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Breastfeeding after General Anaesthesia: a Survey of Knowledge and Practice amongst Anaesthetists
Abstract Number: S5A-4
Abstract Type: Original Research
The benefits of breastfeeding are well established, with mothers encouraged to breastfeed for at least 6 months . As some mothers may require surgery during this period, anaesthetists should be aware of the potential transfer of drugs into breast milk and recommended interval times before recommencing breastfeeding to avoid any unwanted effects on the nursing infant. Anecdotally, health professionals often inform mothers to withhold breastfeeding or “pump and dump” their breast milk post-operatively. Currently, there is limited consensus data on safe post-operative interval times, however, recent advice recommends that mothers should be able to resume breastfeeding once awake, stable and alert . Our objective was to assess the variability of advice being given to patients by anaesthetic doctors.
A short anonymous online survey was created with a series of scenarios focusing on breastfeeding mothers requiring different surgical procedures. They incorporated a range of general and regional techniques, anaesthetic agents, analgesics, muscle relaxants, anti-emetics and antibiotics for procedures of varying urgency. This was distributed to anaesthetists of all training grades across major London teaching hospitals. Participants were invited to select the advice they would give in relation to post-operative withdrawal of breastfeeding. For our analyses, a correct response was deemed “no need to discontinue”.
66 responses were gathered between May-October 2017. Responders were split unequally between different grades (see graph). The range of correct responses across all scenarios varied between 46-75%. There was no statistically significant difference between correct response and level of training [χ2 = 3.441, p=0.329].
Although the literature suggests anaesthetic drugs are transferred to breast milk, levels are almost never clinically significant and pose little or no risk to the nursing infant . This survey highlights a variation in knowledge amongst UK anaesthetists of all training grades and calls upon improved teaching programmes with regards to safe post-operative interval times for breastfeeding.
1. Cobb B et al. Breastfeeding after Anesthesia: A Review for Anesthesia Providers Regarding the Transfer of Medications into Breast Milk. Transl Perioper Pain Med. 2015; 1(2): 1–7.
2. Dalal PG et al. Safety of the breast-feeding infant after maternal anaesthesia. Paediatr Anaesth 2014; 24:359–71