I had a call from a mom re bf before surgery. Her 3 mo will be having kidney surgery to redirect her ureter. The surgery should last about 3 hrs. The surgeon has told her she can bf up to 3 hrs before the surgery (per Litman and Schreiner articles). Her question was what if the surgery is delayed? Ruth Lawrence says "Instructions to breastfeeding mothers should limit the amount of bf after 4 hours and permit feeding on a prepumped breast predominantly for comfort." Now we all know that even if mom puts baby to a "prepumped breast" she will still have a MER and the baby will receive milk. And why does Ruth Lawrence say 4 hours, rather than 3? By "limit the amount of bf" does Lawrence still allow moms to bf up to the time of surgery, but only on a pre-pumped breast? I also am trying to find the reference that says breastmilk, even if aspirated, does not harm the lungs. Anyone know where to find that? What guidelines do you use in your hospitals? Any other references to help this mom? I did check the archives first, but all I saw was stop bf three hours before surgery. Anyone allow two hours or allow bf on a pre-pumped breast up to the time of surgery? Cynthia D. Payne LLL of Berkshire County Massachusetts