I had posted to the list some weeks back about my 2 1/2yo son needing to
have some teeth extractions following a dental injury a few months ago.  I
was encouraged and relieved to hear the many responses I received both on
and off list -- thank you very much for sharing your experiences, if I
didn't get a chance to respond back to you!

My son had his teeth out yesterday, and very thankfully the dentists were
able to easily remove the infected bone fragments without needing to cut
into his gums at all (which would have been a much more involved
procedure).  So nursing, according to the dentist, was totally fine.

He was having considerable issues in the PACU (post-anesthesia care
unit/recovery room) from a respiratory standpoint because he'd also
undergone bronchoscopy with an excessively voluminous broncho-alveolar
lavage performed while he was under anesthesia (previously planned, to
re-assess an ongoing micro-aspiration problem).  I finally decided to try
offering breastfeeding, with the hesitation of his PACU nurse evident as he
was not maintaining adequate oxygenation without facemask oxygen.  I
frequently am called to deal with urgent patient problems in the PACU so she
wasn't going to argue too much with me. ;)

To everyone's surprise, his O2 sats slowly rose and he maintained them
nicely in the low-to-mid-90's as long as he was nursing!  We decided that in
addition to milk, I apparently lactate oxygen, or maybe even heliox.  Really
though, I think nursing was comforting enough to him that he was able to
ignore the respiratory distress and drowning sensation and relax a little
bit.  He was oozy from his gums when nursing until this morning but luckily
the teeth extractions have been the easiest part of the whole ordeal.

-Sarah Reece-Stremtan M.D. (pediatric anesthesiology fellow in Washington
DC)

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