Pat,
in Journal of Anesthesiology it is reported that, when hard data is
unavailable, recomendations are based on a survey of current practice by
major medical sites.  The results of a survey regarding NPO requirements
for breastfed infants can be found in this article:

Preoperative Fasting Practices in Pediatrics
Lynne R. Ferrari, M.D.*; Fiona M. Rooney†; Mark A. Rockoff, M.D.‡
This article is featured in “This Month in Anesthesiology.” Please see
this issue of ANESTHESIOLOGY, page 7A. ANESTHESIOLOGY 1999;90:978-980

There is less agreement about breast milk feeding. Some institutions
(36%) consider the composition of breast milk to be equivalent to that
of a clear fluid, others (34%) equivalent to a solid, and the remaining
institutions consider it “something else.” This is likely due to the
paucity of data examining absorption of breast milk in healthy infants.
Most institutions (77%) consider at least a 4-h fast for breast milk to
be sufficient; only 23% allowed breast milk to be ingested less than 4 h
before induction

Practice Guidelines for Preoperative Fasting and the Use
of Pharmacologic Agents to Reduce the Risk of
Pulmonary Aspiration: Application to Healthy Patients
Undergoing Elective Procedures

A Report by the American Society of Anesthesiologists Task Force on
Preoperative Fasting ANESTHESIOLOGY 1999;90:896-905

Preoperative Fasting Status (Breast Milk)
There is insufficient published evidence to evaluate the relationship of
the timing of breast milk intake before procedures to the incidence of
emesis/reflux or pulmonary aspiration. The Consultants and Task Force
support a fasting period for breast milk of 4 hours for both neonates
and infants.

Recommendations:
It is appropriate to fast from intake of breast milk for 4 or more hours
before procedures requiring general anesthesia, regional anesthesia, or
sedation/analgesia (i.e., monitored anesthesia care) [Table 1].
Preoperative Fasting Status (Infant Formula)
There is insufficient published evidence to address the safety of any
preoperative fasting period for infant formula. For infants and
children, the Consultants and Task Force support a fasting period of
6 hours. For neonates, the Consultants support a fasting period of 4
hours, and the Task Force supports a fasting period of 6 hours.

Recommendations:
It is appropriate to fast from intake of infant formula for 6 or more
hours before elective procedures requiring general anesthesia, regional
anesthesia, or sedation/analgesia (i.e., monitored
anesthesia care)
--

Denny Rice, RN, IBCLC
Dallas Texas USA

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html