nursing after surgery

[LucyG]

I found out today that I definitely have to have my gall bladder removed in a few weeks. The surgeon told me to plan on not nursing for 24 hrs., but I called the lactation consultant, and she said I should only have to "pump and dump" one, or maybe two, feedings. Has anyone else had general anesthesia while nursing? How long did you wait to resume bf after surgery? As I understand it, post-op pain medication can be chosen so as not to interfere with bf.

[nigele]

I wish I had more info. for you but I wanted to tell you my baby had general anesthesia himself for surgery so I wonder why they think you cannot breastfeed after getting anesthesia yourself? If I were you, I would check with one or two more lactation consultants to see what the concensus is. Also, did the surgeon think the anesthesia would be the problem with nursing, or rather holding the baby against your wound??

[LucyG]

I'm fairly certain he was thinking of anesthesia's effects on the baby, rather than of my incision. I'm planning to have the surgery done laproscopically, so the wound(s) should be small.

[COElizabeth]

I think that the general principle most doctors follow is that the baby in this case is an "innocent bystander" and that he or she should not be exposed to drugs through breastmilk, even if those same drugs would be considered safe if the baby needed a procedure himself. The doctor basically views any possible side effects from anesthesia as a risk tradeoff that is worth it for the benefit of a baby having the eye surgery, for example, but doesn't see any risk to the baby of not nursing for a day or week or whatever when the mom has a procedure. I don't think that's a completely accurate view, because there are some risks to interrupting nursing - like in my case, where James basically hardly ate anything for the 24 hours we had to stop after I had a bone scan.

I did talk to the radiologist a couple of times before the procedure. He first told me I needed to stop nursing for 48 hours, but when I quoted a Nuclear Regulatory Commission recommendation to him he said 24 hours was okay. He also clarified that babies do sometimes get bone scans and that even if I nursed right away, the dose of radioisotopes the baby would get through the milk would be much less than if he himself received a bone scan. This did reassure me a lot. Regardless of the "innocent bystander" principle, I now felt that if things got really, really bad (screaming wise!), it would be a very small risk if I nursed early. We made it through the 24 hours, but it was comforting to know that the risk was getting smaller and smaller by the minute. My internist had also told me that the risk was small no matter what.

I think the risk is probably considered even less for some other drugs (I had actually gotten radioactive substances, which was kind of scary). I would talk to the doctor again, tell him or her it's important to you to minimize the disruption, clarify what drugs you are likely to receive and ask the lactation consultant to look them up in Dr. Thomas Hale's book on Medications and Mother's Milk. His book has really good information on how long drugs stay in the body, how likely they are to pass into milk, etc. Also, ask your doctor if there is anything you can do to help your body get rid of the drugs. The radiologist told me that the isotopes would be excreted in urine, so the more I drank, the faster they would leave my body.

If you have trouble finding info, let me know and I will try to help. I know how confusing and upsetting the prospect of an unwanted interruption can be, but you and your baby will make it! I had a bad night of trying to feed my crying son milk through a Motrin dropper because he was refusing the bottle, but we made it through and all was fine again the next day! Good luck!

Elizabeth
Mom to James
9-20-02

[newbelly2002]

Lucy,

As I mentioned to you in the other post, docs and LCs can give very different opinions. One of the best people to speak with, however, is the person who knows the medicine the best: the anesthesiologist. He/she will be able to not only know the effects of the meds in and out but help you choose the best meds for your procedure and situation.

To pump and dump one feeding post-op is actually being very careful--my LC told me I didn't even need to do that. For me, it was really important to make sure DS got the milk he needed (of course, we were only 2.5 weeks post delivery) once I was told I was in a safe zone. And while the wounds are small, they are really inconveniently placed when it comes to nursing--be aware!

And to answer your other question, DS and DH did stay overnight with me in the hospital. We were able to make that decision after the surgery and I really appreciated the hospital being felxible on that point.

Let me know if you have any questions. I'd be happy to help out. I'm sorry you have to go through this but it does make for a MUCH better quality of life (and no more panic about what food will trigger the next attack!)

Paula, Mama to Dante 8/1/02
http://www.shutterfly.com/osi.jsp?i=67b0de21b339c8d20516

[ginalc]

Hi LucyG,

I had my gallbladder removed a few years ago, and I can tell you, the LAST thing on my mind directly after surgery was my child! Even done laproscopically, this procedure knocked me off my feet. I was in terrific shape before the surgery, yet it took me 2 weeks to feel like I could stand up straight again. The procedure leaves you feeling bloated and uncomfortable. Perhaps your surgeon is just considering how YOU are going to feel after surgery, regardless of the medication.

I would recommend pumping and having enough milk for baby to drink from a bottle for 3 days straight. Hopefully, you'll feel fine and be ready and willing to nurse. If not, at least you'll have some on reserve.

Take your pump to the hospital and let the Lactation Consultants there know you're having surgery. Consider scheduling them to come to the room and assist you in pumping or nursing baby after surgery.

Also, you may benefit from speaking to baby's pediatrician and asking for suggestions.

HTH,

gina, mom to 3