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Thread: supply issue after surgery

  1. #1
    Join Date
    Mar 2006
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    54

    Default supply issue after surgery

    Hi, I'm new here. I have a 4 week old baby who is mostly breast-fed. He was a little premature so we have been pumping and giving him one bottle each night (from daddy) since he was about 5 days old with no problem (on the advice of the LC - he had trouble staying awake long enough to eat enough because he was born early).

    Anyway, things were going fine until last week, when unexpectedly I had to have surgery. I had spinal anesthesia so I could continue to breastfeed and not need to "pump & dump" any milk, but still I was away from him for about 10 hours. I was only able to pump once during that time (after about 6 hours since his last feeding in the morning) because I couldn't sit up well until then! And I was too sore to nurse him much for the first 48 hours after surgery except side-lying, and he tends to doze off in that position and doesn't nurse as well. I nursed him that way every other time, and my husband or MIL gave him bottles of either pumped milk, or then lacto-free formula when the frozen milk ran out.

    So now I'm dealing with my supply having diminished greatly, even though it was only 2 1/2 days of disrupted schedule. I'm trying to find mother's milk tea or just fenugreek capsules around here but not having much luck. I'll try two more stores tomorrow, then I may have to order online. I wanted to buy it in person so I don't have to wait.

    I am nursing him at every feeding now, but 2-3 x a day he has literally emptied me, and cries because he continues sucking and there is NOTHING more coming out but he's still hungry, so he's been getting 4-6 ounces of formula per day total (2 ounces at the end of the nursing sessions when he's still hungry). I then try to pump an hour after the feeding but am only getting 1/4 ounce usually.

    This is so frustrating. Of course I am not giving up BFing but I want to be able to cut out the formula too! Is there any hope? Is there something else I should be doing? I've been switching breasts several times during the feedings because I read that gets more milk into the baby - once he starts to slow down or weaken his suck, I burp him and switch sides. He is nursing on each breast at least twice at each feeding.

    Any advice or anyone who has been through something similar, I would greatly appreciate hearing about it!

  2. #2
    Join Date
    Jan 2006
    Posts
    683

    Default Re: supply issue after surgery

    If you had an adequate supply prior to the surgery then it shouldn't be too difficult or take too long to get your supply back to where it was before the surgery. As an example, if a mother stopped nursing entirely for 2 days it would take her about 2 days of near constant nursing to get her supply back to where it was on the day she stopped nursing. Make sense?

    Keep in mind that baby guzzling down a bottle of formula after a marathon nursing session or crying after such is not an indication that mom's supply is low. The only way to know whether baby is truly not getting enough from mom is if baby fails to gain weight. A good indication this is to monitor baby's wet and poopy diaper output (unless baby is older than 6 weeks old and then poops can be more infrequent than they were previously).

    It sounds like you are doing great in helping to increase your supply. You mentioned that you are pumping after each nursing session -- what type of pump are you using? If it's not a hospital-grade double electric pump then you may want to look into renting one, just until you get over this hump. Keep in mind that fenugreek or any other galactogogue is only effective if it's coupled with increase breast stimulation. Ideally you'll want to either nurse or pump every 2 hours. You should see an increase in your supply within 24-72 hours. You would probably also see the same increase in your supply if all you did was pump or nurse every 2 hours (meaning, the fenugreek may not be necessary). Also, while baby is nursing you may want to try breast compressions.

    Here is some additional information for you:

    How Can I Increase My Milk Supply?
    How can I tell if my baby is getting enough milk?
    I would like to resume breastfeeding after an interruption. How do I relactate? (I realize that you aren't relactating, but this link has information on fenugreek & other herbs used to increase milk supply)

    HTH & good luck!

  3. #3
    Join Date
    Mar 2006
    Posts
    54

    Default Re: supply issue after surgery

    Thanks so much for the quick supply. I use a Medela Pump In Style double electric pump. Do you think a hospital rental pump would be that much better? We have no insurance coverage for breast pumps so we'd have to pay $50 to rent one for a month. The only problem I have with the PIS is that the pieces take a long time to dry out completely and if there is even a tiny bit of water (like even a droplet) inside, it gets into the tubing when I start up the pump. Hmmm. So I wash the pieces after each use but then it takes a long time for it all to dry out inside. I can't think of what you call the piece I'm referring to - the part that the shield, valve, and bottle and tube all attach to.

