Last update: Jan. 8, 2020

Preoperative Fasting In Breastfeeding Infants

Low Risk for breastfeeding


Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
Read the Comment.

Clear fluids (e.g. water, juices) and breast milk are digested in two to three hours. They do not interfere with acidity and amount of residual fluid appearing in the stomach after that period.

Infants especially the younger ones are likely more relaxed when arriving to operating room if they have not been forced to fasting for a long period (Brady 2009, ABM 2012).

However, the American Society of Anesthesia has stated that less than 4 hours period as a preoperative fasting period would not be advisable (ASA 2011).
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Traslation pending:
Si un lactante amamantado requiere un intervención quirúrgica con anestesia general, regional (epidural) o que precise algún tipo de sedación, hay riesgo de aspiración pulmonar de contenido gástrico si no se hace un tiempo de ayuno previo a la anestesia o sedación (Brady 2009).
Las tomas de líquidos claros (agua, soluciones azucaradas, zumos, infusiones) y de leche materna se digieren en dos a tres horas y no afectan a la acidez y cantidad de líquido que queda en el estómago una vez pasado este tiempo, no interfiriendo con la anestesia.
Los niños, sobre todo muy pequeños, llegan mucho más tranquilos a quirófano si no se les obliga a ayunos prolongados (Beck 2019, ABA 2017, Costa 2016, ABM 2012, Brady 2009).

Si el lactante va a ser intervenido quirúrgicamente puede tomar pecho y/o líquidos claros hasta 3 a 4 horas antes de la anestesia. Tiempos mayores de ayunas no son necesarios (ABA 2017)
Las sociedades de Anestesiología consideran suficientes ayunos mínimos en lactantes amamantados de 3 (Cook 2006) a 4 horas (ASA 2017, Lawrence 2016 p517, Arun 2013, Sumiyoshi 2013, Hanna 2012, ABM 2012, ASA 2011, Smith 2011, Weiss 2010, Søreide 2005, Ferrari 1999, Splinter 1999, Emerson 1998, van der Walt 1990), incluso en recién nacidos prematuros (Beck 2019).
Estas 4 horas pueden ser difíciles de soportar para lactantes muy pequeños y recién nacidos, causándoles llanto e irritabilidad por hambre. Una toma hasta 2 horas antes de una solución de líquido claro (solución de agua con azúcar y electrolitos, zumo sin pulpa, infusión), seguido del uso de un chupete o el consuelo de un familiar distinto de la madre hasta el momento de la anestesia puede ayudar a mitigar el problema (ASA 2017 y 2011, ABM 2012; Lawrence 2005). Varias sociedades pediátricas preconizan la toma de líquidos claros hasta 1 hora antes de la anestesia (Thomas 2018).

Tiempos mínimos de ayuno recomendados (ASA 2017 y 2011, ABM 2012):
- Líquido claros......: 2 horas (Thomas 2018: 1 hora)
- Leche materna....: 4 horas
- Fórmula artificial.: 6 horas
- Leche de animal..: 6 horas
- Sólidos ligeros.....: 6 horas

Si el procedimiento quirúrgico no requiere sedación ni anestesia general, no es preciso ningún tipo de ayunas y la toma de pecho simultanea al procedimiento puede servir de analgesia (ABM 2012).

Las reprogramaciones y cambios o retrasos en el horario quirúrgico son la causa más frecuente de ayuno prolongado de modo innecesario (Arun 2013), junto con la falta de guías de ayuno preoperatorio específicas (Ramírez 2002).

La mayoría de intervenciones quirúrgicas permiten el amamantamiento en cuanto el bebé esté despierto; precisa una valoración individual según el tipo de operación y de enfermedad; mientras no pueda ser amamantado, conviene que la madre se extraiga y almacene leche (CW 2019, ABA 2017, Lawrence 2016 p517).


