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."
Breastfeeding and the Use of Human Milk
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Readers may send questions to this
email address. This column is for informational purposes
only and is not a substitute for professional or medical advice.
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