Hi, Cath:  Your mom requiring a pacemaker should not have any issues with 
breastfeeding because of the surgery.  If I am reading your post correctly, her 
baby will be about 6-8 weeks old when she has the procedure done - the baby 
no longer being such a newborn should help.
Typically, a pacer implant is done thru day surgery in an EP (electrophysiology) 
lab under conscious sedation.  A fentanyl/vistaril combination is typically used 
in the US, neither of which are contraindicated for breastfeeding.  The entire 
procedure takes about 2 hours - most patients go home that same day.  She 
should find out if her doctor is planning same-day surgery or an overnight 
stay, for observation.  Any radiation exposure is minimal and should not disrupt 
breastfeeding.  A chest X-ray is done after the procedure to check lead 
placement in the heart.  She will have an incision in her upper left 
(occasionally done on the right) chest and will have restricted arm movement 
for 6-8 weeks.  She will be instructed not to perform extreme arm motions 
such as lifting her arm above her head or reaching behind her back until the 
leads attach to her heart muscle. She may want to start hunting now for front-
opening bras to use during the recovery period.
She will probably need help with lifting the baby, especially the 1st couple of 
weeks after surgery.  If she requires a hospital stay, arrangements should be 
made ahead of time with the staff for baby to be brought in for visits.  She will 
also be on continuous monitoring for her entire hospital stay, so she may need 
to get creative in positioning baby around the leads on her chest. Probably the 
most important issue to address with her are her cardiac medications.  Some 
of the antiarrhythmics are classified as L5 by Hale, especially the Class 3 
drugs, such as amiodarone and dofetilide (which is not in the 2006 Hale, but is 
even stronger than amiodarone).  If she needs to be started on any of the 
antiarrhythmics, she is looking at a 3 day hospital stay.  All of these drugs 
require continuous heart monitoring when a patient is started on them because 
the risk of suffering cardiac arrest is initially so high.
Good luck in working with this mom!


Pam Hirsch, BSN,RN,IBCLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL   USA

Who knows all these things from an up close and personal perspective, having 
had a pacemaker for 5 years now and who was on all the antiarrhythmics 
currently on the market before finally discovering one that works!

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