Mother's of nurslings needing abdominal ultrasound are also often told that
the nursling may not breastfeed for a long period of time. Like surgeons
and anesthesiologists, radiologists and radiology technicians may not be
aware that less physiologic foods take more time to digest than human milk.
In the case of abdominal ultrasound, in addition to the references already
posted in regard to preoperative fasting, my Unit in La Leche League
International's Lactation Consultant Series II, "Congenital Disorders in
the Nursling," might be useful. It should be noted that two distinct but
related issues are at hand: for surgery, gastric emptying (due to concern
about the possibility of aspiration) and, for ultrasound, the production of
stomach gasses in the course of digestion (because they prevent
transmission of ultrasound waves). However, depending on their result, some
abdominal ultrasounds may lead to surgery. Therefore, both issues may
actually be at hand for abdominal ultrasounds.
I have yet to see a study on the timing of cessation of the production of
stomach gasses after human milk is consumed, but perhaps I have just missed
it. If anyone knows of another reference, be it a case or a study, I would
appreciate them letting me know where I can find it. Here is an excerpt
from one of the cases presented in my Unit (Alice is the nursling [at risk
for a variety of abdominal cancers due to hemihypertrophy] and Madeline is
her mother):
"Ultrasound imaging of Alice's abdominal organs has been conducted every
three months since her birth to screen for cancer. Each time Madeline
called to make an appointment, she was told that Alice could not breastfeed
for eight hours before the screening. The ultrasound technician gave the
same information. Concerned about the impact on her young exclusively
breastfed baby, Madeline found and reviewed research on gastric emptying
time after breastfeeding and consulted with the radiologist to determine
the rationale for such orders. The doctor explained that the gasses
produced in the stomach during digestion prevent transmission of ultrasound
waves, blocking the view of organs behind the stomach. However, he
supported flexibility in the timing of breastfeeding, acknowledging that
ultrasound images cannot be obtained at all on a distressed, crying baby
with a tense abdomen."
"As Alice grew more capable of accommodating some delay in breastfeeding,
Madeline experimented with its timing. She found that if she concluded
breastfeeding just two hours before an ultrasound screening, the gasses
produced during digestion did not block the view of organs behind the
stomach. Madeline and her husband changed ultrasound technicians three
times before finding one who was fully supportive of breastfeeding."
Good Mojab, C. Congenital disorders in the Nursling. Unit 5. Lactation
Consultant Series II. Schaumburg, IL: La Leche League International, 2002.
Evidence-based guidelines for preoperative fasting and abdominal ultrasound
would prevent much unnecessary suffering for both nursling and mother
during times that are already very stressful.
Cynthia
Cynthia Good Mojab, MS clinical psychology, IBCLC, RLC
Ammawell
Email: [log in to unmask]
Web site: http://home.attbi.com/~ammawell
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