have to suddenly pump round the clock

[lovely rita]

I've just got home from a 2-day hospital stay due to MRSA and am looking at 7-10 days of heavy antibiotics that will prevent me from nursing.

My dd is 14 months old and had been nursing pretty frequently. I want to try to keep my supply going during this time (also want to avoid plugged ducts/ mastitis issues), so I've rented a hospital pump-- Medela Lactina-- but I don't have any of the accessories. Can all the accessories be purchased at Target? I've never used an electric pump before-- I have no idea what I'm even looking for.

How frequently should I pump to prevent my supply from tanking? What are the chances she's even going to be interested in nursing after 10 days away? She's so stinking confused. My heart is going to break if this is how we end up weaning.

[blueridgewoman]

Wait, what antibiotic are you taking that will prevent you from nursing? I was hospitalized for staph too when dd was a week old and I pumped at the hospital and nursed as soon as I got home (and I do mean as soon as-- I'd barely gotten in the door and dd was on my breast ). Since, I've been on four courses of antibiotic by mouth and two courses of IV abx in the hospital and I'm still nursing. I guess I'm just hoping you received some bad information regarding what you'll be taking and you can still nurse.

In terms of the pump, I think the Lactina takes the same equipment as the Pump in Style except possibly for the tubing. I used a Symphony at the hospital, and that was the case. I'd check on the Medela website or possibly give them a call.

Do you have a lactation consultant in the area, or a local La Leche League? I would email or call them right away. I dealt with a lot of pain after my first bout of staph, and then got thrush from all the drugs, plus dd was confused after not nursing for a couple days since she was so young. I'm not saying this to scare you, I'm just thinking that a good LC could really help you out with all this.

I'm so sorry for what you're going through. I know how it feels and it really sucks.

[guestmama9904]

yikes, im so sorry you have to go through this! what medication are you on?
as far as pumping i guess i would say every 3-4 hours for 10-15 minutes. my son nursed a LOT at 14 months, like every 2 hours or so.

[stickywicket67]

where you rented the pump should be able to sell you a packet w/ the 2 tubes, breast cups and parts, and bottles for the pump you rented. i think i paid $40 for all of it when i left the birthing center's lactation office w/ my rented pump. (they should have offered them to you when you rented the pump- it seems weird they didn't.) i had a Lactina i rented and the parts are the same as the PIS Advanced. i think you can buy most accessories at Target. or online. or call your local LLL they probably would know.

not sure about how often to pump to keep up supply. someone else with more experience should answer that question.

good luck.

[blueridgewoman]

Okay, it looks like the tubing is the same as the Pump in Style Advanced (NOT the normal Pump in Style!). Here is a picture.

http://www.amazon.com/Advanced-Symph...ges/B000PE8E0E

I think that all the other parts are exactly the same regardless of the Medela pump you get. I've always been able to find Medela stuff at BRU and that's probalby your best bet if you have one. They definitely have the breast shells, bottles, membranes and all of that there in little sets so you don't have to worry about forgetting something.

Would the hospital or wherever you rented the pump have rental kits with all of this, possibly?

[blueridgewoman]

Oh, and I pumped every 2.5 hours for 10 minutes when I had this issue.

Sorry, I'll shut up now.

[MaryJaneLouise]

Seriously, what drugs are you on? Someone can look it up in Hale's Medications & Mother's Milk for you, for its true safety. most doctors don't know anything about bfing safety.

[thixle]

Originally Posted by MaryJaneLouise

Seriously, what drugs are you on? Someone can look it up in Hale's Medications & Mother's Milk for you, for its true safety. most doctors don't know anything about bfing safety.

I totally agree with everyone else here.
They usually say pump and dump for everything, you have to pry to find out if it is truely unsafe. And then almost every drug has an equally effective bfing safe equivilant.

here's a big rant from me, and my DD was about the same age as yours is now: http://www.mothering.com/discussions...d.php?t=827191 post #5

Oh, and since you are taking a hard course of antibiotics, check into probiotics. You take them 2 hours before or 2 hours after taking the antibiotic and it REALLY helps prevent yeast infections and thrush. You can even just eat/drink gobs of yogurt with live active cultures (2 hour rule) for a similar benifit. I wish I knew that the first time I was on long term abx. DD and I both had yeast problems!

