2020 Conference speaker series
Wendy Jones PhD MRPharmS, Breastfeeding and Medication Pharmacist
Wendy Jones PhD MRPharmS, Breastfeeding and Medication Pharmacist, discusses anaesthetics and breastfeeding in a guest blog for the 2020 Baby Friendly Virtual Conference
It feels like I have been fighting one particular battle for as long as I have been providing information on the safety of drugs in breastmilk. My heart sinks when I see a message which starts “I have to have an operation…and at the pre-op assessment they told me…”
Anyone who has ever had to have surgery will empathise with the anxiety that goes with that looming appointment date. To have planned surgery when you have a breastfed baby brings additional needs to plan.
- Where will the baby be whilst I am having my operation?
- Can I have my partner/ mum/friend in the ward to help me look after my baby as I recover?
- Can the baby stay with me?
- Will I be able to have painkillers?
- How will I cope after the operation?
Then you hear the words, “You need to pump and dump your milk for 24 hours” – and some people are told longer! So now you have to add in expressing and freezing milk in advance for your baby in that 24-hour period. But it isn’t always that easy. Breastmilk isn’t a tap, as we all know, but that somehow seems to pass some professionals by.
Then we have the complications of poor mothers who need emergency operations who have no time to plan, who may be too poorly to discuss breastfeeding or who don’t have a breast pump with them.
I wonder why, when you are breastfeeding a 10-month-old or a 2-year-old, surgery is seen as so much of a barrier to anaesthetic and pain relief compared to a c-section, whether under epidural or full general anaesthetic? Why sedation needs to interrupt breastfeeding for 24 hours when the mother is conscious and wide awake in a few minutes? Am I missing something? Maybe what is missing is a belief in the wonders of breastfeeding and breastmilk.
I worked with a small team of anaesthetists to write guidelines on the use of anaesthetic drugs, sedatives and painkillers for breastfeeding mothers. I lost count of the times I sent them copies of heart-rending stories of mums trying to deal with barriers to breastfeeding in the hope that they would understand why I was so passionate about the topic.
Then along came COVID 19 and added a whole new other dimension – but that is maybe another story.
My underlying message is that in trying to “do no harm”, we often cause harm in unexpected ways, and in the process dis-empower mothers (and fathers) who are doing their best for their babies. I hope that now anaesthetics and breastfeeding can co-exist and that I never have to have the conversation again. It has been a very long and emotional journey.
A new consensus document on anaesthesia and sedation in breastfeeding women has been produced by members of a Working Party established by the Association of Anaesthetists of Great Britain and Ireland and has been informed by the Unicef UK Baby Friendly Initiative and endorsed by the RCM and RCOG. For more information on breastfeeding, you can also see our range of helpful resources.
