# Give 4 month old pedialyte or let him starve?



## Blucactus (Nov 20, 2006)

I wanted nothing but breastmilk in my baby until at least six months, but he is going in for a surgery and he can't be breastfed for 6 hours prior to it. They specifically state they don't consider breastmilk a clear liquid. I can give him water, apple juice, 7UP or Pedialyte for up to 2 hours before the surgery.

Is is going to be better to give him Pedialyte (if he will even take it, he's never even had a bottle) or let him go hungry/thirsty for 6 hours?? My first instinct is that my ideals are going to have to die & I should give him the Pedialyte, but is there anything I might not be considering long-term health-wise if I do that??

Help, the surgery is coming up this Friday!


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## Empress (Jun 30, 2002)

I'd call them tomorrow and discuss it.

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


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## Ruthla (Jun 2, 2004)

First of all, everything I've heard is that breastmilk is a "clear liquid" from a GI standpoint and should be fine for 2 or 3 hours before surgury. You do have the option of feeding him what you feel is best and then telling the dr's what they want to hear. If breastmilk is truly not permitted, then I'd go with the pedialite over letting the baby starve- but I honestly don't think that should be necessary.

What do they say about how long before surgury a baby could be fed formula?


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## bigknitwit (Sep 2, 2004)

My dd had surgery at 4 months, and she only had to fast for 3 hours before surgery, since she was EBF and young. I would take serious issue with this, if I were in your shoes.


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## Blucactus (Nov 20, 2006)

Quote:


Originally Posted by *Empress* 
I'd call them tomorrow and discuss it.

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

Thank you, I will check that out.


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## Blucactus (Nov 20, 2006)

Quote:


Originally Posted by *Ruthla* 
First of all, everything I've heard is that breastmilk is a "clear liquid" from a GI standpoint and should be fine for 2 or 3 hours before surgury. You do have the option of feeding him what you feel is best and then telling the dr's what they want to hear. If breastmilk is truly not permitted, then I'd go with the pedialite over letting the baby starve- but I honestly don't think that should be necessary.

What do they say about how long before surgury a baby could be fed formula?

His surgery is at 6 am: _"no solid food, no milk or milk products including breast milk"_ after midnight the night before surgery. When we first went in for a consult, I asked the surgeon about breastmilk specifically, bc I thought I'd heard it was considered a clear liquid; he said NO absolutely not, and I didn't aurgue with him bc I didn't know enough about it to make a case. _"clear liquids up until 4 am"_ ...It seems really sick to me that I can give my little tiny baby 7Up but not breastmilk.







:

He is going under a general for it, I don't know if that makes a difference about feeding? It's for a hernia and they are going to be working very closely near his intestines. Does it matter?


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## Stinkerbell (Aug 11, 2005)

it matters because of anethesia. Clear liquids will be absorbed into his body very quickly. Anything with protein takes a bit longer to digest, so can be anywhere in his digestive tract. If he reacts badly to the anethesia (very unlikely but they have to consider it) he can vomit and if he vomits while intubated, he will aspirate the vomit. If it is a small bit of water (clear liquid), it wont be a big deal. If it is something with a matter to digest, it will be a big deal.

That's the WHY.

As for my experience as a nurse, we always said no breastmilk 3 hours prior to surgery.


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## ~Megan~ (Nov 7, 2002)

They are wrong. Nurse your baby. Breastmilk digests in about 1.5 hours.


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## hipmummy (May 25, 2007)

Nurse your baby, so not let him starve. By the time you get there they process you and so forth and so on another two-three hours could go by. Go with your gut. As I always say shame on those trauma victims for going out to dinner before there accident. Aside from their injuries most do fine with the anesthesia.


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## leerypolyp (Feb 22, 2005)

Good thoughts to you and your little one. This has to be hard.

I won't offer advice, but I will point out that most doctors receive little education about breastfeeding or breastmilk. I will also point out this link from LLL, which states that 1) recent studies indicate a more reasonable fasting time for breast milk would be 3 hours (many hospitals use 3 or 4 hours), and 2) the anesthesiologist is another person to talk to about this.

That kellymom link is a very, very good one too.

Good luck.


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## DreamsInDigital (Sep 18, 2003)

My baby is 11, almost 12 months old, and if I couldn't nurse her between midnight and 6am she would be hysterical. Breastmilk leaves the belly within about 90 minutes so if you nursed him before 3 or 4am it should be fine. But tell anyone who asks that you haven't nursed him since midnight.


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## alegna (Jan 14, 2003)

I would not withhold breastmilk for 6 hours. That's not acceptable.

If the anesthesiologist wasn't comfortable with me nursing 3 hours before surgery, I'd find a different anesthesiologist or hospital if necessary.

-Angela


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## mamaverdi (Apr 5, 2005)

Every baby has a different digestion time, so it's not entirely accurate to state that breastmilk digests in X hours.