[blueridgewoman]

Yep, I have several bfing books and stuff, and all say that most abx are perfectly safe. So does Dr. Sears' baby book.

[lovely rita]

Thanks for all the replies. I went back to the place where my mom rented the pump, and they did have the accessories kit for sale. So I tried to use the stinkin thing and just got drops, and reverted to my hand pump. I guess I'll just keep trying.

The abx that everyone (doctor, LC) was concerned about is called doxycyclene, I believe. I tend to trust them, because the other abx (bactrim) also says not to take while bf'ing, but they both said "that's actually ok." Plus-- the milk I've pumped so far is green. Really green. Of course that could be from the post-op narcotics. Ugh.

I'm just sad right now. And feeling sick. And it was almost easier in the hospital because my little sweetie had no opportunity to grope at me and look up with sad eyes when I say no. :-(

I'm trying to wrap my head around the possibility that this could be the end for us. I wanted to make it to at least 18 months, but part of me is just feeling very pessimistic that we'll recover from this.

[lovely rita]

Oh yeah, and maybe this should go in Lactivism, but I have a long list of hospital personnel to complain about for their totally dismissive attitude about the fact that I'm still nursing. Almost every person I encountered was like, "Oh, well she's old enough to wean anyway, so this is a no-brainer," and offered no support on the matter. I mean-- hello!!!-- even if you think this is the right age to wean, you'd have to be an idiot to think this is an appropriate way to wean-- abruptly from 4-5 full feedings a day to nothing at all.

When I went in for surgery, this totally bitchy nurse said the above, and when I responded with, "Well, she's still very attached to it, so I intended to wean quite slowly," she laughed and said, "Well of course she's gonna get attached, but that's just something you gotta get over sweetie! I nursed mine for a year, so I understand, but it's time honey!" And I'm thinking, what did you do, say "Happy Birthday, no more milk for you"? Does she seriously think it's ok for it to happen so quickly? For either of us? The last thing I need right now is a bout of mastitis.

So instead of counting backwards from 10, I was ranting: "Listen, nobody seems to understand that this is important to me. My baby was nursing a lot, and that complicates things for me and I need you to get that. It's an emotional issue, but it's also a physical issue because I risk further infection if I stop suddenly. I need you to get that. Please." That's the last thing I remember saying. Take that, bitchy nurse!

[thixle]

However, a close examination of available literature indicates that there is not likely to be harm in short-term use of doxycycline during lactation because milk levels are low and absorption by the infant is inhibited by the calcium in breastmilk. Short-term use of doxycycline is acceptable in nursing mothers.

From LactMed, my new favorite website
http://toxnet.nlm.nih.gov/cgi-bin/si...temp/~2p4q5H:1

Hope that helps! Rest assured you can nurse *some* even if you want to pump part time. But with her age and weight (more than an infant, I assume), I would say nurse and cuddle until you both feel better.

eta- it looks like the main side effect is tooth staining? but the calcium in bm keeps the baby from metabolizing- see also tetracycline

[blueridgewoman]

I'm guessing that the milk is green because of the infection. Mine was yellow and clumpy.

There's a thread in Lactivism with a link to a WHO document w/ acceptable meds. I'd check there and call a LLL leader. I'm so sorry you got such crappy support.

[elanorh]

I wonder whether nursing her 1-2 times a day would be fine, at least, given the above information. I think personally I might try that route, if I were in your shoes - both to help with maintaining supply, and to help in maintaining some semblance of nursing for your little one during this tough time.

I know that older nurslings sometimes go a week or more without nursing and then resume again - in the CLW forum people talk about that. Hopefully yours will do the same, I'd think that at 14 months especially if you are still nursing a little, you could get her back to breast.

