Bridging the Evidence-Practice Gap in Breastfeeding After Anesthesia: A Case Report and Practical Framework for the Non-obstetric Provider

Despite updated recommendations from major professional societies, outdated guidance to interrupt breastfeeding after anesthesia persists in clinical practice. This discrepancy reflects an evidence-practice gap, particularly in non-obstetric perioperative settings and in cases involving newer anesthetic agents. This report describes a 32-year-old lactating female undergoing elective laparoscopic abdominal surgery under general anesthesia using a multimodal approach, including dexmedetomidine and sugammadex. Detailed perioperative management, medication selection, and counseling strategies are presented. Breastfeeding was resumed approximately 60 minutes postoperatively once the patient was awake and neurologically intact, with no observed neonatal adverse effects. Current recommendations support early resumption of breastfeeding after anesthesia, emphasizing maternal recovery rather than arbitrary time intervals. This case operationalizes these principles in a contemporary anesthetic context and provides a structured framework for perioperative counseling and management. Particular attention is given to agents with limited lactation-specific data, including dexmedetomidine and sugammadex, highlighting the role of pharmacokinetic principles such as relative infant dose and oral bioavailability in guiding clinical decisions. This case supports existing guideline recommendations and illustrates their application in modern anesthetic practice. It provides a practical, evidence-informed approach to managing lactating patients undergoing non-obstetric surgery while identifying areas where further research is needed.