No BF for 3-13 days due to surgery - how to avoid weaning?

[mommadotta]

I'm going to have (outpatient) surgery on Friday that will necessitate my being on medications from the time of surgery up to potentially 10 days after surgery. The doctor said I should wait at least 24hrs after I stop taking the last dose of medication before resuming BF, while the nurse advised me to wait at least 72hrs to be safe. The length of time that I'm taking meds depends on how much pain I'm experiencing and whether I have to take antibiotics for an infection. I have a pretty good stash of breastmilk stored in the freezer, although I must admit that haven't literally added up exactly what I have and what I'll need-- I've just been pumping as much as reasonably possible and taking over the entire top shelf of the freezer. I know that DS is OK with a bottle and switching between bottle and breast readily; sometimes he's on the bottle for ~8-9hrs at a time when I have to work out of the home all day.

What I'm wondering is if anyone here might have some suggestions for things that we can do to try to minimize the risk that DS might self-wean during this time. (He's just over 13 weeks, and we first introduced a bottle at 5 weeks.) I'm obviously motivated to get off the meds as soon as I feel I can (if I went through labor and delivery with no meds, I should be able to recover from surgery without too much reliance on drugs, right? Here's hoping!), but I have to be realistic and accept that I may need to be on them longer than I'd like.

I'm already planning to "pump and dump" throughout the time I can't BF directly, so I understand about maintaining supply. I also have the BornFree bottles, which I understand are supposed to be "slow-flow" to be BFing-friendly. But is there anything else my DP and I can do to help DS come back to the breast when I'm able to start again? Thanks so much for your advice!

[eclipse]

What medication is it? Most pain meds they can give you after surgery are the same as they would give after a c-section, and most antibiotic are compatible with breastfeeding. If you list the names of the meds some one who has Dr/ Hale's book can look them up for you. Or, you can try checking yourself here - http://neonatal.ttuhsc.edu/lact/medi...orumspage.html

I really would not trust your doctor on this without doing further research.

[alegna]

:

I'd bet a large sum that your meds are fine for breastfeeding.

-Angela

[Cutie Patootie]

I am actually in bed now, recovering from "out-patient" surgery that lasted 3 days. Anyway, what the doctors and nurses tell you is standard protocol...72 hours , no matter what they give you. Like the op said, most pain meds are fine to take when bf'ing...I have been on intravenous diloted...percocet...vicatin and on antibiotics. Sempro, I think. They may fight you about antibiotics. You must insist that they be bf compatible or you simple won't take them. They will cave. They fuss and moan and say this is the only thing that you should be taking, but when push comes to shove, there is always something else. I had another "out-patient" surgery when dd was 2 months old. The doctor/surgeon fought me up and down on the antibiotics. I threatened not to have the surgery and started to walk out, and wouldn't you know it, he suddenly found something else. On the day of the surgery, I was prepped and lying in pre-op when the same doctor came in to "inform" me that I would need to stop breastfeeding because he decided that the other ab was the one I would be taking. I simply got up in my airy hospital gown and said I wouldn't be having surgery today. He said, "okay, okay...I'll find something else." Stand your ground. They will accomodate, you may have to fight it out. Your baby is small. I definitely wouldn't stop bf'ing for that amount of time is there is a way not to.
Tell your doctor to pick up "medications and mothers' milk", a well known and renowned medical book that all doctors should have or have access to.

[Ruthla]

You certainly can't nurse WHILE in surgury, and it's a good idea to have extra milk stored just in case you're in recovery longer than expected.

But get the names of all the medications you'll be getting, including any anethetics used during surgury, and check them out with somebody who has Dr Hale's book- either post the meds online and somebody can look it up for you, or PM somebody who posts here saying she has the book, if you don't want to share the meds on a public board.

If you do need to pump and dump for any length of time, it's important to keep on pumping so you don't lose your milk supply (though it may be reduced anyway just from the stress of surgury, and it's common for supply to lower a bit from all that pumping as it may not be as efficient as the baby/it's hard to find time to pump when caring for a baby.)

[PatioGardener]

I agree with the PPs. Often the only time a mom undergoing surgery needs not to breastfeed is when she is having the surgery. From what I have heard, once she is able to hold the baby without fear of dropping him/her, then she is OK to breastfeed. Ask your doc for the exact names of the meds and check them out. I'm with Angela - I bet they are fine too. And if they aren't, I bet they can find safe alternatives.

Cutie Patootie - I just read your post. You are a breastfeeding mamma to be reckoned with! I love it!

[readytobedone]

i can't tell you how many times (in 7 whole months!) i've had to promise to pump and dump drugs that hale's says are perfectly safe for nursing

the sad fact is, docs would rather you pump and dump and risk losing your nursing relationship than have to worry about whether your drugs are safe--because they are just practicing CYA and don't usually care about nursing that much anyhow.

just look the drugs up; they're probably fine. and if they are fine, just nod and ignore the pump and dump stuff--because even if you shove hale's in their face, they probably will never have heard of it.

can you tell i'm in a bad mood regarding doctors today?

of course, if the drugs aren't safe, then you should ask about/research alternatives. good luck!

