DD having sedation dentistry- help please

[Shaunsmom]

DD has two spots on her back upper teeth that need fillings. The spots aren't horrible but enough to need fillings and not sealants.

DD is two and is still the ever loving nursling.

Going thru the guidelines of what to do and what not to do...there's no eating or drinking after midnight until the surgery. Surgery is at 11:20am and we need to check into the outpatient area at 9:50am.

From what I can find online, it's okay for DD to nurse up to 4 hours before surgery, so she's okay to nurse up until 7:20am (from what I gather).

The dental asst. that called to give me all the info said i was okay her DD to nurse up to four hours before the time we are supposed to be there at 9:50 which means nursing no later than 5:50am.

I'm looking for the most accurate time frame to allow DD to nurse before she goes under anesthesia. Any help?

ETA- once she's sedated and the dentist is in her mouth, if the two teeth that need fillings now will benefit more from crowns, that's what he'll do...forgot about that part until I read Gypsy's post. Thanks for jogging the memory from yesterday's visit.

[JustMoi]

breast milk is considered a clear fluid, if that helps

[pawprint]

I have some links saved about this. hold on.

[Shaunsmom]

breast milk is considered a clear fluid, if that helps

Don't take this the wrong way but is it really considered a clear fluid? Any helpful links to back that up? I just don't want to with hold nursing her for longer than necessary or jeopardize anything with the anesthesia.

[pawprint]

Here we go...

http://www.asahq.org/publicationsAndServices/sedation1017.pdf

http://www.llli.org/llleaderweb/LV/LVDecJan02p132.html

Ds2 had dental surgery days after his second birthday. It was very scary and I am sorry you have to go through it too. He came out perfectly on the other side and now has a mouth full of perfection, lol. No cavities since.

I nursed him what i thought was going to be three hours beforehand, but it was more like four. It was fine. I spoke with the anesthesiologist about it but he gave me shit so I just did what was recommended by the studies.

[_Gypsy_]

I'd have those teeth crowned, not just filled.

Ds had two dental surgeries - the first one capped two teeth and filled some cavities - he would have never needed the second one if the first one would have crowned the teeth instead of just filling them.

[ima062002]

http://www.kellymom.com/health/illness/baby-surgery.html - it's not surgery per se but the guidelines would still apply.

It also refers to your question to JustMoi.

"There is less agreement about breast milk feeding. Some institutions (36%) consider the composition of breast milk to be equivalent to that of a clear fluid, others (34%) equivalent to a solid, and the remaining institutions consider it "something else." This is likely due to the paucity of data examining absorption of breast milk in healthy infants. Most institutions (77%) consider at least a 4-h fast for breast milk to be sufficient; only 23% allowed breast milk to be ingested less than 4 h before induction... In conclusion, this study shows the variation in fasting patterns and the difficulty in developing practice guidelines. It is far easier to simplify guidelines by making all patients NPO after midnight. This is not the optimal or safest practice for pediatric anesthesia, nor is it the accepted practice of the majority of clinicians. The question posed to the pediatric anesthesia community is "Can reasonable guidelines be developed that could be agreed on by the majority of practitioners?" Our results indicate that a "2-4-6-8 rule" represents the majority of institutions that provide anesthesia for children in North America. This restricts clear fluids for 2 h, breast milk for 4 h, formula for 6 h, and solid food for 8 h before induction of anesthesia. In elective surgical procedures, acceptance of this as a guideline deserves further discussion by the anesthesia community and would serve to simplify the current confusing and arbitrary policies that exist in different institutions."

[Shaunsmom]

Here we go...

http://www.asahq.org/publicationsAndServices/sedation1017.pdf

http://www.llli.org/llleaderweb/LV/LVDecJan02p132.html

Ds2 had dental surgery days after his second birthday. It was very scary and I am sorry you have to go through it too. He came out perfectly on the other side and now has a mouth full of perfection, lol. No cavities since.

I nursed him what i thought was going to be three hours beforehand, but it was more like four. It was fine. I spoke with the anesthesiologist about it but he gave me shit so I just did what was recommended by the studies.

I am a bit nervous about the whole experience. I think we're going to take a trip to the hospital this weekend, to show DD where we are going next week. So far her experiences with the trips to the dentist have been pretty good and she doesn't seem afraid when we're at the appts. either.

I think I'll play it by ear on the nursing part. If we have to be there at 9:50 and the procedure is set for 11:20...I think it might be reasonable to feed her last within 2-4 hours prior to the procedure.

The article I read from La Leche mentioned a part about talking with the anesthesiologist and work with him and the dentist on how long DD can nurse beforehand but...(yeah, there's always a but) I don't want to be given a hard time about it either.

[pawprint]

I tried to talk to him, but he clearly had no idea what he was talking about. Not my job to educate every num nutz on earth. There is clear, medical science that says it's a clear fluid. I'm cool with making my own call on that. If apple juice counts as a clear fluid- breastmilk sure as heck must be. My guess it is digests a lot fast than juice!

The one thing i would really fight for is to be able to nurse immediately. DS woke up crying and went straight to the breast. Where the teeth were extracted and capped we didnt' even know if he would be able to nurse again. He lathed on, pulled off, and went right back on. He nursed three years after that. It was very stressful at the time, but all of these years later I am really satisfied with how it all went and glad that I informed myself, made my own choices, and stood up for ds's need to nurse immediately.

[Shaunsmom]

Thanks Paw (and everyone else who has chimed in so far)...

I'm good to go. OTOH, DH follows orders like this to the T and is one of those people that is convinced that "just because Dr. So and So said so", that it's almost like the word of God. KWIM?

However, since DH doesn't know about the eating/drinking guidelines that I was informed of...don't think it is something that needs discussion between me and him.

I don't feel I'm withholding pertinent information...it always is something like if they (doctors) are saying something, that they must know because they are a doctor and I'm only the lactivist mama that I am with no medical degree (from DH's perspective).

In the end, we both want the best possible for our kids, which means I go with my gut on certain things like bfing. I will inform the dentist and the anesthesiologist that I plan to nurse DD right after the procedures are complete:)

[Sputterduck]

I'd have those teeth crowned, not just filled.

Ds had two dental surgeries - the first one capped two teeth and filled some cavities - he would have never needed the second one if the first one would have crowned the teeth instead of just filling them.


It can go both ways. We fought and fought to Not get my son's teeth crowned. We went to 4 dentists I think in the whole struggle. The 4th was awesome, did fillings, and now 4 years later he's fine and I'm so so glad I fought for just fillings. He was only 1 at the time, now he's 5 and will start losing teeth soon and so far they are holding strong.

[Sputterduck]

Oh, and be careful about the nursing if the dentist might not like it. The kid who came in after my son was turned away because he had one cheerio that morning.