    I got some Mother's Milk herbal tea today. I'm going to start drinking it 3x a day and see if it makes any difference.

    Things are made more difficult by the fact that I'm still healing from surgery, so if he doesn't wake up to nurse, I'm not getting up to pump or wake him because I need the rest! Hopefully it will get better soon!

  4. #4
    Join Date
    Jan 2006
    Posts
    683

    Default Re: supply issue after surgery

    I don't think you need a different pump - the PIS is a good pump. Perhaps you could buy a second set of pump parts?

    I understand that you are needing your rest and need to heal and there's really no reason to pump during the time that baby is normally asleep. Just try to nurse him every 2 hours during his most active time. You may also want to try co-sleeping with him so that you can rest and nurse.

    Let us know how your progress goes I'm sure you'll do great!

  5. #5
    Join Date
    Mar 2006
    Posts
    3

    Default Re: supply issue after surgery

    I felt a lot better after reading this. I am having surgery on Friday. I am terrrified that my milk supply will not make it through my stay in the hospital. I am having a tumor removed from my panceras. It will be a 3 hour surgery and I will be in the hospital for 5 days. My baby is only 3 1/2 months and I really want her to continue to breastfeed. I have pumped and stored about 125 ounces but I have no clue how long that will last. As long as I continue to pump and dump in the hospital my milk supply should remain right? Are there any pain medications or antibiotics that are safe to take while nursing? Are there any medications that decrease milk supply? The doc that is performing the surgery is great but he seems to know so little about nursing.

    I just ordered the Mother's Milk tea. I hope that will help!!

    Thanks for any advice!

  6. #6
    Join Date
    Jan 2006
    Posts
    683

    Default Re: supply issue after surgery

    There's really no reason to pump and dump! There are a host of medications (antibiotic, painkillers, etc) that are compatible with breastfeeding. My best suggestion is for you to get a list of the medications that the hospital will have you on and we can look those up in Hale's for you.

    Is there anyway that baby can be with you at the hospital so that you don't have to pump and can simply nurse directly? 5 days is a long time for a 3 1/2 month old to be away from mom!

    Keep in mind that Mother's Milk Tea or any other galactogogue is only effective if it's use is coupled with frequent nursing or pumping. Taking a galactogogue on it's own is unlikely to yield any measurable milk supply increases

  7. #7
    Join Date
    Mar 2006
    Posts
    3

    Default Re: supply issue after surgery

    Thanks for the quick response! The day before surgery I will be on Fleet phospho-soda, flagyl, and neomycin. It was recommeded that I do not nurse that day. What do you think? I would love for her to visit in the hospital because I will REALLY miss her but my husband and I are scared that she will get sick.

    Any recommendations on positioning? My incision will be under my right ribs.

  8. #8
    Join Date
    Jan 2006
    Posts
    683

    Default Re: supply issue after surgery

    Fleet phospho-soda is just a laxative - Hale shows it as a LRC L1 (safest).

    Flagyl is an antibiotic that Hale shows as a LRC L2 (safer).

    Neomycin is not shown in Hale's book, however he does say this about it in his medications forums -- Neomycin

    I hope this information helps you in your decision as to whether to nurse the day before surgery! Since you'll be on antibiotics you may want to incorporate a probiotic so that you can ward off thrush

    As for positioning -- perhaps the football hold or side-lying.



  9. #9
    Join Date
    Mar 2006
    Posts
    54

    Default Re: supply issue after surgery

    I know that when I had my surgery, the anesthesiologist was very informative to me about pain meds. He said that even if I'd had general anesthesia (which I didn't, I opted for spinal) there would be little of it in my breast milk and BFing would be fine. He also said that even the strong pain meds after surgery (like Demerol injections) may cross into the breast milk in small amounts but it's not going to hurt the baby. He was talking about molecules and how they have to travel through your liver before they'd enter your breast milk and would probably be broken down because they are small molecules... I'm really not good at chemistry. :P But I just wanted to tell you what he said. I'm sure your anesthesiologist can explain it as well. I took Darvocets for about 5 days after Truman's birth and again for about 4 days after my surgery and it seemed to have no effect on him at all. He didn't even sleep any more than normal.

  10. #10
    Join Date
    Mar 2006
    Posts
    3

    Default Re: supply issue after surgery

    Thanks for all of your information and support. This has been a very difficult time for me and my family. It helps to know there is a place I can turn to for support.

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