Since nearly 40% of metabolic and bariatric surgery (MBS) patients are individuals with the ability to bear children, many may seek to become pregnant or may be currently lactating when seeking surgery. While many patients plan to breastfeed, MBS patients are at high risk for premature cessation of breastfeeding. Limited literature exists on the impact of MBS on lactation and there are no established guidelines to help clinicians support and educate MBS patients about breastfeeding. Herein, we aim to fill that gap by providing a comprehensive guide for bariatric surgeons, obstetricians, women's health providers, lactation consultants, registered dietitians, bariatric nurse coordinators, and advanced practice providers to support breastfeeding in patients with a history of MBS or who are considering MBS. We review physician-patient discussion points on how MBS impacts lactation, the micronutrient and caloric needs for this unique population, and data to support successful breastfeeding in post-MBS patients who are lactating regarding practical, anesthetic, and imaging considerations.
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Breastfeeding in metabolic and bariatric patients: a comprehensive guide for surgeons, patients, and the multidisciplinary team.
Surg Obes Relat Dis
December 2024
Department of Surgery, University of California Davis, Sacramento, California; Center for Alimentary and Metabolic Sciences, University of California Davis. Electronic address:
Since nearly 40% of metabolic and bariatric surgery (MBS) patients are individuals with the ability to bear children, many may seek to become pregnant or may be currently lactating when seeking surgery. While many patients plan to breastfeed, MBS patients are at high risk for premature cessation of breastfeeding. Limited literature exists on the impact of MBS on lactation and there are no established guidelines to help clinicians support and educate MBS patients about breastfeeding.
View Article and Find Full Text PDFNeuromodulation for Headache Management in Pregnancy.
Curr Pain Headache Rep
January 2025
Department of Neurology - Headache Division, University of Miami Health, University of Miami School of Medicine, 1120 NW 14th Street, 13th Floor, Miami, FL, 33136, USA.
Purpose Of Review: Management of primary headache disorders during pregnancy is limited due to known teratogenicity or unknown safety of many currently available pharmaceutical therapies. Here, we explore the safety and efficacy of non-invasive neuromodulatory devices as another treatment modality for pregnant patients.
Recent Findings: There are six FDA-cleared, non-invasive neuromodulatory devices currently available for the management of headache that include remote electrical neuromodulation (REN), noninvasive vagal nerve stimulation (nVNS), external trigeminal nerve stimulation (eTNS), single-pulse transcranial magnetic stimulation (sTMS), and external concurrent occipital and trigeminal neurostimulation (eCOT-NS).
Introduction: Some adolescents undergoing metabolic and bariatric surgery (MBS) have suboptimal responses to surgery, particularly over the longer term. This study aimed to quantify changes in weight loss over time in adolescents undergoing MBS and identify preoperative predictors of weight loss.
Methods: This was a prospective, observational cohort study of 73 adolescents (12-19 years) living with obesity undergoing MBS.
Religious Fasting Following Metabolic and Bariatric Surgery (MBS): Insights from Jewish Practices in Israel.
Medicina (Kaunas)
December 2024
Division of General Surgery, Tel Aviv Sourasky Medical Center, Tel-Aviv 6423906, Israel.
: Religious fasting in patients after Metabolic and Bariatric Surgery (MBS) remains a topic with limited clarity. This study aims to present the results of a survey on religious fasting in patients after MBS in Israel. The questionnaire was sent to members of the Israeli Society for Metabolic and Bariatric Surgery (ISMBS).
View Article and Find Full Text PDFReal-World Open-Label Experience with Rimegepant for the Acute Treatment of Migraine Attacks: A Multicenter Pilot Study.
Brain Sci
November 2024
Headache Outpatient Clinic, Neurology Department, Patras Agios Andreas General Hospital of Patras, 26335 Patras, Greece.
The present open-label multicenter pilot study sought to prospectively evaluate the efficacy and safety of rimegepant in treating migraine attacks. The primary endpoint was pain freedom at two hours post-dose, while the co-primary efficacy endpoints included a reduction in the headache intensity and freedom from the most bothersome symptoms (MBS) associated with migraine at the same time point. To test the potential efficacy of rimegepant, patients were asked to record in a questionnaire all the relevant changes with each migraine attack treated with rimegepant at two hours post-dose vs.
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