Aspiration is usually the concern.

Is this an urgent surgery? Do you have a pediatrician who is supportive and can help with this situation? Is this a children's hospital?

Our orders here are 4 hours breastmilk, 2 hours clears. Formula fed and non-human milk fed babies have to wait 6 hours.

So breastmilk is considered semi-clear.

I would offer the opinion that you should do what you feel comfortable doing. Understand the risks of aspiration. And take responsibility for your choice. Or IF you can find someone else to work with who will do what you want, then perhaps that is the better choice.


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## preemiemamarach (Sep 7, 2007)

the hospital where I worked considered breastmilk a clear liquid, and it could be given up to 3 hours before anesthesia.

When my then 5 month old had a CT scan last month, they (different hospital) gave me the same 6 hour spiel on breast milk, but allowed pedialyte 3 hours prior. I just gave him breast milk 3 hours prior because I was comfortable with the risk. He was allowed his prevacid suspension, which is 20 mL of very thick liquid, so I felt like an ounce or two of breast milk wasn't that much of a risk.


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## Panserbjorne (Sep 17, 2003)

That's a ridiculous and outdated policy. I'd definitely question it, and personally would just nurse my baby. Dd had some medical diagnostic tests at 1 month where they said the same thing. I researched it and nursed her. Granted it wasn't surgery, but as a pp said breastmilk digests VERY quickly. You could contact an IBCLC that is familiar with protocols.


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## Blucactus (Nov 20, 2006)

Quote:


Originally Posted by *Stinkerbell* 
it matters because of anethesia. Clear liquids will be absorbed into his body very quickly. Anything with protein takes a bit longer to digest, so can be anywhere in his digestive tract. If he reacts badly to the anethesia (very unlikely but they have to consider it) he can vomit and if he vomits while intubated, he will aspirate the vomit. If it is a small bit of water (clear liquid), it wont be a big deal. If it is something with a matter to digest, it will be a big deal.

That's the WHY.

As for my experience as a nurse, we always said no breastmilk 3 hours prior to surgery.


yes, i understand that. i'm sorry i wasn't more clear--i meant i wasn't sure if it mattered feeding-wise that they will be working so closely with his intestines.


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## Blucactus (Nov 20, 2006)

Quote:


Originally Posted by *mamaverdi* 
Every baby has a different digestion time, so it's not entirely accurate to state that breastmilk digests in X hours.

Aspiration is usually the concern.

Is this an urgent surgery? Do you have a pediatrician who is supportive and can help with this situation? Is this a children's hospital?

Our orders here are 4 hours breastmilk, 2 hours clears. Formula fed and non-human milk fed babies have to wait 6 hours.

So breastmilk is considered semi-clear.

I would offer the opinion that you should do what you feel comfortable doing. Understand the risks of aspiration. And take responsibility for your choice. Or IF you can find someone else to work with who will do what you want, then perhaps that is the better choice.


It is not an urgent surgery, but he is in screaming pain when his intestines bulge out into the space they are going to repair. So it is necisarry eventually & he will periodically be in pain until it is done.

It is a children's hospital. I don't think they have a lot of experience with breastfed children. Our surgeon is young & seems semi-open to suggestion.

We do have a great ped, I am embarassed that I didn't think of that; she is VERY pro BF so perhaps I could get her on board for an advocate.

Thank you all for your input. Anyone else?


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## Panserbjorne (Sep 17, 2003)

the risks of aspiration are the same in any surgery. Even emergency surgery when someone keels over in the middle of dinner and needs immediate intervention. Look at the aspiration rates there. Um-no difference. We've come a long way since it became the standard of practice to advocate for an empty belly. The only *risk* as far as I see it is with an incompetent anesthesiologist (and yes, I've reviewed the literature and would encourage anyone else to do the same.)


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## scoob (Mar 16, 2004)

My son had to go in for surgery on his feet at 4 months at an excellent children's hospital (Children's Healthcare of Atlanta). They considered breastmilk a clear liquid and I think I nursed him at 3-4 hours before the surgery. Our surgeon didn't even talk to us (except in vague terms) about prep. Like others have said, it's the nurses and the anesthesiologists who know more about that end of things.

Best of luck to your little guy! I hope everything goes smoothly.


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## Blucactus (Nov 20, 2006)

I've got some calls in to people to figure this all out. If they give me a hard time about it, it's still the only children's hospital in the area and my baby does not travel well--he screams in the car, so going to another hospital is not an option.


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## Thompson'sMommy (Jul 15, 2006)

Good luck with your decision. IMO I think it is a lot of we'd better cover our own butts. I'd BF.


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## chiromamma (Feb 24, 2003)

I would breastfeed. Breastmilk is considered a clear fluid. Give La Leche League a call. Find the local professional liason leader. She should have reams of info for you and your docs. Good luck.


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