< We have just had an influx of new anaethetists, who have started
ordering that women who have ropivacaine hydrochloride (naropen) in their
epidurals, either in birth suites or for their caesarean sections,
express and dump their first two breastfeeds, with the babies given comps
instead. >

To me, those anesthetists are just demonstrating ignorance of the
breastmilk manufacturing process (and value). The first 2 feeds, and
probably many more, are of colostrum that is already in the ducts, having
been building up drop by drop in the ducts during the last half of
pregnancy, to say nothing of the fact that the value of the immunities
that would be discarded is priceless! (At what volume of colostrum
removed would the feeding be considered ended and the next one begun???)

The medication that would enter the mother's blood stream from the
anesthetic would not be incorporated into the mother's milk till the
hours after birth, and then who knows how long it would take to move
forward in the ducts after the colostrum to reach the baby. With any
luck, maybe it would be processed out of the blood stream operating on
the same principal as the blood level/milk level of alcohol??

Another study waiting for someone to obtain serial laboratory analyses of
samples of milk from amounts removed 3 hourly for several days from
mothers after first being administered this anesthetic. I doubt it would
be funded by the people who make the drug though! LOL! One more instance
of their literature being mainly to CYA? (An old American idiom to
indicate a kid's maneuver to "Cover Yo'  A--" to protect his bottom from
a whipping!)

Jean
************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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