Recommendations for Preprocedural Fasting for the Breastfed Infant
Publication Date: July 17, 2012
Last Updated: March 14, 2022
Recommendations
Minor painless procedures or procedures requiring local anesthesia for pain control that do not require sedation or fasting. Minor procedures such as circumcision with a local block, diagnostic examinations, placement of peripheral intravenous lines, and drawing blood can be performed without sedation or general anesthesia. A procedure that is considered minor should cause minimal physical trauma and psychological impact, therefore not requiring sedation. Without sedation, the infant can protect his or her airway with an intact cough/gag reflex, and thus fasting is not required. (Iundefined)
The need for sedation should be decided upon at the physician’s discretion based on the intensity and duration of the procedure as well as the infant’s medical history.1 If sedation is not necessary, the need for oral analgesics or other means for comfort should be determined by the practitioner.
323908
If it is a minor procedure not requiring sedation or general anesthesia, then feed normally. Infants are more likely to tolerate minor procedures when the usual feeding pattern is maintained. They will be more comfortable when they have eaten in a normal routine. Without anesthesia, even if the patient is sleeping during the procedure, the upper airway reflexes are intact, and infants will be able to naturally protect their airways. (I, )
323908
If possible, consider breastfeeding for comfort during the minor procedure without sedation. Breastfeeding while receiving a heel stick, intravenous placement, or drawing blood has been shown to be an effective means of pain relief and should be an option made available to mothers and infants. (III, )
Please refer to the Academy of Breastfeeding Medicine Clinical Protocol #23 for more information.
323908
Exceptions for the active patient. The child who is unable to follow instructions or cooperate because of age or level of development may require sedation for minor procedures after efforts to perform the procedure without it have failed. Under these circumstances, the procedure may need to be postponed so that the patient can follow strict fasting guidelines. (, )
323908
Overview
Title
Recommendations for Preprocedural Fasting for the Breastfed Infant
Authoring Organization
Academy of Breastfeeding Medicine