What is considered a "clear liquid" for anesthesia purposes? - Mothering Forums

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#1 of 20 Old 06-04-2008, 05:17 PM - Thread Starter
 
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DS (2 years old) has to undergo general ansethesia next week for some necessary dental work. The instructions from the anesthesiologist say no solid food or milk for 8 hours, no clear fluids for the last 2 hours before the surgery. I know breastmilk is considered a clear fluid (didn't bother to ask because I don't want to deal with an argument about it!), but what else is considered a clear fluid? The appointment is not until 11AM, which means no breakfast for DS - can he have Jello or anything? Apple juice? Any other ideas?
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#2 of 20 Old 06-04-2008, 06:13 PM
 
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No jello. That is not liquid. You can do apple juice, water, teas. BUT, you can also do a nice homemade, well strained chicken stock/bone broth that will fit the safety criteria yet provide some actual nutrients as well.

Still a sleepy mama to my fabulous 2 year old girl
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#3 of 20 Old 06-04-2008, 07:33 PM
 
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I just had an appointment with a surgeon today because my son has to have a procedure done in a couple of weeks. Anywhoo, breast milk is NOT considered clear fluids. Breast milk is considered solid food. I know, I know....I have no idea how my son is going to handle this when we have been nursing on demand his whole life.

"Breastfeeding is a robust, biologically stable activity so central to our evolutionary identity that it names the class of animals to which we belong" (Breastfeeding Atlas, Third Edition)
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#4 of 20 Old 06-04-2008, 07:35 PM
 
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Jello is considered a liquid because it's liquid at room temperature. It will melt to a liquid in your mouth. I work with a lot of post-op patients and they they love their jello when they are on a clear liquid diet.

Anything you can see through is considered a clear liquid.
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#5 of 20 Old 06-04-2008, 07:46 PM
 
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Originally Posted by Gavin'smom View Post
I just had an appointment with a surgeon today because my son has to have a procedure done in a couple of weeks. Anywhoo, breast milk is NOT considered clear fluids. Breast milk is considered solid food. I know, I know....I have no idea how my son is going to handle this when we have been nursing on demand his whole life.
I'm sorry but your surgeon is mistaken. Breast milk IS a clear fluid.

http://www.kellymom.com/health/illne...y-surgery.html
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#6 of 20 Old 06-04-2008, 07:47 PM
 
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Originally Posted by Gavin'smom View Post
I just had an appointment with a surgeon today because my son has to have a procedure done in a couple of weeks. Anywhoo, breast milk is NOT considered clear fluids. Breast milk is considered solid food. I know, I know....I have no idea how my son is going to handle this when we have been nursing on demand his whole life.
Breast milk is NOT considered solid food. Don't let them tell you otherwise! My ds had three surgeries between 13 and 22 months of age, and nursed up until 4 hours before each of them. I did argue with the hospital before the first surgery, but they ended up changing their whole protocol after the person I spoke with did some research and realized I was right.

You can PM me if you want to talk about your son's procedure... it's so stressful when little ones need stuff done.
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#7 of 20 Old 06-04-2008, 07:50 PM
 
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Yepper. BM is considered a clear liquid. My daughter has had numerous surgies and procedures in her short life so far. Anethesiologists have all said its clear.

Anne, Mama to Conner 2/27/04 blahblah.gif  Gabrielle 2/6/06 W/LMC-TCS, Neurogenic Bladder, AFO & KAFO wearer, Neurogenic Bowel energy.gif & Delaney 5/12/08 mischievous.gif &  Beethoven cat.gif& Gizmo cat.gif

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#8 of 20 Old 06-04-2008, 08:03 PM
 
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http://www.cincinnatichildrens.org/h...anesthesia.htm

Quote:
Clear liquids are fluids you can see through:
Water
Sugar water
Pedialyte
Gatorade
Kool Aid
Apple juice
Pulp free juices
Soft drinks
Jello
Popsicles
Breast milk

Orange juice, cow's milk, soy milk, and formula are NOT clear liquids.

If your child is having surgery in the afternoon, your child may have a light breakfast up to 8 hours before surgery. A light breakfast is cereal, toast, and a clear liquid. Do not give meat, fried or fatty food for breakfast.

Stop all solid foods at 8 hours before surgery.

If the fasting guidelines are not followed, the anesthesiologist will determine when the surgery will be performed.

