Development and Evaluation of Clinical Protocol for Breastfeeding after General Anesthesia

Abstract

Inconsistent post-anesthetic advice imparted to breastfeeding mothers leads to unnecessary weaning or premature abandonment of nursing. This Doctoral of Nurse Practice (DNP) project set out to identify evidence-based research regarding post-anesthetic advice to communicate to breastfeeding mothers from their anesthesia providers. The first phase of the project involved the systematic development of a Clinical Practice Guideline (CPG) based on current evidence in the literature. The second phase of the project was the appraisal of the developed CPG by an interdisciplinary panel utilizing the AGREE II instrument. The overall quality of the developed guideline resulted in a combined score of 92%, representative of a high-quality guideline. Appraiser’s judgment concerning the recommended use of the developed guideline resulted with an answer of ‘Yes’ to the recommended use of the guideline. The overwhelming evidence suggests that drugs administered to a breastfeeding mother during the perioperative period are not harmful and will not precipitate adverse outcomes in the healthy breastfed infants (Dalal, Bosak, & Berlin, 2014). A breastfeeding mothers return to baseline mentation and strength, suggest drug redistribution from plasma and milk, and termination of drug action (Cobb et al., 2015). Mothers are encouraged to continue breastfeeding and disregard the past recommendation to “pump and dump.” The American Academy of Pediatrics Committee on Drugs surmises, “The benefits of breastfeeding outweigh the risk of exposure of most therapeutic agents via breastmilk” (Sachs, 2013, p. 805).