Should maternal anesthesia delay breastfeeding? A systematic review of the literature

Oliveira, Morenna Ramos e; Santos, Murillo Gonçalves; Aude, Débora Alves; Lima, Rodrigo Moreira e; Módolo, Norma Sueli Pinheiro; Navarro, Laís Helena Camacho

doi:10.1016/j.bjane.2018.12.006

Cited by 7 publications

(11 citation statements)

References 45 publications

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“…In essence, we found data on two different ‘fasting’ patterns, with an acute model <24 h in 71 women [ 9 , 10 , 11 ], or a more chronic, repetitive fasting (during Ramadan) model in 81 women [ 12 , 13 , 14 , 15 ] ( Table 1 ). In our assessment, the acute model is likely very similar to the interruption of caloric intake as part of analgo-sedation related to surgery or diagnostic interventions and strongly suggests that this is not associated with changes in macronutrient composition [ 1 , 2 , 3 , 9 , 10 , 11 ]. Based on the data we retrieved, the impact of chronic repetitive fasting during Ramadan on breast milk is moderate but not clinically relevant (being mainly based on morning samples, so at the start of fasting), although there remains a call for further focused research on this topic.…”

Section: Discussionmentioning

confidence: 85%

“…Consequently, women may also want to breastfeed shortly following analgo-sedation for surgery or diagnostic procedures. To further facilitate this practice, guidelines are provided by different learned societies [ 1 , 2 , 3 ]. We also recently summarized the available knowledge on lactation during or after exposure to commonly prescribed analgesics, narcotics or sedatives (opioids, intravenous and inhalational anesthetics, benzodiazepines, non-opioid analgesics, and local anesthetics) following surgery, diagnostic procedures or medical indications [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Acute Maternal Fasting or Fluid Abstention Does Not Significantly Affect the Macronutrient Composition of Human Milk: Clinical and Clinical Research Relevance

Allegaert

Smits

2020

Children

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There are guidelines on lactation following maternal analgo-sedative exposure, but these do not consider the effect of maternal fasting or fluid abstention on human milk macronutrient composition. We therefore performed a structured search (PubMed) on ‘human milk composition’ and screened title, abstract and full paper on ‘fasting’ or ‘abstention’ and ‘macronutrient composition’ (lactose, protein, fat, solids, triglycerides, cholesterol). This resulted in six papers and one abstract related to religious fasting (n = 129 women) and observational studies in lactating women (n = 23, healthy volunteers, fasting). These data reflect two different ‘fasting’ patterns: an acute (18–25 h) model in 71 (healthy volunteers, Yom Kippur/Ninth of Av) women and a chronic repetitive fasting (Ramadan) model in 81 women. Changes were most related to electrolytes and were moderate and mainly in the chronic repetitive fasting model, with no clinical significant changes in macronutrients during acute fasting. We therefore conclude that neither short-term fasting nor fluid abstention (18–25 h) affect human milk macronutrient composition, so that women can be reassured when this topic was raised during consulting. Besides the nutritional relevance, this also matters, as clinical research samples—especially estimating analgo-sedative exposure by lactation—are commonly collected after maternal procedural sedation and maternal fasting. Based on these results, it is reasonable to assume stable human milk composition when such data are used in physiology-based pharmacokinetic (PBPK) models.

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Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Acute Maternal Fasting or Fluid Abstention Does Not Significantly Affect the Macronutrient Composition of Human Milk: Clinical and Clinical Research Relevance

Allegaert

Smits

2020

Children

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“…According to a study that evaluated the delivery of bupivacaine through breast milk after a TAP block [ 9 ], neonatal toxicity is extremely unlikely to occur. Local anesthetics, including lidocaine, seem to be safe for breastfeeding women because of their short half-life, poor oral bioavailability (less than 30%), and low concentration in breast milk [ 15 ]. Most drugs commonly used in general anesthesia are considered to be safe for the breastfeeding of healthy infants when administered in a single dose.…”

Section: Discussionmentioning

confidence: 99%

“…But, in some drugs, there have been no published studies on transmission through breast milk (inhaled anesthetics, muscle relaxants, and remifentanil) or only limited data are available. If multiple administration of drugs is needed or a nursing patient has an unhealthy neonate, breastfeeding of the neonate may be adversely affected [ 15 ]. In brief, the TAP block is a safe anesthetic method for breastfeeding women, and the patient in the present case was able to proceed to breastfeed normally from the day of the operation.…”