You've got a lot larger fish to fry right now, with pumping and recovery etc., but - when you're recovered, the AAFP quotes on the risks of weaning prior to 2 years of age, etc. could be great to send to the hospital in a letter of complaint. The lactivism forum could help with reviewing the letter and suggesting what to cite.

My 'round the clock pumping experience was when Ina was much younger (3 to 4 months and then some) -- but she did return to breast successfully.

[guestmama9904]

my best friend had a tonsil absess and was on intravenous doxycycline and was breastfeeding. she was also needing to take liquid vicodin. her baby was fine and so was she. i would simply breastfeed, forget the pumping.

[thixle]

Originally Posted by blueridgewoman

I'm guessing that the milk is green because of the infection. Mine was yellow and clumpy.

Plus-- the milk I've pumped so far is green. Really green. Of course that could be from the post-op narcotics. Ugh.

I woke up thinking about this-- Breast infection can make your milk lumpy and yellow. I'm assuming the OP didn't have MRSA in her breast tissue because she is worried about mastisis... So, it would have to be a severe infection of the brest to make her milk green. Narcotics do not make your milk green.

Is it a pale almost flourescent green? Did you have a CT scan or anything looked at with radioactive dye? That can tint the milk green, I have been there a few times. And yes, you have to pump and dump 12-24 hours after radioactive dye has been injected (usually do it through your hand). The green stays about 3 days, but is not harmful to an infant (super low dose)-
and because of weight, a toddler would be getting less.

Also, I was on a long term antibiotic- 8 months (so a 7-10 day treatment is a short treatment). The antibiotic tinted my milk blueish, like the green from the CT, but blue. Slightly flourescent- like teeth that have been bleached way too much. It also made my urine brown. From the med's text, only tiny amounts of the med were excreted in bm, and the heavy wastes of the antibiotic were flushed through the urine.

lovely rita--I keep posting here because it is incredibly hard to fight doctors. You shouldn't have to - they should be there to protect you and make you feel better physically, without screwing with your children and trying to make you feel like a freak for breastfeeding.

The medicine you are taking is 'proven safe' for short-term use while nursing. Yes, a small amount of medicine will pass through your breastmilk... Would this medicine be used in a child/toddler with MRSA? In much higher doses than found in your milk? What is the safe limit for your DD's weight? Is she going to exceed that amount drinking your milk? You have to make the choice that is right for you.

I *personally* would take the pump back and nurse my child. I take 14 pills every day- 5 different medicines daily- that are 'proven safe' or 'not proven, but likey safe' for use while breastfeeding a toddler. I've had the run around in the hospital with the doctors telling me my daughter was to old to nurse at 14-15 months... of course, one of those doctors is now my specialist that I see every few months. Every time he gives me a new prescription, I tell him I'm bfing, he asks my daughter's age and weight, then types it into his database to see if the med is safe for her... It took a year to get to this point with him, though, and he still rolls his eyes (DD is 2.5 now) but he knows now that it is important to me and I will change doctors if he gives me a hard time about extended bfing...

[blueridgewoman]

I totally, totally agree with thixle. As usual.

[lovely rita]

Thanks again. I read the link you sent, thixle, and phoned two different LC's to see what they thought. Everyone said that with her age, weight, and somewhat varied diet, the short-term use of the abx, and available data about how much is actually secreted in milk, it would definitely be safe to nurse once or twice a day, maybe more. So the plan is to keep pumping during the day and nurse at bedtime. If my supply seems to dip anyway, I'll add a second feeding in the morning. I know it's almost certain that nursing like normal would be ok, but for now I like the peace of mind of keeping the quantity of milk a bit lower than normal.

So I nursed her at bedtime tonight. She stared at me for a second, like "Are you SERIOUS???" and then nursed for a good long time. Then she smiled blissfully. It was sweet.

[lovely rita]

Oh yeah-- and my pumped milk looked and tasted normal this afternoon, so that was one more check in the "go ahead and nurse" column. No more green.

[blueridgewoman]

I wish you all kinds of luck. You're a good mom for keepin' on.