If I was doing the injection (which I won't be -- adult acute pain management is NOT my thing!) I would not advise the mother to interrupt breastfeeding.  I assume this is an epidural steroid injection or a facet injection; decent doses of steroid are used for these procedures (we used to use around 80mg of methylprednisolone/Depo-Medrol), but a single injection of this would still be considered L2 in Hales latest MMM.  

If mom receives "conscious sedation" for the procedure, which some practitioners like to use when performing these procedures, continuation of breastfeeding should be fine as well.  Doses commonly used in these situations, such as midazolam 2mg and fentanyl 50-100mcg, should result in low milk levels.  If mom or doc is *really* concerned about this given the infant's young age, however, a single pump-and-dump afterwards would be more than sufficient to prevent much transfer to the baby.  OR forgo sedation altogether.  Many physicians do not like to use it anyways for these procedures because it could mask nerve injury or complications.

-Sarah Reece-Stremtan M.D. (pediatric anesthesiology fellow in Washington DC)

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