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Discussion Starter · #1 ·
Not sure if this is the best place for this, but here goes...

My 17 months old daughter is due to have dental surgery sometime in the next few months, as she has a chipped front tooth. They will put her to sleep for about an hour, with a breathing tube.

I'll be able to breastfeed her up to 6 hours before the surgery, and she can have water and solids up to 8 hours before the surgery.

Her Daddy and I are paranoid about the anesthesia, and also about the fasting period before. It is likely that her surgery will be around 7:30am, so that means no nursing after 1:30am...and this is a child who likes her nursing on and off through out the night, and has always slept right next to me.

I guess am going to have to set an alarm to wake myself up at 1:15am or so, nurse her one more time, manhandle her off the breast at 1:30pm and hope she doesn't wake, then go sleep in another room. Then Daddy will have to take over! Yikes! When she wakes, will she fall asleep again being rocked by Daddy? How am I going to deal with her begging to nurse and tugging on my shirt when I see her in the morning? She always gets a sippy cup of water in the morning...what will she do if we hand her an empty one?! So sad!


I guess I'm just wanting to hear from others who have been through this, to hear how it was for you. And if there's anything I can do to make this easier on all of us.

Thanks,
Alyssa
 

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Hi Alyssa,

I don't know if this is going to help much. But I couldn't not reply, seeing that you are probably going to the same dental office we went to, Monarch at Metrotown?

Our dd was just over three years old when she had dental surgery, and we were worried about all the same things you are. Of course, our daughter was older, more aware of what to expect with no food or water in the morning and surprisingly didn't complain at all.

Positive affirmations helped. They helped me be positive and calm for her until we got to the clinic and then once there, we received such good care.

The anastesia (sp) freaked out both dh and I. Watching your child go under is a bit freaky. But she recovered very well. She sept and woke up hungry,(we intoduced fluids and foods slowly) and happy.

I hope it all goes well for everyone,

Tricia
 

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We'll be going through this soon as well. My 17 mo has had bad teeth for months, and one of the weakest ones cracked yesterday or today. We were hoping to postpone the surgery to 2 yo, but the crack sort of makes that a pipe-dream.

I have taken a lot of comfort in the success stories of others. Most people say that the babe wakes up very happy, but hungry, like the pp mentioned. I've read some people say that the babe even acts relieved; as in, even though they'd never acted like the tooth had bothered them, once it's fixed they seem happier. I've also heard that it's really scary to see the babe going under, which I can totally imagine being the case. That moment, the waiting, and the 6hr nursing boycott are my biggest worries (aside from the very obvious one.)

I'm sorry you have to go through this. If you're like me, then you might also take comfort in the "well, at least it's not as bad as..." thought process. In which case, at least it's a isolated event/tooth and not a mouth that's been ravaged by decay.

As far as the no-nursing worry. I've tried weaning at night, both with and without the help from hubby, so I have a general idea what I'm going to be in for when the time comes. Personally, I think that it's easier to just to it yourself, especially if it's just the one night. My babe was very very unhappy with Daddy, and I felt Horrible listening as he wailed for Mommy. When I did it by myself, I wore multiple, tight, high collar shirts to minimize boob and clothes grabbing opps. And I comforted in 30-60 minute bursts, as needed. The babe, while he wanted milk desperately, did far better with me than with Dad. But, if your babe is used to be comforted by Daddy then that would definitely make our situations different. My babe has only woken with Daddy the one time we tried it.

Again, I'm sorry you're going through this. I'm sure things will go smoothly, and I wish I had more to comfort you with. Maybe when you're done with this process and have it safely behind you you can come back and offer me some advice and comfort. At this point I can only simply agree that it's a sad and scary thing for the mommy to have to think about. Best of luck.
 

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I have heard from nurses that it is very important that the dental staff be certified in advanced pediatric life support and that only certain anesthesia be used for dental procedures. In fact, once I confirmed that what they were saying was true, I decided to cancel my five year old's upcoming dental work and switch dentists. You may want to ask some pointed questions about the sort of monitoring that will occur and whether the dentist is certified in advanced pediatric life support. Also about the specific kinds of anesthesia.

Good luck.
 

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Discussion Starter · #5 ·
Hi again,

Thanks for all the responses so far.

My daughter's dentist is with Monarch Pediatric in Port Moody (the Burnaby office was booked out so many months in advance, we went to Port Moody instead.) The dentist is Dr John Hung (though it could be someone else from the Port Moody office that actually does the surgery) and the anesthesiologist is Dr Raymond Khawaji.

If anyone has any experience with this anesthesiologist I'd love to hear about it. I talked to him already and I know that the anesthesia involves a breathing tube and that she will be monitored, though I don't know what type of monitoring or the name of the anesthesia, nor do I know about his certification. He said he has had no "issues" in the past 10 years of practice (I asked about issues because I felt uncomfortable asking outright, "Say, have you ever killed anyone or put them in a coma?")