Anne, Mama to Conner 2/27/04 blahblah.gif  Gabrielle 2/6/06 W/LMC-TCS, Neurogenic Bladder, AFO & KAFO wearer, Neurogenic Bowel energy.gif & Delaney 5/12/08 mischievous.gif &  Beethoven cat.gif& Gizmo cat.gif

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#9 of 20 Old 06-04-2008, 08:59 PM
 
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Quote:
Originally Posted by Gavin'smom View Post
I just had an appointment with a surgeon today because my son has to have a procedure done in a couple of weeks. Anywhoo, breast milk is NOT considered clear fluids. Breast milk is considered solid food. I know, I know....I have no idea how my son is going to handle this when we have been nursing on demand his whole life.
Others have given you actual resources, but I also know of plenty of people who fed BM before surgery. It is okay. However, if you doc told you this you probably shouldn't mention that your LO had BM or they might not do the surgery.

Still a sleepy mama to my fabulous 2 year old girl
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#10 of 20 Old 06-04-2008, 10:09 PM - Thread Starter
 
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Thank's for all the input, everyone!

Gavin'sMom, I'm sorry your little one has to have surgery. As others have mentioned, I've done a lot or research, which makes me comfortable breastfeeding for as long as they allow clear fluids. Obviously, you have to decide what you're comfortable with for your son. As a pp mentioned, should you choose to bf in that time, unless you convince the surgeon and anesthesiologist by providing them with research, you probably shouldn't mention that you ignored their recommendations. I didn't feel like arguing about it with the anesthesilogist, so I'm just not mentioning it.

DS has never had Jello before - I guess he'll get an interesting breakfast of apple juice, broth, and jello
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#11 of 20 Old 06-05-2008, 01:42 AM
 
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huh?: I cannot believe that they would tell me that.... Wow. I guess now I don't know if I should bring it up or just ignore it? I mean, how receptive are they going to be to if I challenge their rules?

"Breastfeeding is a robust, biologically stable activity so central to our evolutionary identity that it names the class of animals to which we belong" (Breastfeeding Atlas, Third Edition)
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#12 of 20 Old 06-05-2008, 01:48 AM
 
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I would just ignore it and nurse. My DD had two breastfed surgeries as well and she got it up to 4 hrs before.

Quote:
The effect of human milk’s categorization is evident in the most recent consensus practice guidelines issued by the American Society of Anesthesiologists (ASA) (1999) where human milk is treated as being in between clear liquids (with a minimum fasting time of two hours) and non-human milk (with a minimum fasting time of six hours). The minimum fasting time the ASA recommends for human milk is four hours.
http://www.llli.org/llleaderweb/LV/LVDecJan02p132.html

it seems like there just isn't a ton of research to prove exactly how long it should be. but it's certainly not a solid.

DD1 7/13/05 DD2 9/20/10
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#13 of 20 Old 06-05-2008, 01:58 AM
 
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Oy. The great clear fluid debate.

Breastmilk is semi-clear in some cases, clear in others, and semi-solid in others.

Then there is the issue that some places say clears until 4 hours before surgery, some say 3, others 2.

Rules usually vary by WHERE the surgery is being held. IF it were in a dentist's office and NOT in an OR/hospital, I would NOT feel comfortable giving an older child with no known health issues breastmilk closer than 3-4 hours before.

They also vary by the type of anesthesia being given (sedation v. general).

They also vary by the type of anesthesiologist.



It depends on the type of surgery and the provisions available and the type of anesthesiologist whether I would give breastmilk to an older child (non-infant) closer than 4 hours before surgery.

My reasoning for this is as follows. When the anesthesiologist tells you their "rules" they are also telling you how they are comfortable working AND what their experience is. They are used to working under certain conditions, and IME they are not prepared to work in other ways w/o prior knowledge.

NOT giving them information puts your child at a disadvantage, especially, and I do mean especially, if you are in an outpatient setting (like a dentist's office) where they are NOT prepared to handle complications like aspiration.

With a non-infant, gastric emptying times are greater than they are with an infant. Avg breastmilk emptying in an older child is about 2 hours, but some people will empty slower, and others faster.

Anyway, YMMV but just some of my thoughts on that.


The Cincy list is somewhat strange:
Jello is NOT always considered clear---besides that it is has coloring.

It lists soft drinks: but really it should say CLEAR soft drinks, and even then...those are not the best choice.

Clear things should be CLEAR and SIMPLE. And nothing acidic.

Apple juice, smart water, clear clear clear chicken broth with only chicken, water, and salt in it, pedialyte.
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#14 of 20 Old 06-05-2008, 02:12 AM
 
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Ok so I had just decided with my husband that I would just go ahead and nurse Gavin up to 4 hours before the surgery and now after reading mamaverdi's post I'm concerned. I also have to say that I didn't realize that by bm being solids that they wouldn't want me to nurse 8 hours before the surgery. My son sleeps through the night so I know he can go 8 hours without bm but I usually fill him up a ton in the morning. And he also nursing a ton during the day.

