surgery while breastfeeding

Question
I'm in the process for lap band surgery. The surgery will probably be when my baby is 4 months old. I'm breastfeeding her. My question is do I need to stop nursing for surgery? If  I can continue breastfeeding how soon thereafter can I resume nursing, in regards to medication and/or painkillers? More specific does anything they give during surgery go into the mothers milk. Also does the milk supply decline after surgery because of the low calorie diet? Thanks for your help.

Answer
Laura,

Some of these questions (such as the question about painkillers) you need to ask to your surgeon since I don't know what they will give you.  This is a good article on painkiller safety in breastfeeding: http://drugs.about.com/lw/Health-Medicine/Womens-Health/Taking-Painkillers-While...
What I would suggest is that you tell your surgeon that you intend to nurse and that you would like to take pain medication that will allow you to keep nursing.  Codeine can be especially dangerous and is best avoided in nursing.

Here are some other considerations:

1) As you point out, reduced calorie intake and lead to loss of milk supply.  This varies a lot from woman to woman, and it's hard to know who will be impacted.  Staying well nourished - following your post-operative guidelines, taking a good bariatric vitamin, etc will help, but it is not a guarantee.  

2) Be prepared to pump milk.  I don't know if you are staying overnight or or having an outpatient placement, but if you are in the hospital for a day, even more, you will probably want to pump and store milk.  This can be great if you get some stored up and frozen because while you are recovering your husband or someone else can give your milk to the baby in a bottle. If you have pain that makes it uncomfortable to hold that baby or are restricted in nursing pumping is also great.  Talk to the hospital where you are having surgery about this.

3) I guess my other question is how long do you want to nurse for.  Nursing is great - both for you and the baby.  I nursed both my kids for a full year.  Both having a baby and having weight loss surgery are life altering events.  One consideration - and perhaps you have thought this through already is to just wait a bit on the surgery.  Wean your baby, then get the band.  You are likely to be losing weight during this time anyway.  Just a thought.

Please let me know if you need more information.

In Health,

Dr. Jacques

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