Help - will 4 week DS return to the breast after 3 days FF?

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Rushed to hospital on Fri night with suspected appendicitis. Just got out of surgery. Had no frozen expressed milk as 4 week old DS was BF on demand and it was going brilliantly.

Apparently he has taken to the bottle + formula like a duck to water - I begged for a pump here in hosp so at least trying to maintain supply but the milk is contaminated with all the drugs I am on. I will prob be able to start bf again when I get home - now in pieces DS will reject me any advice to get back on track with BF?

You can get meds that are compatible with bfing, the Drs may grumble about it but if they check in Hale's Medications & Mother's Milk they will find compatible drugs (not BNF - too conservative and doesn't seem to have latest research even in the most up-to-date editions).

I had pancreatitis and in hospital for a week when DD3 was 6m and EBF (no solids as per her paed.) and I had morphine, cyclizine, IV Paracetamol, Buscopan, Diclofenac and all were considered suitable for bfing on (my baby was 6 months though so it may be a bit more concern with a smaller baby). She was brought in once or twice a day by DH, MIL, my dad, etc for feeds and the rest she had as bottles (she'd never had formula/bottles until I was in A&E and in too much pain to feed her). She's bfing now at 2.3y and I had another week off when I had my gall bladder out at 9m.

There is a bfing counsellor/pharmacist called Wendy Jones who runs the Drugs In BreastMilk helpline who can talk you through what meds you have taken, how long (if at all) they are contraindicated for bfing and what alternatives may be used. Email is [email protected] and the no. is 0844 412 4665.

Has your hospital got a maternity ward? If so they should have an Infant feeding Co-ordinator who will be able to provide you with a double electric pump and support you in pumping so that you can rebuild your supply and with getting baby back to bfing.

You can also request baby be brought in for feeds and at 4wks you may even be able to get a private room on the maternity ward (I had chest pains when 2wks post natal with DD1 snd even though she was mainly bottle fed she was able to stay with me on maternity ward in a private room).

I hope you recover quickly and baby goes back to bfing ok.

Thank you for great advice - I am in private room on post surgery ward and a pump has just been delivered - will now attempt to express for the first time - hope I can with my 4 cannulas and an oxygen mask!! Have asked for DS to visit tomorrow at 2 so will try to BF him then as well once I've got a list of my medications and confirmed all clear - thanks again for resources.

Also worried DS is a greedy piglet and won't want to put in the work of BF and will prefer the easier bottle to me or will get nipple confusion. The things you worry about late at night post-op!!

Oh you poor thing, great advice from TruthSweet.

Even if you can't / don't want to bf on the drugs, get him brought in so you can do skin to skin and cuddling.

This from La Leche:

"If possible talk with the anesthesiologist about the drugs that will be used. In almost all cases, breastfeeding is fine as soon as you're alert enough to hold your baby."

Nipple confusion is a risk but some babies do happily switch between both. I would think that the fact he is young will mean he still has lots of instinct to breastfeed.

Worrying is not going to help, you need to get yourself on the mend for everyone's sake. I know, easy to say.

Remember you can hand express after using pump for extra stimulation. Not trying to worry you but you could be at risk of mastitis if milk is not removed, so don't worry about asking a nurse for help - expressing is for your health too.

I don't know about the drugs and milk contamination but I do know that my DD, who was younger, was FF for a whole week while I was ill. She took to it, like your DS, like a duck to water. But, with a bit of perseverance and lots of MN help, we re started BF, at first mixed and then exclusive. So it can be done. Please don't worry and I hope you are feeling much better soon.

If it helps, you could think of the formula like another one of your meds, the normal physiological function of your breasts was disrupted while you were ill so formula stepped in to take it's place until you are well enough to resume that function. Does that work for you?

Second Albrecht's suggestion of getting a nurse to help you position pumps for you - they'd think nothing of changing your cather while you are unable to get to the loo (the only bfing/weeing comparision that's valid!).

Oh you poor thing.

No advice, but I just wanted to say that I mixed fed both of my DD's from week 2 and they both happily switched between formula in a bottle and breast and did so for many months.

It is completely possible at this early stage to resume breastfeeding, especially as you are expressing and he is established. When you get home just do lots of skin to skin, he will remember and is likely to relatch, have the baby brought in as often as possible to feed if possible and if at all possible have them bring in a cot to enable you to keep baby with you now you are recovering xxx Don't offer any bottles when you get home, just breast feed whenever you need to xxx

Try to express at least 2-3 hourly if you feel up to it

Thanks for wonderful advice all. Feel much more confident we can get back on track now.

