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Date: | Wed, 7 Aug 2002 14:17:45 -0700 |
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If I'm understanding correctly, the question relates to how soon before the surgery the baby can receive breastmilk? If so, I have a couple of references that may help.
Boston Children's Hospital (I don't have the area code, just a phone number of 355-7921) has written day surgery instructions that allow breastmilk up to 3 hours before surgery.
The American Society of Anesthesiologists made a statement a few years ago; they recommend that the baby fast from intake of breastmilk for 4 or more hours before procedures requiring general anesthesia. Apparently they arrived at the 4 hours because it was between clear liquids (2 hour fast) and non-human milk (6 hour fast), someone told me!
As to the "clean" bowel, we all know that the gastric system isn't exactly clean to begin with, but the family may need to talk this over with the surgeon to see what is thinking. As we know and studies support, the gastric emptying time for human milk is pretty short and absorption is fairly complete.
Two articles that may help:
Schreiner, M. S. Preoperative and postoperative fasting in children. Ped Clinics N Amer 1994; 41(1):111-20
Litman, RS et al. Gastric volume and pH in infants fed clear liquids and breast milk prior to surgery. Anesth Analg 1994; 79:482-5.
Jack Newman once mentioned trying to schedule the surgery late in the morning or early in the afternoon, say about 1 pm, so baby can last breastfeed about 9 am. It may be easier to distract the baby during the day than it is at night, if the surgery is scheduled early in the morning.
Jeanne Brotherton, RNC, IBCLC
Bellingham, WA
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