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Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Preoperative Fasting In Breastfeeding Infants is also known as Preoperative Fasting. Here it is a list of alternative known names::


Groups

Preoperative Fasting In Breastfeeding Infants belongs to these groups or families:

References

  1. Beck CE, Witt L, Albrecht L, Winstroth AM, Lange M, Dennhardt N, Boethig D, Sümpelmann R. Ultrasound assessment of gastric emptying time in preterm infants: A prospective observational study. Eur J Anaesthesiol. 2019 Jun;36(6):406-410. Abstract
  2. Thomas M, Morrison C, Newton R, Schindler E. Consensus statement on clear fluids fasting for elective pediatric general anesthesia. Paediatr Anaesth. 2018 May;28(5):411-414. Full text (link to original source) Full text (in our servers)
  3. ABA - Australian Breastfeeding Association. Breastfeeding and hospitalization. 2017 Full text (link to original source) Full text (in our servers)
  4. ASA. [No authors listed] Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures: An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use o... Anesthesiology. 2017 Mar;126(3):376-393. Abstract Full text (link to original source) Full text (in our servers)
  5. Lawrence RA, Lawrence RM. Breastfeeding. A guide for the medical profession. Eighth Edition. Philadelphia: Elsevier; 2016
  6. Arun BG, Korula G. Preoperative fasting in children: An audit and its implications in a tertiary care hospital. J Anaesthesiol Clin Pharmacol. 2013 Abstract Full text (link to original source) Full text (in our servers)
  7. Sumiyoshi R. [Preoperative fasting and fluid management in pediatric patients]. Masui. 2013 Abstract
  8. Hanna AH, Mason LJ. Challenges in paediatric ambulatory anesthesia. Curr Opin Anaesthesiol. 2012 Abstract
  9. Academia de Medicina de Lactancia Materna. Protocolo clínico de la ABM n.º 25: Recomendaciones para ayunos previos a procedimientos en bebés lactantes: Pautas “NPO”. Breastfeed Med. 2012 Full text (link to original source) Full text (in our servers)
  10. Academy of Breastfeeding Medicine. ABM Clinical Protocol #25: Recommendations for preprocedural fasting for the breastfed infant: "NPO" Guidelines. Breastfeed Med. 2012 Abstract Full text (link to original source) Full text (in our servers)
  11. Smith I, Kranke P, Murat I, Smith A, O'Sullivan G, Søreide E, Spies C, in't Veld B; European Society of Anaesthesiology. Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol. 2011 Abstract
  12. ASA - American Society of Anesthesiologists Committee. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anesthesiologists Committee on Standards and Practice Parameters. Anesthesiology. 2011 Abstract Full text (link to original source) Full text (in our servers)
  13. Brady M, Kinn S, Ness V, O'Rourke K, Randhawa N, Stuart P. Preoperative fasting for preventing perioperative complications in children. Cochrane Database Syst Rev. 2009 Abstract Full text (link to original source)
  14. Weiss G, Jacob M. [Preoperative fasting 2008: medical behaviour between empiricism and science]. Anaesthesist. 2008 Abstract
  15. Cook-Sather SD, Litman RS. Modern fasting guidelines in children. Best Pract Res Clin Anaesthesiol. 2006 Abstract
  16. Søreide E, Eriksson LI, Hirlekar G, Eriksson H, Henneberg SW, Sandin R, Raeder J; (Task Force on Scandinavian Pre-operative Fasting Guidelines, Clinical Practice Committee Scandinavian Society of Anaesthesiology and Intensive Care Medicine). Pre-operative fasting guidelines: an update. Acta Anaesthesiol Scand. 2005 Abstract Full text (in our servers)
  17. Lawrence RA. Lactation support when the infant will require general anesthesia: assisting the breastfeeding dyad in remaining content through the preoperative fasting period. J Hum Lact. 2005 Abstract
  18. Ramírez-Mora J, Moyao-García D, Nava-Ocampo AA. Attitudes of Mexican anesthesiologists to indicate preoperative fasting periods: A cross-sectional survey. BMC Anesthesiol. 2002 Abstract Full text (link to original source) Full text (in our servers)
  19. Ferrari LR, Rooney FM, Rockoff MA. Preoperative fasting practices in pediatrics. Anesthesiology. 1999 Abstract Full text (link to original source)
  20. Splinter WM, Schreiner MS. Preoperative fasting in children. Anesth Analg. 1999 Jul;89(1):80-9. Review. No abstract available. Abstract
  21. Emerson BM, Wrigley SR, Newton M. Pre-operative fasting for paediatric anaesthesia. A survey of current practice. Anaesthesia. 1998 Abstract Full text (link to original source) Full text (in our servers)
  22. van der Walt JH, Foate JA, Murrell D, Jacob R, Bentley M. A study of preoperative fasting in infants aged less than three months. Anaesth Intensive Care. 1990 Abstract

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