LACTNET Archives

Lactation Information and Discussion

LACTNET@COMMUNITY.LSOFT.COM

Options: Use Forum View

Use Monospaced Font
Show Text Part by Default
Show All Mail Headers

Message: [<< First] [< Prev] [Next >] [Last >>]
Topic: [<< First] [< Prev] [Next >] [Last >>]
Author: [<< First] [< Prev] [Next >] [Last >>]

Print Reply
Subject:
From:
Pamela Morrison IBCLC <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 12 Sep 1996 00:19:00 GMT+0200
Content-Type:
text/plain
Parts/Attachments:
text/plain (48 lines)
Laura - Welcome to Lactnet, isn't it great?  A couple of years ago I worked
for a short time with a mother who had brain surgery, I was never really
sure what for, an enlarged blood vessel of some kind.  She was just about
comatose for several days in the Intensive Care Unit and she had an
exclusively breastfed baby - at home - who was bottle-fed during mother's
hospital stay.  The mum was really motivated to continue breastfeeding after
the surgery, but I was only consulted shortly beforehand so there was no
time to suggest that she pump in advance to leave EBM for the baby.
My care consisted of visiting daily to instruct the nursing staff how to
maintain the mother's breastmilk supply and prevent the breasts from
becoming engorged.  She was lying flat, it was difficult to pump so I showed
the staff how to massage and manually express the breasts and suggested that
this be done every four hours.  Somehow every time I went in there were
different nurses and I realized that they were only occasionally (rather
than regularly) expressing. I am not a nurse, and I found it personally very
distressing to go and examine and express a "body" that didn't respond in
any way, but I would always talk to her as if she WAS awake and tell her
what I was going to do and why etc.  Later she told me how much she
appreciated this, she could hear me all the time, she always knew when I was
there!

The interesting thing was that breastmilk production slowed dramatically,
right from the beginning, even though I knew the nurses were NOT following
my suggestions and it would reasonably be expected that there should have
been massive engorgement. But the breasts became only a LITTLE firm and it
was difficult to express more than a very small quantity of milk - about 20
ml.  After 4 days or so her condition improved to the point where she was
moved out of the ICU and she was more wakeful.  As this happened the
breastmilk supply increased.  She was still flat, but when I showed yet
another nurse how to manually express the "squirt" went right up and over
the top of the curtains around the bed like a fountain.  She was eventually
able to express the breasts herself to maintain her supply, was discharged
home after 2 weeks and went home to partially breastfeed her baby.  She
lived about 200 km away so I lost touch at this point.

I've had two other clients who were unconscious and whose breastmilk
production also just mysteriously dwindled dramatically - one was a car
accident victim, the other had puerperal psychosis (massive doses of IV
chlorpromazine).  Again the breasts became just a little "firm", and
quantity of EBM that could be expressed was very tiny.  The car accident
case was grief-stricken about the loss of her nursing relationship when she
finally came to and worked over the next three months to bring back the milk
and succeeded although the baby couldn't be persuaded to nurse again.  So sad.

Hope this helps a little. Best wishes to your client.

Pamela, Zimbabwe.

ATOM RSS1 RSS2