Breastfeeding and surgery -- update post #8

[wendypf]

I'm scheduled to have surgery under general anesthesia tomorrow morning. I will be on painkillers and antibiotics (so far I have failed to get a list of possible medications -- working on this... its been difficult because what they do will depend on what they find)

DD is 1YO and I do have a supply of milk in the freezer. Some days she will hardly nurse at all during the day. She nurses all night.

Any ideas how this will effect us? I realize there are a lot of unknowns... I'm mostly scared (and wow, does breastfeeding help in these times or what??)

[liberal_chick]

I had surgery when ds was about 9 weeks old, so still 100% EBF. I set dh up with some bottles and frozen milk and off I went.

I had discussed with my doctor before hand that I was breastfeeding and would need all medication to be safe. I don't know what kind of antibiotic they gave me (they did it through the IV, and it allowed me to develop thrush, fyi), but my painkiller was Tylenol 3, although I did take a percoset just after surgery.

The aneistheologist wanted me to pump and dump after surgery for 4 hours post-op, but my nurse in recovery was a CNM and told me just to go ahead and nurse (which was a good thing b/c ds refused the bottle and was starving).

[mamazee]

I had medical emergencies come up within two months of the births of both my kids. With the first, everyone said it was fine to bf immediately afterward, and I did. With #2. the surgeon wanted me to pump and dump, but everyone else said it wasn't a big deal - just to bf. The aneasthesiologist said that it's a new recommendation based on the potential for lawsuits or something - that he'd advised to just bf immediately afterward for 25 years with no problems and that birthing moms are given aneasthesia and those moms bf immediately afterward so he thought it was a silly change. I talked to a lactation consultant, and she agreed that it was fine to bf immediately afterward. And I did, with pain killers and all, and my dd wasn't effected at all.

It was no big deal either time. I'd talk to a lactation consultant about it instead of a doctor, though.

[wendypf]

The anesthesia group told me to pump and dump for 24 hours... I tried to explain to the receptionist that the lactation consultant knows better about the drugs and all I wanted was a list of possible medications (I realize they can't be sure) so I can plan in advance... she said the best they can do is give me a list after surgery.

Luckily I'll have time after surgery before DD needs to nurse -- I'll bring printouts from Kelly mom for DH to look through while I'm recovering -- it will give him something to do

[monkey-lamb]

I had surgery and had to stay overnight in the hospital when my DD was 5 months old. I was more scared of being away from DD and her having to get to sleep without nursing than I was of the surgery. When I called the doctor's office to find out about the medications I would be given during surgery, they told me I had to dump for THREE DAYS! I was cared to death and pumped like crazy to make sure I left enough milk. I later found out that this is pretty much their stock answer. When I met with the anesthesiologist the morning of the surgery, we went over the medications and he said I really only needed to for 24 hours.

That being said, I would plan for the worst and then talk to the anesthesiologist before and after the surgery. Even at only 5 monhts old, my DD did great and was so happy when she got to nurse again. Good luck!

[PatioGardener]

Best wishes for your surgery.

Kellymom is a super resource for this topic:
http://www.kellymom.com/health/illness/mom-surgery.html

The bottom line seems to be that as soon as mom is able to breastfeed, she can breastfeed.

Can you insist that any antibiotics you are given are breastfeeding compatible? Here is agood list of alternatives if the doc doesn't have a copy of Hale's book: http://www.kellymom.com/health/meds/...ml#Antibiotics

[PatioGardener]

Bump

[wendypf]

I had the surgery today -- if anyone can help me with these drugs (they were very firm in the hospital, 24 hours...). i could really use the comfort of nursing, I was diagnosed with cancer today... i'm not sure how much longer I'll be able to...

reglan
zofran
propofol
fentanyl
versed
desflurane
decadron
robinul
neostigmine

[PatioGardener]

Awww Mama, I am so sorry.

reglan - given to breastfeeding mothers to increase milk supply.
zofran - L2 - given to children ages 4-12.
propofol - L2 - used during C-sections - moms nurse right away
fentanyl - L2
versed (midazolam) - L3 - Hale says that it is gone after 4 hours. No pediatric concerns.
desflurane - couldn't find in Hale's.
decadron - L3. Avoid high doses over a long period of time
robinul - L3, but short half life and Hale says that it is unlikely significant quantities will get into milk. Plus it isn't absorbed orally, so he says it is remote that it owuld pose a significant risk to a breastfeeding infant.
neostigmine - can't find in Hale's.




L2 SAFER: (http://www.kellymom.com/health/meds/..._risk_cat.html)
Drug which has been studied in a limited number of breastfeeding women without an increase in adverse effects in the infant; And/or, the evidence of a demonstrated risk which is likely to follow use of this medication in a breastfeeding woman is remote.

L3 MODERATELY SAFE:
There are no controlled studies in breastfeeding women, however the risk of untoward effects to a breastfed infant is possible; or, controlled studies show only minimal non-threatening adverse effects. Drugs should be given only if the potential benefit justifies the potential risk to the infant.


Hope that helps, Mama. I hope someone can fill in the blanks/give more info too.

[~LadyBug~]

I had to have a vaginal hysterectomy and I was able to nurse as soon as could after surgery. I had NO problems at all.