Pump and Dump; Anesthesiologists Lead the Feed

We would like to commend the editors of the October 2017 issue for emphasizing the topic of perioperative lactation for patients having surgery. We especially appreciate the infographic by Wanderer and Rathmell,¹  titled “Anesthesia & Breastfeeding: More Often Than Not, They Are Compatible.” Wanderer and Rathmell’s work represents a paradigm shift in the way breastfeeding patients are managed and invites anesthesiologists to continue to support the maternal–infant dyad after delivery.

We are writing to voice our concern that many of our specialty’s foundational textbooks contain timeworn recommendations including “the mother should discard milk produced within the first 24 h after anesthesia.”²  Of perhaps equal concern is that many principal anesthesia textbooks omit the subject completely, further perpetuating anecdotal and potentially disruptive practices.

In most cases it is safe for patients to resume breastfeeding as soon as they are awake and alert. It is our hope that as perioperative physician leaders, anesthesiologists will take on the role of educating breastfeeding patients presenting for surgery as well as the healthcare providers involved in their operative encounter. We believe this begins with expanding the teaching of our trainees to include the most current literature regarding this topic. We would respectfully request this be considered for future editions of comprehensive anesthesiology texts, so we may continue to be leaders at the junction of evidence-based and patient-centered practice.

The authors declare no competing interests.