Hi Nikki vbg :-) and all,
To refresh everyone's memory, this is about the woman whose bone marrow was
killed by a virus and she is awaiting a bone marrow transfusion.
My big thanks to my co-Leader Michele for posting my question on Saturday.
I was in St. Louis (3 hours from home) helping my brother look at houses
when I got the very frantic call from the Mennonite family's private nurse.
Why is it that all the calls I get when I am at home are about "what time is
the meeting?" and when I am out it is something that I need to look up?????
I spent the whole day on one cell phone, using 4 total phones because not
one of us had a charger with us.
I didn't hear back from any of your Lactnetters Saturday but I did manage to
get a hold of LLLL/IBCLC Dee Kassing and LLLL/MD Carrie Vlastos (Thanks Dee
and Carrie!). We tried really hard to look at this situation from the doc's
perspective to see if we could think of any reason why breastfeeding might
be contraindicated. The conclusion that we came to is that the doctor is
focusing on the wrong possible problem.
Here is what we came up with (VERY condensed for time)... First the
doctor's concern.
-She is bruising very easily right now. Is it possible that while
breastfeeding, the compression from baby or suction from pump would cause
bruising, and since her blood won't clot--that she might in his words "bleed
to death"????
We know that breastfeeding is not contraindicated in anemia, so we ruled
that out as a problem. Also we figure that the transfusions she is
receiving are giving her enough clotting ability, that this really shouldn't
be a problem. So we ruled this out. However, here is what we are more
worried about.
-What we all agreed was more of a concern was preventing her from getting an
infection. She has had trouble with plugged ducts and mastitis for much of
her nursing experience. Since she is having to rely on the transfused blood
to provide all her white cells, if she were to get mastitis from abrupt or
even partial weaning, it would be way too easy for the mastitis to become a
systemic infection. We figured that the doctor should also be worried about
germs the baby would bring in off the street. But we ruled this out,
because I think she is allowed to have visitors!
-The other concern that we felt might actually carry some weight and we
would like some opinions on is: since this mother is having to rely solely
on the white cells in the transfused blood for her germ fighting defense and
can't make her own AND knowing the white cells are involved in the process
of making milk---could breastfeeding impede her recovery--due to the fact
that she has a static number of white cells and isn't producing extra?
Honestly I amazed that she was making any milk. (I need to go reread how
milk is made :-) When the nurse and I talked the first time, mom reported
that she was very full and was demanding to feed her baby. (BTW, baby is
being wetnursed by her sister.)
The last time I talked with the nurse on Saturday she said that the mother
had been put on 3 or 4 different antibiotics. One of which was for herpes.
The mother got very angry and refused to take it-asking the nurse just how
she would get that while in the hospital?? Good question!
I haven't heard anything more from the family but I would very much like to
hear from you all.
Warmly,
Nikki Simmons in Missouri
-----Original Message-----
Part of the medical staff is supportive of her continuing
breastfeeding but a new Dr. today said she must stop immediately because
Dr.
is afraid mom will bleed to death because of breastfeeding.
Dear Friends:
Will the baby suck all of the mom's blood out through the nipple and
turn her inside out, so that her innards fall all over the floor?
This better be good!!!!
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
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