Surgery-No Liquids Past 12AM- Nightwean?

[Wilbur]

Hi,
My 2-year-old is scheduled for dental surgery in October (he'll be 26 months). Of course, they tell you no food or drink after midnight the night before the surgery. He's still night nursing constantly- and I'm thankful that he does: a bit more background, DH has currently moved out to take a job in another state, our relationship was rocky and we're not sure if he's coming back. I work part time and am in school close to full time, and we may have an opportunity for DS to receive a sizeable scholarship to an incredible Montessori program that would begin this fall. That's a lot of separation/stress/change, and he's handling everything well, I think in part thanks to the night nursing/cosleeping. This would be bad timing for nightweaning, however, it seems like the surgery is going to be traumatic enough and I don't want to add to that by having it be the first night and morning that he is cut off, it seems like if that's normal already, the day of surgery won't be as traumatic. Any thoughts? I figure that some of you must have experience with night-nursing toddlers requiring surgery.
He's a very verbal, logical boy, so I think I could explain some of it to him, but I don't think any amount of verbal preparation will cut it when it comes to taking away his 'milk'.
Thanks for any advice!

[Gnatty]

In your position I do not think I would attempt night weaning. My 27 month old son recently was hospitalized and had two surgeries, one while in the PICU and one as an outpatient surgery more recently.

With our recent surgery, it was scheduled for 1pm and he was allowed clear liquids (which of course includes breastmilk) until 10am, but no solid foods or dairy products after 7. I would encourage you to double check on when he needs to stop all liquids, first off... they may not need him to be off clear liquids quite that long.

During my son's hospitalization, he was not allowed to nurse because his kidney specialist was adamant that he had to know exactly how much liquid he was taking in and how much was coming out. I pumped instead. That was for several days... I think four? and since then he has gone back to nursing fine.

I think you need to weigh how hard it will be on him to have multiple nights where he wants to nurse and can't, versus one night.

If you wanted to nightwean anyway, then this might be a good reason to, but it sounds like you don't, so I would say no.

Hope all goes smoothly either way.

[aihley]

Originally Posted by Gnatty

I think you need to weigh how hard it will be on him to have multiple nights where he wants to nurse and can't, versus one night.

If you wanted to nightwean anyway, then this might be a good reason to, but it sounds like you don't, so I would say no.

Hope all goes smoothly either way.

This. It's only one night - he'll be fine. You two may lose some sleep over it, but it will be fine. He'll still want to night-nurse afterward. Just look at it as a bit of a speed bump. You guys will fall right back into habit like it never happened. He may even night-wean himself by October. Basically, whatever is least stressful for both of you.

[Wilbur]

Thanks... That's definitely good advice, they said no liquids but I'll double check, and you're right, one night is manageable if I can prepare him a little bit ahead of time. He'll be a little bit older by then too... Thanks for putting things in perspective for me.

[pumpkin]

Check what time you are scheduled for. They often use the same cutoff for a 6am surgery as for a 4pm surgery. I had a late afternoon surgery and when pressed they admitted it was actually 6 hours before so I could even have a light breakfast and keep hydrated through the morning.
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[tibeca]

My DD had dental surgery when she was 18mos. Quite traumatic. We did not night wean or keep her off nursing all night. According to kellymom.com (see link) you only need avoid breastfeeding for 3-4 hours prior to surgery. A much easier feat if you can keep him moving and explain it to him. DD was angry at me about not nursing, but 3 hours was a cinch compared to night weaning.

http://www.kellymom.com/health/illne...y-surgery.html

[thepeach80]

There's no reason to not nurse after midnight. BM can be safely consumed at least 4 hrs before the surgery. It's actually sooner in most cases, but 4 hrs it the conservative cutoff most people give. All 4 of mine have had procedures done and we've always followed the 4 hr rule.

[anj_rn]

Most clinics switch to the nothing after midnight at 1 year of age as a standard. Contact the dental offica and explain that your child is still breastfeeding through the night. You should be able to continue breastfeeding up to 4 hours prior to the scheduled anesthesia. When my DD has needed anesthesia, I make sure to make her feed right before the 4 hour mark to prevent her from being hungry & cranky before the procedure.

[justKate]

Just wanted to add that you'll need to emphasize that its breastmilk--I think there are guidelines that say 6 hours for food/cow milk and the care provider may not have really though about it.

I'd also try to find out (as well as possible) what time the procedure will actually begin and set the food-clock accordingly. DD (18 mos.) had surgery last month and we were shocked at how well she did. I hope it goes smoothly for both of you.

[MCatLvrMom2A&X]

They told me the same thing when they wanted to do dental work on my ds at that age and I told them it was out of the question so they backed down and said he could nurse up to 4 hours before the procedure.

Since bm digests super fast it is gone in that amount of time.

[Whozat]

My daughter has had general anesthesia twice (open-heart surgery at 4.5 months, dental work at 22 months) and both times the cut-off for breastfeeding was 4 hours before the procedure (at two different hospitals).

If you google "breasfeeding anesthesia" you'll find several sources citing that as the standard.

I would recommed specifically asking how close to the procedure you can breastfeed, and then using the sources you find to back you up if they say something more than 4 hours.

(Or using your own judgement about what to do, and what to tell them you did. But I didn't tell you to do that.)

[revolting]

My daughter went under general anesthesia for dental work at 25 months, and she was not allowed to nurse overnight. It was a hard night, but not anywhere near as hard as I imagined. Also, we've done both dental work under general anesthesia and dental work in a papoose, and maybe this colors my view, but dental work under general anesthesia did not seem traumatic for my daughter - not a walk in the park, but not traumatic - including one night without nursing almost a year before she was night weaned.