ASK DR.MOORE September 17, 2004
Dr. Mark Moore, author of the gender selection book Baby Girl or Baby Boy--Choose the Sex of Your Child, answers readers' questions on pregnancy and pediatrics.
BREASTFEEDING, SURGERY AND ANESTHESIA
Q: Can I breast-feed after my gallbladder surgery and will the anesthesia affect my baby?
Dr.Moore: Breast-feeding is a good thing--so much so, the American Academy of Pediatrics recommends an infant be given nothing else but breast milk for their first six months of life!
Benefits of breast-feeding include: increased immune protection for the infant, decreased incidence of allergic manifestations, a simplified diet of balanced nutrition, increased infant-mother bonding, savings on store-bought formula and the inherent bottles and mixing that go with it, and a possible link to lower obesity rates in adolescence. Bonus: There is no better way to melt away the excess pregnancy pounds than a suckling infant.
A breast-feeding mother may undergo surgery because of ailments that arose during pregnancy but were non-emergent. Often the surgeon will postpone surgery until after delivery--for example excision of a lump or bump. Sometimes pregnancy can aggravate an underlying problem like gallbladder disease (cholelithiasis, cholecystitis) and the mom will need a cholecystectomy (surgical removal of gallbladder).
Medications given for surgical anesthesia circulate in the bloodstream and are eliminated via the lungs (breathed out), kidneys or metabolized by the liver. The majority of medications and inhaled anesthetic agents are excreted into the milk but in very minute quantities. Not only does the medication get diluted out in the mother’s bloodstream, the amounts that are excreted into the milk are very small. Assuming a patient is able to do so, most physicians do not mind a mother to breast-feeding immediately after a surgical procedure. Remember, the mother/patient must be awake and alert enough to hold the baby.
The surgical procedure determines which type of anesthesia may be used. General inhalational, regional (epidural, spinal, local anesthetics) or intravenous medications (twilight) or a combination may be given. Will the baby absorb these drugs via the breast-milk? Yes, but in relatively insignificant amounts. The amounts absorbed by the baby during breast-feeding are small compared to the blood levels reached when a baby receives anesthesia for a surgical procedure on itself.
The circumstances surrounding each surgery and anesthetic can vary so plan to ask your physician about breast-feeding on your pre-op visit.
The AAP's policy statement on breastfeeding and
the use of human milk states, "exclusive
breastfeeding is sufficient to support optimal
growth and development for approximately the
first 6 months of life" and "Breastfeeding should
be continued for at least the first year of life
and beyond for as long as mutually desired by
mother and child."
http://aappolicy.aappublications.org/cgi/content/full/pediatrics;115/2/496
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Readers may send questions to our email address. This column is for informational purposes only and is not a substitute for professional or medical advice.
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