----- Original Message -----
From: "MomtoLJ" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, July 14, 2005 11:39 PM
Subject: Re: post-op feedings in nicu
>I totally agree with what Katie said here, and I've had lots of personal
>experience. Lexie had surgery at 6 months, 18 months, 2 1/2, 4 and then at
>7, something like that. Those were for her eyes. Breastmilk was the first
>thing she had after all but the six month one. After that surgery the
>nurse wanted her to drink 4 ounces of water, she never had water in a
>bottle and didn't know what to do with it. I was not as strong and so I
>gave her a little, tried to make her take it, and finally gave up, sucked
>down the water myself, went to the door and showed the nurse the empty
>water bottle and she nodded and so I breastfed Lexie immediately. With the
>other surgeries I was stronger, and just nursed her, period. She always
>seemed to have an easier time coming out than the other babies in the
>recovery room who were a. not with mommy (I always insisted on being there
>immediately and generally held her as she was waking up), b. being given
>juice or water. Lexie had bowel surgery when she was nearly three, and was
>NPO for a good 36 or so hours post op, and then her first food was
>breastmilk. She did recover fairly quickly but breastmilk was really the
>only thing that didn't irritate her tummy until she was a good week post
>op.
> Joylyn
>
> Kathryne Bredbeck wrote:
>
>> I don't work in the NICU, so I don't know if my comments will be of
>> interest to you or not. However, I have a 15 month old who has had 3
>> minor surgeries and 2 major surgeries---usually on his urinary tract.
>> I'm also not sure if this information will be pertinent since the baby's
>> surgery is on the bowel.
>>
>> After ever surgery my son has been permitted to breastfeed directly or
>> take breastmilk (if his suck was still too uncoordinated) as soon as he
>> felt ready...which is always right away. This was true at ages: 10 days,
>> 30 days, 46 days, 1 year, and 13.5 months.
>>
>> I have also had a case where the nurse was willing to let him nurse as
>> long as he didn't begin to vomit. My son has never vomited breastmilk,
>> but he has vomited pedialyte and apple juice. (This might be a good
>> point to make---that breastmilk is antinauseating.)
>>
>> I have had another case where is suck was very uncoordinated, and I was
>> able to convince the nurse that he wasn't gulping milk so was ok.
>>
>> From my person experience, the person to go to is the Surgeon. The
>> surgeon can write the orders for the baby to be permitted to breastfeed
>> immediately on waking. Working with the surgeon is key to a successful
>> surgery as well as FEELING the surgery was successful. I find surgeons
>> to be very reasonable, but they like quick facts that are precise and to
>> the point. If the mother can put forward a good case to the surgeon, and
>> if the surgeon does not have any medical reason that it is not possible,
>> then the surgeon will usually help the mother get what she wants. It
>> will also help for her to remind others of what the surgeon told her.
>>
>>
>> Some general things about breastfed babies and surgery:
>>
>> Remind the mother to pump every two hours while the baby is NPO and in
>> surgery. If the baby continues to have an uncoordinated suck for long
>> after surgery, pump afterwards until baby's mouth returns to normal.
>>
>> Let the mother know that the baby's sucking mechanism needs to be closely
>> monitored after having endotracheal anesthesia. It was mentioned to me
>> by the former surgeon and the new SLP well after the fact that
>> endotracheal anesthesia can cause the infant to protect their airway thus
>> altering their ability to breastfeed. This can be fixed with the help of
>> a good speech language pathologist, but it is much easier to fix if
>> caught earlier than later.
>>
>> Remind the mother that it is her baby. Even a breastfeeding mother tends
>> to lose this I think when there is surgery involved with the baby. There
>> is a detachment process that is involved with every surgery. Holding the
>> baby close to the breast afterwards is very healing no matter if the baby
>> is permitted or can nurse or not.
>>
>> And in the words of my baby's surgeon: "You don't have to convince them
>> of anything. You tell them what they can and cannot do, what you will
>> and will not allow." I find that when following this advice, the medical
>> staff is more likely to treat me as (a) an adult and (b) a partner in my
>> child's care and health.
>>
>> One last thing: I found an article on Kellymom.com that was helpful:
>> Breastfeeding the Hospitalized Baby by Cyndi Egbert. That and general
>> info about surgery for the baby can be found here:
>> http://www.kellymom.com/health/illness/baby-surgery.html
>>
>> Katie Bredbeck
>>
>> PS: For sedation procedures (of which he has had 10 or more), the nurses
>> seem less likely to permit breastfeeding immediately --- they want him to
>> have pedialyte or apple juice first. It depends on the nurse though, and
>> the doctor ordering the procedure and the procedure itself. I also find
>> with sedation that his suck is less coordinated.
>>
>>
>>
>>
>>
>> On Thursday, July 14, 2005, at 05:49 PM, Sharon Knorr wrote:
>>
>>>
>>> Just got back from ILCA and am working on a new case sent to me by
>>> email.
>>> Can any of you who work in the NICU give me some guidance here? I have
>>> been
>>> unable to get detailed info yet, but the basic question is, what is the
>>> standard of care for post operative feedings for a breastfed baby? Baby
>>> had
>>> part of bowel removed. Plan is to start with Pedilyte, then pedilyte
>>> plus
>>> breastmilk and then exclusive breastmilk. Is this pretty standard
>>> treatment? I know for adults you get nothing, then clear fluids, then
>>> soft
>>> foods and back to a normal diet as tolerated. I know that most
>>> institutions
>>> do not consider breastmilk to be a clear fluid. Mom would like to go
>>> directly to breastmilk from IV. Any guidance would be appreciated.
>>>
>>> BTW, both the LLLI and ILCA conferences were wonderful. Had a great
>>> time
>>> and enjoyed talking with many of the folks from Lactnet. Hope that you
>>> all
>>> had a nice and safe trip home.
>>>
>>> Warmly,
>>> Sharon Knorr, BS, IBCLC
>>> Newark, New York
>>>
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>> "Beer is proof that G-d loves us."
>> ---Ben Franklin
>>
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>
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