I've been contacted by a mom (I have her permission to post to this list)
whose older toddler had to have a procedure which required emergency general
anesthesia. The doctor asked when the last time the child had eaten. The
mom replied that he'd only nursed during the past 8 hours. The doctor
replied that when aspirating stomach contents it made no difference whether
it was breastmilk or a cheeseburger. That just doesn't sound right to
either of us, but we're having trouble coming up with a citation. She'd
like to write the doctor a polite letter citing the lessened dangers of
aspirating breastmilk. Here are some more details.
> we know the details of emptying time and that it is never wise to risk
> aspiration. But in an emergency, isn't human milk better to aspirate
> than a cheeseburger?
>
> I checked the Lactnet archives and found that on June 23, 1999, Marie
> Biancuzzo was replying to a request for a cite when she wrote:
>
> <<I know it's in R. Lawrence's book, but she probably cited a primary
> source.>>
>
> I just checked my Lawrence and couldn't find anything. I looked on pages
> 496-497.
> If you know of another area to check, please LMK (let me know). I couldn't
find
> anything in the index for aspiration.
>
> On May 20, 1997, Katherine West wrote:
>
> <<Human breastmilk does not; in fact, I learned (possibly from Dr.
> Jelliffe?? I'm sorry I cannot remember nor can I put my hands on any
> data) that human breastmilk is a "physiological normal" fluid. This is
> "normal" in the chemistry definition/sense, which I understood to mean
> that breastmilk has similar properties to blood serum - similar pH, etc.
> Obviously, breastmilk aspiration should be avoided if possible, but if
> breastmilk is aspirated, it is gentle on lung tissue and will actually
> be absorbed by the lungs at the cellular level (as if it were serum).
> Also, (especially if it were fresh breastmilk) it will have lysozymes,
> white blood cells and macrophages all "applied" locally in the lungs
> which should actually decrease the risk of a secondary bacterial
> pneumonia!>>
>
> This is exactly what I'm looking for, but doesn't include a citation. :(
>
> This Breastfeeding Abstract has a wealth of info, but it speaks about
> gastric emptying time, for the most part.
> http://www.lalecheleague.org/ba/Aug95.html
>
Thanks in Advance for any "scientific evidence" we can send to this doc.
Warmly,
Dawn Martin
Doula and IBCLC candidate 2002
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