{
  "abstract": "Hospitalization of a breastfeeding mother or child can result in disruption of the feeding cycle and unintended weaning, breast discomfort, mastitis, and psychological distress.1 2 However, intraprocedural lactation support guidelines are scarce, and no guidelines specific to neurointerventional procedures have been published. We recently treated a patient with a Cognard IIa+b dural arteriovenous fistula who also had aneurysms of the feeding dural arteries. While discussing the treatment plan (including the high likelihood of the embolization procedure lasting 6 hours or more), the patient informed our team of her desire to maintain breastfeeding for her newborn because of many well-documented benefits to both the newborn and mother.3 Our institution, like many, had preprocedural and postprocedural lactation guidelines, but did not have a protocol to support the practical implementation of intraprocedural lactation support.1 4 5 A multidisciplinary team comprising the neurointerventional surgical team, anesthesiologist, neurologic intensive care unit (ICU) staff, pharmacists, and a dedicated lactation consultant was involved in the pre-procedure planning phase to define our lactation support flow chart (figure 1). We present this approach to intraprocedural and periprocedural lactation support so others can use the guide when caring for breastfeeding patients whose normal feeding cycle is disrupted by a neurointerventional procedure. The patient’s perspective is also included to highlight the emotional and physiological importance of supporting lactation goals, while also providing a sense of agency amid the profound disruption associated with the diagnosis and treatment of a neurovascular disorder.",
  "authors": [
    {
      "affiliations": [
        "Neurology, UCSF Medical Center, San Francisco, California, USA"
      ],
      "name": "Shaadi Settecase"
    },
    {
      "affiliations": [
        "Department of Pediatrics, UCSF, San Francisco, California, USA"
      ],
      "name": "Anya Levinson"
    },
    {
      "affiliations": [
        "Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Sarah E Dodd"
    },
    {
      "affiliations": [
        "Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "Reade Andrew De Leacy"
    },
    {
      "affiliations": [
        "Department of Obstetrics and Gynecology, UCSF, San Francisco, California, USA"
      ],
      "name": "Sarah Quigley"
    },
    {
      "affiliations": [
        "Neurology, UCSF Medical Center, San Francisco, California, USA"
      ],
      "name": "Nerissa Ko"
    },
    {
      "affiliations": [
        "Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California, USA"
      ],
      "name": "Allison Lamboy"
    },
    {
      "affiliations": [
        "Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California, USA",
        "Department of Neurological Surgery, UCSF, San Francisco, California, USA"
      ],
      "name": "Matthew Robert Amans"
    }
  ],
  "title": "Intraprocedural lactation support for neurointerventional surgery",
  "uid": "92d8dbfa-f4db-574b-8945-516c9e135a53"
}