If I can find out the type of anesthesia used and the type of monitoring used, how will that help me, I wonder? I don't know anything about anesthesia types and monitoring types, to know what is better or worse.

maybeknott: I'm sorry you have to go through this, too! I think we are going to do a trial run some weekend, where dd gets "Daddy nursing" from maybe 2-6pm and we'll see how it goes. Daddy has been able to walk her to sleep and lay her down, and once when she awoke, he was able to walk her to sleep and lay her down again. That was for naptime though. Not sure if nighttime will be different. She's teething canines now and wants to nurse alot during teething so I dunno.

The trouble for me with wearing extra shirts is that she still knows what's underneath, and she has a word for nursing, so it makes it hard...she'll know I understand what she wants but won't understand why I won't provide! Also, I know I won't get any sleep for fear that I will undo my shirts and nurse her in my sleep. I have, in the past, fell asleep in one bed in the same room as her, then woken in the morning to find myself lying in a different bed, nursing her, and don't remember how I got there.

Thanks,
Alyssa
 

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I can help you a little I think, as far as what inezyv posted.

If you have a dentist and anesthesiologist, then I assume this is going to be done in a surgery center or a hospital. With a breathing tube would be general anesthesia. This is what I do weekly in a surgery center (we've never had even a minor problem with anesthesia, if my experience helps any). If this is the case, at the minimum the anesthesiologist and the nurses in our surgery center are certified in pediatric acls. They have to be. It is reccommended that the dentist be too, although they would not have to be unless they are doing sedation in the office (which would be oral or IV sedation). It is preferable IMO to do it in a surgery center or hospital where I (the dentist) can concentrate on the dentistry and the MD can concentrate on the anesthesia. I don't feel safe monitoring both at the same time, so I never bothered with IV certification. I only work on children.

HTH at least a bit and hugs. I know all of the anesthesiologists that would ever work on my son, and I would feel comfortable with GA if need be, but I would still worry, it's what we are supposed to do right
 

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Alyssa, the way it will help you is if you use this information to evaluate the risks. Someday, I found your information very useful. What is acls? Is that Advanced Pediatric Life Support except with different initials?
 

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When my son was about the same age, he had 8 teeth extracted and 4 pulpotomies while under general. He was a fiendish nurser, too. I nursed him up to about 2 hours before his surgery, figuring how fast bm is processed. He did fine.
 

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acls is advanced cardiac life support...the staff at our surgery center would have to be certified for all ages. (It's an all dental surgery center, but that includes the outpatient surgeries the oral surgeons do).
 

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My nursing son also had dental surgery. I found staying busy at home before we left for the surgery center was a good way to avoid breastfeeding. At the hospital, he was distracted and did not even ask.

Have you considered anything to help your dd handle the surgery? I took my son to a chiropractor/homeopath prior to surgery and he gave him arnica and hypericum. The arnica helps the body deal with trauma and the hypericum is specifically for puncture wounds (dental drills, scalpels, etc), etc. My son took these remedies before and after surgery.
 

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Discussion Starter · #11 ·
The surgery is scheduled to occur in a private office, the anesthesist's office. There are at least two people involved. The person handling the anesthesia and the dentist doing the surgery. The waiting list for the hospital is 1 year out, whereas the private office the wait is only 6-8 weeks. Unfortunately I don't think this tooth will last a year.

InstinctiveMama: I have had great success with arnica on myself and will definately try to give dd some.

Alyssa
 

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Hi Alyssa,

Dr. Khawaji was the anesthetist for our daughter's dental work too. I was told he is also a doctor at BC Women's & Children's hospital for the dental surgeries there. As I remember, there was a team of 4 people in the surgery room.

I can only say again that my dh and I were pretty scared about the whole event, but the care our daughter was given was of the highest standard. And as worried parents, the staff, nurses and doctors, thoughtfully listened to our concerns and explained everything to us as it would happen. LAnd like pp have said, afterwards, our dd was relieved and now brushing teeth is painless for her. ... Lastly, the big bonus, was that the actual price of the dental work was $500 less than we were originally quoted, because she didn't need 2 root canals and the chipped tooth was salvagable. This was indeed good news to us as we don't have extended coverage.

HTH

Tricia
 

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Our dd is scheduled for GA in December-they say the same thing, no liquids or foods for 6 hrs before the surgery. I think I'm dreading that more than the procedure itself, as I co-sleep with dd and also bf her on long car trips (the dentist is an hour away). My dh is pressuring me to nightwean, and even though I know it is probably for the best, I'm having so many emotions I just can't deal with!
 

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You can find information on kellymom.com about 4 hours being the standard for no breastmilk before surgery. Boston Children's I remember being the most progressive with 3 hours before for all clear liquids in which breastmilk was included.
 

