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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>>
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