Section: Discussionmentioning

confidence: 99%

Transversus abdominis plane block as a sole anesthetic technique for evacuation of rectus abdominis muscle hematoma - A case report -

et al. 2020

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Background: Transversus abdominis plane (TAP) blocks have been used for analgesia in various abdominal surgeries. However, a TAP block as the sole anesthetic method for surgery has rarely been reported.Case: A 33-year-old breastfeeding primipara woman was admitted to the hospital due to a rectus abdominis muscle hematoma. Because the patient refused other anesthetic methods, evacuation of the hematoma was performed under an ultrasound-guided bilateral TAP block. A 23-gauge needle was inserted in an in-plane method using a linear ultrasound probe. An injection of 10 ml of 2% lidocaine was made to the right lateral TAP and the left lateral TAP. After confirming the sensory blockade of the T10 to T12 dermatomes, surgery was performed successfully. The patient’s condition stabilized during the surgery. Breastfeeding was performed on the day of surgery. Conclusions: The evacuation of an abdominal wall hematoma in a breastfeeding patient was successfully performed under a bilateral TAP block.

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“…O aleitamento materno traz diversos benefícios para a nutrição infantil, sendo foco de estudos de interesse multiprofissional (21) . Nota-se que a maior parte das entrevistadas pretende ofertar a amamentação por mais de seis meses.…”

Section: Discussionunclassified

Orientação Profissional Quanto Ao Aleitamento Materno: O Olhar Das Puérperas Em Uma Maternidade De Alto Risco No Estado De Sergipe

Santana¹,

Mendonça²,

Chaves³

2019

revenf

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Objetivo: Analisar as ações de promoção, proteção e apoio à prática da amamentação realizada pelos profissionais de saúde, no olhar das puérperas. Métodos: Estudo descritivo e observacional, realizado em uma maternidade de alto risco no município de Aracaju, SE. Resultados: 96% das puérperas realizaram o pré-natal completo e 56,78% não receberam nenhum tipo de orientação. Dentre as orientações recebidas, a mais citada refere-se ao tempo recomendado para a amamentação (12,29%), seguida da importância da amamentação (9,75%). Conclusão: Mesmo com a adesão da maioria das puérperas à realização do pré-natal completo, há ainda uma necessidade de maiores informações, orientações e apoio dos profissionais quanto ao aleitamento materno.Descritores: Orientação profissional; Aleitamento materno; Puerpério.PROFESSIONAL ORIENTATION ON BREASTFEEDING: THE LOOKING OF PUERPERAS IN A MATERNITY OF HIGH RISK IN THE STATE OF SERGIPEObjective: To analyze the actions of promotion, protection and support to the practice of breastfeeding performed by health professionals, in the eyes of puerperal women. Methods: Descriptive and observational study, carried out in a high risk maternity hospital in the city of Aracaju, State of. Results: 96% of the women who completed the full prenatal care and 56.78% received no guidance. Among the received guidelines, the most cited refers to the recommended time for breastfeeding (12.29%), followed by the importance of breastfeeding (9.75%). Conclusion: Even though the majority of postpartum women are adherent to complete prenatal care, there is still a need for more information, guidance and support from professionals regarding breastfeeding.Descriptors: Professional orientation; Breastfeeding; Puerperium.ORIENTACIÓN PROFESIONAL EN EL ALCANCE MATERNO: LA MIRADA DE LAS PUÉRPERAS EN UNA MATERNIDAD DE ALTO RIESGO EN EL ESTADO DE SERGIPEObjetivo: Para analizar las acciones de promoción, protección y apoyo a la práctica de los amamantamiento realizados por la salud, en los ojos de las mujeres puerperales. Métodos: Descriptive and observational study, llevado a cabo en un alto riesgo de maternidad hospital en la ciudad de Aracaju, State of. Resultados: 96% de las mujeres que completó el completo prenatal care y el 56.78% recibido en la guía. En las primeras pautas, el más citado se refería al recomendado para el amamantamiento (12.29%), seguido por la estima del amamantamiento (9.75%). Conclusión: Sin embargo, la mayoría de las mujeres postpartum de las mujeres son adherentes a completar el prenatal care, todavía no es necesario obtener más información, orientación y apoyo de los profesionales que se comprometen a amamantar.Descriptores: Orientación professional; Lactancia materna; Puerperio.

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Should maternal anesthesia delay breastfeeding? A systematic review of the literature

Cited by 7 publications

References 45 publications

Acute Maternal Fasting or Fluid Abstention Does Not Significantly Affect the Macronutrient Composition of Human Milk: Clinical and Clinical Research Relevance

Acute Maternal Fasting or Fluid Abstention Does Not Significantly Affect the Macronutrient Composition of Human Milk: Clinical and Clinical Research Relevance

Transversus abdominis plane block as a sole anesthetic technique for evacuation of rectus abdominis muscle hematoma - A case report -

Orientação Profissional Quanto Ao Aleitamento Materno: O Olhar Das Puérperas Em Uma Maternidade De Alto Risco No Estado De Sergipe

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