NHS hospital guidance on breastfeeding a baby or child before their general anaesthetic

If a breastfed baby or child needs to have a general anaesthetic, how long before their surgery do they need to stop breastfeeding? I’m researching the instructions given to parents by NHS services across the country. It appears that most hospitals say the last breastfeed should be at least 4 hours prior to surgery, but I have found two that allow breastfeeding until 3 hours prior to surgery. I am copying and pasting the relevant sections below as I find them. Sometimes the policies only give a time of day and not the number of hours prior to surgery – in this case I have used as a reference point the time that water can be given up to – it’s standard that water can be given 1 or 2 hours prior to surgery, so if the time mentioned in relation to breastmilk is, say, 1 hour prior to that of water, then I’m assumed they’re saying that breastmilk can be given until 3 hours prior to surgery.

1) Instructions to breastfeed up to 3 hours before surgery:

Alder Hey

Children over 1 year of age

 Up to 6 hours before the anaesthetic, children can have food and milk products.

 Up to 1 hour before the anaesthetic, children can have clear fluid only

Babies under 1 year

 If on solids, foods as above

 Up to 4 hours before the anaesthetic, babies can have formula feeds

 Up to 3 hours before the anaesthetic, babies can have breast milk.

 Up to 1 hour before the anaesthetic babies can have water only.

(This policy appears to assume that only babies under 1 year are breastfed.)

Oxford Radcliffe Hospitals

Your child may have breastmilk before 5:30am.

Your child may only drink water or squash (not fruit juice) until 6:30am.

2) Instructions to stop breastfeeding at least 4 hours before surgery:

Royal College of Anaesthetists

■ Four hours before, babies can have breast milk.

St George’s Healthcare

If you are breastfeeding, you may continue to breastfeed your baby until 04.30 hours (4.30am). Your child may safely continue to drink clear fluids from the following list until 06.30 hours (6.30am) on the morning of surgery:
Water (not fizzy)
Blackcurrant juice (such as Ribena, C-Vit)
Clear Apple juice only (no pulp).

Royal Free London

We give the following timings in clinic depending on if we expect the operation to be in the morning or afternoon. Please be aware that this may change. You will be given final instructions when you are phoned by the nurse the day before surgery.

Children having surgery in the morning:

• Normal dinner the night before.
• Miss breakfast in the morning.
• Water till 6.30am
• Breastfed babies may feed till 4am on the day of surgery.

Children having surgery in the afternoon

• Light breakfast on the day of surgery to be completed by 6.30am
• Water till 11am
• Breastfed babies may feed till 8am on the day of surgery

Evelina London

You can breastfeed your baby up to four hours before the operation.

Leeds Children’s Hospital

7:30am admission for the morning operating list:

• 2.30am is the latest your child can have any food and most drinks – this includes milk, formula milk feed, fizzy drinks, thickened drinks, smoothies, fruit juice and sweets.

• 4.30am is the latest that breast milk can be given.

• 7.30am is the latest your child can have water or clear diluted squash such as Robinsons or similar, please give them a drink at this time

12noon admission for the afternoon operating list:

• 7.30am is the latest your child can have any food and most drinks – this includes milk, formula milk feed, fizzy drinks, thickened drinks, smoothies, fruit juice and sweets.

• 9.30am is the latest that breast milk can be given.

• 12.30pm is the latest your child can have water or clear diluted squash such as Robinsons or similar, please give them a drink at this time

Manchester University

 Up to 4 hours before the anaesthetic, children can have breast milk.

Kingston Hospital