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My 6 month old ds had surgery at Children's in DC last Thursday, and we were told 4 hours, also. I didn't want to read this and not post. I've been there, just this week, and it's really scary! Hugs to you, for sure! The anesthesiologist that treated ds said that, while they shouldn't have anything on they're tummies, it's also important that they not be dehydrated. Good luck!
 

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Discussion Starter · #17 ·
I wonder why the dentist would suggest you night wean after the surgery?(Other than it seems most dentists are really gung ho on suggesting weaning.)

My daughter's dentist suggested I wean her right after he first saw her (at 15 months old) saying that kids who nurse tend to fall asleep on the breast and suck a long time and this bathes their teeth in milk and it causes cavities. Now everything I've read indicates that breastmilk alone does not cause decay, but that breastmilk combined with food particles can cause decay. So the key thing should be to get the food off the teeth with brushing, not weaning the poor babe. (Oddly he said it would be ok for me to pump and feed her breast milk in a cup!)

Any how, we did not wean (night or otherwise) and aren't planning to until dd is ready.
 

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DD had to have similar things done at about 2.5. There were several liquid forms of sustenance that the anesthesiologist OK'd for a certain amount of time before her appointment--we did juice popsicles for the first time. Call your doc & find out what there exact rules are concerning food. Also, they may be scheduling the early appointment to make things easier on you thinking that it will be easier to fast at night. Perhaps you can get a later appointment.

Finally, kids are amazing. They can often deal with things much better than we think they can (or can ourselves).

 

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My 17 month old just had her dental surgery a few weeks ago. Our dentist didn't say anything about weaning. He said to make sure she gets one good tooth brushing a day. He said that while she may have developed cavities, my breastmilk serves so many other great purposes for her. Plus, there is no proof that it's primarily my breastmilk that caused her decay. It was likely a combination of things.

Her appt. was at 7:30 am also. I nursed her last at 2:30am, we woke at 5:30 am (have to love Bay Area traffic) and she was fine. Daddy had to take over a little more to distract her from wanting "milks". But that part went fine.

It's watching your child go under, and come out of it that was really the hardest part.
Hopefully I'm not taking over your thread, but this was my experience.

We got there at 7:30 am, and they gave her some liquid valium up her nose. It burned and she cried. Daddy had to hold her still for it. They put some numbing lotion on her hands for the IV. I held her as she got loopy. It was very emotional for me to see her with such a faraway look in her eyes. She tripped out on her hands a bit, and giggled.

The anes. came out to take her back. I told her I was taking her back. I laid her on the dentist's table and she cried. There were 5-6 people around her. I stepped back to get out of the way. The dentist put a laughing gas mask on her, and she cried for a few seconds. The anes. put some of those wires and patches on her to monitor her. By this time I was crouched in the corner. I was feeling faint at the thought of the IV going in. I stepped out of the room and went to the waiting room.

About an hour later it was done. They weren't able to get a vein in her hands, so they had to put it in her foot.
The dentist called us into his office and was telling us how it went. She got 3 root canals and 4 caps on top, 1 root canal and cap on the bottom, a cleaning, and a flouride treatment. All I wanted was DD in my arms.

I was not prepared for how she would be acting as she came out of the anesthesia. She was groaning/growling and clawing around. You couldn't just hold her, I had to really hold her to keep her from wriggling out of my arms. Her voice was scratchy from the breathing tube. Her breathing sounded scratchy/gurgly too. Finally she drifted off to sleep in DH's arms, and we left. She slept in the car for about 20 minutes. When she woke up, we stopped and she nursed for a long time. She smelled like a doctor's office. I couldn't wait to wash it off of her. We played outside for a little while, and then got back on the road. She napped a few times that day.

She was very crabby and moody for the next 2-3 days. It also threw off her sleep patterns. I gave her Tylenol a couple of times. I waited a week or so to brush her teeth, because I wanted her gums to heal first. It was done on the 24th, and she is now back to normal.

Good luck to you. I felt very guilty through all of this. It is a very sucky situation, but you guys will get through it. PM me if you want.
 

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Thank you for this thread! And thank you Dani for posting your true story - it is better that we know what it is like!

My little guy will be having the dental rehab surgery to either cap or remove his top front four teeth in January - just two weeks after his 2nd birthday. I plan on printing out several articles about breastfeeding and pre-op fasting that I got form the LLL website and giving them to the ped anth. Our dentist never said we had to wean before or after. He actually said that nursing after will be a great comfort to DS and that it would not be the time to wean probably!

I am definitely scared - and can't imagine what I will do during the surgery - probably knit a sweater! But I do know we HAVE to get it done - he is in pain from the decay.

On a side note: his older sister had four cavities filled in two separate visits right before she turned 3. We chose not to do the GA and did laughing gas instead. We also let her eat breakfast. Both were bad ideas. She vomited and she also was scared. If I had to do it over again - I would do GA with her so they could have done more of the work they needed to do - she didn't get sealants for example.

Thanks for the support of all these threads - and for the good ideas for homeopathy.
 
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