My 15 month old son is going to be given a sedative and then GA.

mamaverdi - I do think you raise some very good points. Particularly about the anesthesiologist...I think I may have to discuss this with my dr more.

"Breastfeeding is a robust, biologically stable activity so central to our evolutionary identity that it names the class of animals to which we belong" (Breastfeeding Atlas, Third Edition)
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#15 of 20 Old 06-05-2008, 11:40 AM
 
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Amy,

It is confusing! I have gone round and round with hospitals/Anethesiologist on this with my daughters surgeries/procedures. Its very frustrating.

Is the appointment first thing in the morning?

Anne, Mama to Conner 2/27/04 blahblah.gif  Gabrielle 2/6/06 W/LMC-TCS, Neurogenic Bladder, AFO & KAFO wearer, Neurogenic Bowel energy.gif & Delaney 5/12/08 mischievous.gif &  Beethoven cat.gif& Gizmo cat.gif

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#16 of 20 Old 08-02-2008, 11:02 AM
 
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Hi!
My son is supposed to have an endoscopy and a colonoscopy on Tuesday. They (Dr. and hospital) told me NO breastmilk for 'gulp' 24 hours. He can have clear liquids but not breastmilk. I know this will be very stressful for us. His intestines need to be clean... I was curious what your feedback might be about this?
He is 2.
I'm nurvous!
Thanks so much!
Dory
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#17 of 20 Old 08-02-2008, 03:29 PM
 
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Quote:
Originally Posted by Gavin'smom View Post
I just had an appointment with a surgeon today because my son has to have a procedure done in a couple of weeks. Anywhoo, breast milk is NOT considered clear fluids. Breast milk is considered solid food. I know, I know....I have no idea how my son is going to handle this when we have been nursing on demand his whole life.
My DS had to have emergency general anaesthesia a few weeks ago -- he's 18 months old. I asked them WHY breast milk is NOT considered okay when JUICE is. The doctor told me that they are concerned about infection. Well, breast milk is sterile. They put breast milk and formula in the same category. I told them what I was going to do and why, but I have to say it wasn't easy. I also had to "fight" with them to have my baby lay on me instead of in the crib.

I nursed my baby before they said I could. They were worried about infection in his esophagus. I was not because breast milk helps infections, it doesn't cause them. My baby went from being quite listless to his perky, naughty self pretty soon after I nursed him -- he had nothing but an IV for a good 18 hours before that.

Oh, I want to be sure to add: I nursed him AFTER his procedure! Before it, I agree, he wasn't allowed to have anything -- I completely understand why, as well. I just thought it was silly that after his procedure, he was allowed to have juice but not nurse. He had an endoscopy to remove a penny!

Jean, happy HS mom to Peter (5), Daniel (9) and Lucie (2) and also someone new... baby.gif
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#18 of 20 Old 08-02-2008, 04:17 PM
 
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Jean,

That Doctor is wrong!

My daughter has had numerous surgeries and procedures with general anesthetic. I was always encouraged to nurse as soon as possible in Recovery. In fact several times they had me get in bed with her to nurse or had rocking chairs for me. I would of been livid if a Doc told me that.

Anne, Mama to Conner 2/27/04 blahblah.gif  Gabrielle 2/6/06 W/LMC-TCS, Neurogenic Bladder, AFO & KAFO wearer, Neurogenic Bowel energy.gif & Delaney 5/12/08 mischievous.gif &  Beethoven cat.gif& Gizmo cat.gif

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#19 of 20 Old 08-02-2008, 08:44 PM
 
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Quote:
Originally Posted by emsimmom View Post
Hi!
My son is supposed to have an endoscopy and a colonoscopy on Tuesday. They (Dr. and hospital) told me NO breastmilk for 'gulp' 24 hours. He can have clear liquids but not breastmilk. I know this will be very stressful for us. His intestines need to be clean... I was curious what your feedback might be about this?
He is 2.
I'm nurvous!
Thanks so much!
Dory
Brest milk causes the body to make fecal matter right? Breast fed babies have breast milk bowel movements that aren't solid but there's something there. The colon has to be absolutely clean as possible so the doc can visualize the color properly. (When I prep adults for a colonoscopy they are put through the ringer as far as pooping goes) If there is fecal matter in the way it'll be hard for the doc to make a proper diagnosis. The clear liquids won't produce fecal matter so that's why they request clear liquids only, keeps you hydrated but keeps the colon clean.

Going without breast milk will be really hard but it's one day and hopefully your child will be able to handle it.

Good luck.
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#20 of 20 Old 08-02-2008, 10:13 PM
 
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I am really grateful for your reply! I thought that was the case, I just needed to hear it.
Thanks!
It will be a hard day but it won't last forever and on Tuesday after his procedure, he can nurse his little heart out. ;-)
Thanks!
Dory
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