide-oxygen mixture for pain during delivery in addition to routine analgesia were more likely to be breastfeeding their infants at 48 hours postpartum than women who did not receive nitrous oxide. This correlation was not found when all women were included in the analysis.[4]

In a nonrandomized, nonblinded retrospective study, 62 women who chose labor with gas analgesia with 50% nitrous oxide and oxygen were compared to a control group of 124 women who did not receive gas analgesia during labor. Most of the women in the study were primiparous. Use of other labor medications was not reported. Women who received nitrous oxide had higher rates of breastfeeding and exclusive breastfeeding than those who did not at 7 days after discharge, at 1 month postpartum, and at 3 months postpartum.[5]

Possible alternatives to Nitrous Oxide