Surgery and the Breastfeeding Infant

When a baby is having surgery, it can be a frightening experience for the parents and the child. However, the closeness and security derived from breastfeeding can be very calming and comforting. Usually, when a baby is scheduled for surgery, breastfeeding will have to be delayed for a period of time prior to, during, and after surgery. This is true for either a minor procedure, in which your baby will only need to be in the hospital for a few hours, or more extensive procedures, requiring several days of hospitalization.

Feedings usually need to be withheld around the time of surgery because the anesthesia given to help your baby sleep during an operation may cause nausea and vomiting if your baby has been fed recently. Going to surgery with an empty stomach can help prevent serious problems that may occur if your baby vomits during the operation. In most cases, your baby will be able to continue to breastfeed up to a few hours before surgery. However, it is essential that you check with your child's doctor prior to surgery. If a feeding is given too close to the time of surgery, the operation may have to be rescheduled.

In most cases, depending on the type of surgery, your baby will be able to return to breastfeeding once he or she is awake enough to drink liquids without problems, as advised by his or her doctor. Regardless of the length of time this takes, there are some things you can do to make the experience less stressful, including the following:

• Since you may have to miss one or more breastfeeding sessions, pumping your breasts to express your milk will relieve discomfort and maintain your milk supply. This process will be a little easier if you plan ahead.

• Ask your baby's doctor or nurse where you may pump while at the hospital. Electric pumps are usually available for your use. If you will be missing more than a few nursing sessions and will not be at the hospital all the time, you might want to rent an electric breast pump, from the hospital, to use during this time.

• Steady milk production depends on effective and regular milk expression until your baby is ready and able to resume breastfeeding. Pump on the same schedule as your baby would normally breastfeed and use a double collection kit that allows you to pump both breasts at once. Most mothers will need to pump for about 10 minutes when double-pumping, or 10 minutes on each breast. If your baby is a newborn and your milk has not yet come in, be sure to pump at least 8 times in 24 hours. You may not see any milk during the first several pumping sessions, and you may only get drops for several sessions after that. The milk produced before days 3 to 5 after delivery is called colostrum, and it is normally produced in low amounts. However, colostrum is especially rich in the anti-infective factors that are important for your baby.

• Breast milk may be frozen for several months, or refrigerated and used within 24 to 48 hours after pumping. You will need to properly collect, label, and store your milk. Consult a certified lactation consultant (IBCLC) for more information about pumping and breast milk storage.

• In most cases, you can resume breastfeeding when your baby has awakened from the anesthesia. However, surgery can be very disruptive and your baby may not be interested or ready to breastfeed immediately after surgery. If your baby is not able to breastfeed the usual length of time, you can pump after the feeding to empty your breasts and maintain your milk production.

Since this is a stressful time for the family, you may find that your milk supply is reduced. Remember to rest and maintain your food and especially your fluid intake during this time to help you stay healthy and maintain your breast milk supply.