Babies who need surgery

Should I keep breastfeeding if my baby needs surgery?

Breastfeeding is generally the best way to feed a baby around the time of surgery. If the baby requires surgery, mothers should discuss the timing of breastfeeding with their health-care providers. If the surgery is minor and definitely does not require sedation or general anesthesia, mothers can breastfeed when the baby is hungry. If sedation or general anesthesia is required, feeding should end four hours before the procedure. Mothers can express for every missed feed and store the milk for later. After a minor procedure, if the baby is stable, otherwise healthy, and the surgery does not prevent drinking, mothers can breastfeed as soon as the baby is awake and interested. 

A) Breastfeeding around the time of surgery

Discuss breastfeeding before and after surgery with your health-care providers.

In general, breastfeeding is the best way to feed the baby around the time of surgery, because (Yu 2020):

  • Breast milk is more easily and quickly digested than infant formula.
  • Breast milk helps the baby heal and grow by providing ideal nutrition.
  • Breast milk protects the baby from other infections before and after surgery.
  • Breastfeeding relieves pain (Reece-Stremtan 2016).
  • Breastfeeding calms the baby before and after surgery (Reece-Stremtan 2016).
  • Babies may tolerate breastfeeding better than bottle feeds (Souza 2018).
  • Breastfed babies may leave hospital sooner (Strom 2020).

B) Breastfeeding before surgery

The Academy of Breastfeeding Medicine has an excellent set of guidelines regarding breastfeeding before surgery (ABM 2012).

If the surgery is minor and definitely does not require sedation or general anesthesia, mothers can breastfeed when the baby is hungry before surgery.

If the procedure may not work without sedation or general anesthesia or definitely requires it, breastfeeding or other feeding of breast milk should end four hours before the procedure.

If the baby is unable to breastfeed, mothers should express for every missed feed. The milk can be stored for later use.

C) Breastfeeding after surgery

After a minor procedure, if the baby is stable, otherwise healthy, and the type of surgery does not prevent drinking, a mother can breastfeed as soon as the baby is awake and interested.   

For babies undergoing major surgery, your health-care providers will indicate when it is safe to feed the baby.

References

Academy of Breastfeeding Medicine (ABM). ABM Clinical Protocol #25: Recommendations for preprocedural fasting for the breastfed infant: "NPO" Guidelines. Breastfeed Med. 2012 Jun;7(3):197-202
 
Souza PC, Gigoski VS, Etges CL, et al. Findings of postoperative clinical assessment of swallowing in infants with congenital heart defect. [Article in English, Portuguese; Abstract available in Portuguese from the publisher] Codas. 2018 Mar 1;30(1):e20170024
 
Reece-Stremtan S, Gray L. ABM Clinical Protocol #23: Nonpharmacological Management of Procedure-Related Pain in the Breastfeeding Infant, Revised 2016.
Breastfeed Med. 2016 Nov;11:425-429

Storm AP, Bowker RM, Klonoski SC,et al. Mother's own milk dose is associated with decreased time from initiation of feedings to discharge and length of stay in infants with gastroschisis. J Perinatol. 2020 Jan 28

Yu XR, Xu N, Huang ST, et al. A Comparative Study on Breast Milk Feeding and Formula Milk Feeding in Infants With Congenital Heart Disease After Surgery: A Retrospective Study. Heart Surg Forum. 2020 Nov 18;23(6):E845-E849