Anesthesiologists Supporting Lactation: The Easy Thing To Do

The benefits of breastfeeding are substantial both for infants and their mothers. Infants who are breastfed have reduced risks of severe lower respiratory infections, asthma, acute otitis media, atopic dermatitis, sudden infant death syndrome, gastrointestinal infections, necrotizing enterocolitis (in premature infants), and probable reductions in obesity, and diabetes mellitus ^1,2 The American Academy of Pediatrics recommends exclusive breastfeeding for the first 6 months of life, and continued breastfeeding for at least the first year of life. ³ Mothers who breastfeed benefit through improved birth spacing and reduced risk for breast and ovarian cancer. ¹ Despite the benefits of breastfeeding being well known, there are several barriers experienced by breastfeeding mothers, particularly when it comes to the continuation of breastfeeding. Medical Schools in the United States generally do not provide lactation education beyond basic physiology. ⁴ Therefore, public health breastfeeding advocacy is essential and can be achieved with the support of families, communities, employers, clinicians, and health care systems. ²

In this issue of the Journal of Women’s Health, Dr. Lehmann and colleagues discuss an important opportunity for the support and continuation of breastfeeding: the perioperative period for patients undergoing anesthesia. ⁴ Prior to current evidence, patients might have been advised to “pump and dump” out of concern that residual anesthetic drugs in a mother’s milk could be harmful to a breastfed infant. Anesthesia residency curriculum has historically not included lactation or breastfeeding and anesthesia, further propagating the “pump and dump” misinformation. Dr. Lehmann and colleagues should be commended for highlighting an important public health teaching moment by anesthesiologists: current evidenced based recommendations support the continuation of breastfeeding throughout the perioperative period. Patients can breastfeed and pump once they are awake, alert, and able to after anesthesia.^5,6 The authors describe a novel intervention, a video-based education developed by their team that can be utilized by health care providers in fast paced environments to obtain just in time education helpful to care for lactating patients undergoing surgery. The authors found the video-based just in time education helpful to deliver information to anesthesia clinicians. This information in this just in time format is important, as individual anesthesia clinicians may go months-to-years without caring for a breastfeeding patient.

We must make breastfeeding the easy thing to do. Lehmann and colleagues illustrate that supporting lactating parents can even occur in the surgical period.