[hipmummy]

I agree with the PP's. Almost all docs know absolutely nothing about bf. They haven't a clue. I know soooo many mamas who quit because of uneducated docs. Whatever meds you do need can also be adjusted to help fit the breastfeeding. I really hate i when they give this info and throw in the na na na na you can' breastfeed and they rellish in the thought. I just want to gov ethem all copies of thomas hale and tell them to go back to school for mandatory breastfeeding training, If I HAD LISTENED TO MY DOCTOR, I would have not nursed ds for 48 hours just to take one dose if an L2. Ds had never had a bottle and was not yet on solids. And I was not even going to have the whole dose. I no longer go to the same dr. because they are very much only do what is good for you, forget your baby practice. www.kellymom.com had alot of info as well. As for having milk on hand, yes pump and pump a lot. You may not feek well. So try to have at least a weeks worth on hand. Good Luck. I have Hales book on hand so PM if you need info or call your local LLL leader, they wil have many resources for you as well.

[mommadotta]

Thanks so much for all the replies! I just dashed off a message to my doctor inquiring about the names and dosages of the medications, but I'm not sure he'll be able to hear back from the anesthesiologist before Friday (too bad it didn't occur to me to ask about this earlier). Tomorrow I'll call the lactation consultants as well to see if they can help advocate on my behalf.

[MCatLvrMom2A&X]

www.kellymom.com has safe medication lists to. There are very few meds that you cannot take while bfing. I would guess over 90% of abx are safe to take.

[mamaverdi]

Do you want to say what kind of procedure it will be? Because some of us might know the types of meds to look up...

Because some of us (and here I'm speaking for myself only) are geeks.

[mommadotta]

Wow, you all are such a great resource! I'm printing up the lists of analgesics and anesthetics to take with me on Friday to be prepared.

mamaverdi, I'll send you a PM.

[mommadotta]

Does anyone know anything about the safety of Salumedrol while BF? Evidently that's one of the (many!) meds I'll be taking.

I'll try to get more info from a lactation consultant at the hospital and from DS's pediatrician before I have to take anything, but I thought I'd inquire here as well to get as informed as possible. Th anks!

[Turkish Kate]

Originally Posted by mommadotta

Does anyone know anything about the safety of Salumedrol while BF? Evidently that's one of the (many!) meds I'll be taking.

I'll try to get more info from a lactation consultant at the hospital and from DS's pediatrician before I have to take anything, but I thought I'd inquire here as well to get as informed as possible. Th anks!

Solumedrol is a steroid, part of most pre-op packages to reduce inflammation, and is listed as an L2--safe for breastfeeding mamas.

Unless you're receiving some sort of chemotherapy or radiation (including tagged isotopes), just about every other medication is okay for breastfeeding. Insist that your doc consult Hale's rather than the PDR. The PDR has the manufacturer's insert information, which is almost always going to say that it's not safe, merely as a CYA.

If your surgery is not an emergency situation, you may want to consider postponing it for a week or two to get all of your drug information straight with your docs so that you can preserve your breastfeeding relationship.

[geckoed]

I had back surgery and said I WOULDN'T wean and DS was refusing a bottle and they had some leg work to do but they switched the drugs given during the operation, did a shot of morphine after and sent me home that day (normally a 72 hour stay). My husband latched the baby on while I was still knocked out in recovery. There ARE safe drugs for sugery and pain and infections. Babies have surgery, pain, infections too.

[The4OfUs]

Hale's is also in searchable format online at Amazon!

http://www.amazon.com/gp/reader/0977...22#reader-link

you can plug in the drug name and find it, and it even gives alternatives.

Good luck with your surgery and stand up for yourself and your babe!! :

[2boyzmama]

I'm sure you've gotten the drift by now, but most drs have no clue what's safe and what's not, so they just give a blanket statement to avoid BF while on any drug. Ridiculous.

My sister had two pretty big surgeries recently and she called me in a panic the night before the first one and we went through the list of drugs one by one. One of her drugs needed to be modified, but otherwise she was just fine. Her baby kept nursing with no problems.

After her second surgery was a different story...her baby self weaned. Now, there were several contributing factors...one is he was older (9 months), two he was started on solids (and has older siblings that he desperately wants to do everything they do...including eat "real" food) and three it was her second big surgery in two months and her milk supply had started to lower becuase of all the drugs, and probably was tasting a bit different. And she was puking up everything, under a lot of stress, etc.

I doubt that will happen to you because your baby is younger, not on solids, and it's only one surgery with a short time on any meds.

Don't be afraid to fight with the drs!!

[pumpkin]

I've had several surgeries over the years and have recovered from all of them without pain medication. I can't take the pain meds because they make me violently ill - every single one I have ever tried - and I end up much worse off then if i had not taken any medication.

So if it comes down to it, while recovering from surgery without pain meds isn't fun, they certainly are not necessary.

[mommadotta]

Ah-- correct spelling helps! Thanks again for all the info and support. The ped said I should wait ~24hrs for the anesthetics to clear, while the LLLI leader said it should be OK to BF as soon as I'm feeling alert. WWYD?

I guess what I'm wondering is, how long is it most likely OK to keep DS on the bottle without serious risk of self-weaning? I know that he can go for ~8-9hrs on the bottle with no problem, since that happens twice every week. But how risky is 24hrs?

[eclipse]

You should be fine to nurse once you feel alert enough too - just like a mom coming off of c-section anesthetic. Your baby is really young - I wouldn't risk going any longer than necessary without nursing. The amount of meds that pass to milk from most medications is negligible.