One final question - how much should I aim to be expressing each 2-3 hours to keep my supply up? Just managed 60ml from each breast but apparently he is taking 150ml of formula from the bottle? (or is this one of those "how long is a piece of string" questions)

I'm so sorry to hear you've been rushed into hospital, what a nasty shock.

I've heard that if baby struggling to get back on boob after bottle to try nipple shields for the start of the feed as they are a more similar feel to bottle, I tried them even my DS was tiny, as having problems latching on, without success, but perhaps worth a try if problems, however I suspect that with a bit of skin to skin contact your baby will be delighted to be back to 'normal'??

As for how much you are expressing, there are schools of thought that you can't express as much as baby will get/ find through natural breadtfeed, but if you believe your supply is down then best to rest up and have your baby feed lots and lots, my HV calls them duvet days where you and baby snuggle up and feed lots just switch baby from side to side.
Hope you are feeling better soon.

I was wrongly told to put baba on ff on the third day after he was born by a nurse where he'd lost weight and my milk hadn't come in. I managed to get him to ebf after a lot of work which involved expressing and mixed feeding. Apparently you don't need to match the quantity in breast milk to formula. Get well soon!

Any amount you remove is great - 120mls is really good btw! - but don't be discouraged if you don't get that each time.

I never managed to get more than 4 feeds from 6 double pumps and for DD3 a feed was 90-120mls even at 9m. Given that at 6m I was ebfing a baby who had been on solids (had been ill so paed took her off them) and a 2 1/2y too (though she was only 2-3 times a day) I had a pretty large supply but I just don't pump well .

Some tips to keep supplies going (but only if you feel up to it/are physically able to):-

Breast massage before expressing to help release oxytocin (massage towards the nipple).

Breast compressions during pumping (if you are wearing a nursing bra you may be able to clip it back up around the pump shield so you have hands free) can help increase yield

Hand express after pumping - I found I only got about 5mls or so per breast but it was really creamy looking so felt worthwhile to put in the effort (you may feel differently )

Cluster pump - like cluster feeding but with a pump (10 mins pumping, 10 mins not, 10 mins pumping, 10 mins not, 10 mins pumping). This doesn't necessarily get more milk out then and there so don't be worried if you don't get much, it's to tell your body to make more in the future. It's also good to do before going to bed as it counts as more than one pump session so you can have a bit longer sleep before pumping.

Pumping at least once overnight - pref between 12-3 but if you are having sedatives or lots of painkillers before lights out you might not wake up - in which case see cluster pumping tip.

All the best and hope you get home soon!

Thank you again for all the wonderful advice, I will put the pumping advice into practice immediately - I am trying to pump every 3 hours but am getting less and less each time so will try massaging, hand expressing (as far as I can with the cannulas) and cluster pumping. reassuring that even if nothing comes out my body is still being primed to produce milk. Maybe I'm just bad at expressing, never having done it before.

The nurses have said DS is not allowed on the ward or anywhere near me bc of infection risk so it looks like it may be more like 5 days or even a week apart from him. The appendix was so nasty they had to do an open incision so I will be in here longer than originally thought. DH put me on the phone with DS this morning and just hearing his little snuffly chirps and wheezes down the phone had me in floods of tears (perhaps I should have tried to BF directly afterwards!)

Ugh, what a disaster - also I keep dropping bottles and getting the breast pump tangled in the catheter tube and the cannula lines, so the surgical nurses are getting pretty sniffy about helping me. It's all glamour, motherhood!!

I'm so sorry that baby isn't allowed on the ward, could your DH take some footage of him snuffling around to help you or bring in one of his sleepsuits/vests so you can have something to smell? It's amazing how much smell is important when they are little!

Bit medical but when they reposition the cannulas (it think they have to do it every X days) could they resite not in your hands or elbows? I have a phobia about needles in my hand so they have to go in through my forearms which has the added benefit of it not interfering with movement.

I would push for him to come to you - it may be one of those rules that mysteriously can be lifted if you make enough fuss.

Is there a Infant Feeding co-ordinator at the hospital, try and get them to argue your case - emphasise the mastitis and breast absecess risk if expressing is not easy. Did you give birth there? Have you been discharged from midwife team?. Also local breastfeeding support group, like La Leche, may know someone at the hospital who would be a help.

I cannot BELIEVE theybare telling you DS cannot come
In: there's a difference between not allowing snotty kids to visit, and denying a 4 week old his mum and mummys boobs.

Seriously, I advise you raise merry hell: ring the ward and insist your baby comes in. Get DH to bring him anyway, and threaten media (they won't know if you're serious!) if they deny you access. Especially with you being in a single room there's not a risk to other patients. Ring the labour ward and ask for the BF counsellor to take up your case (that may be on Monday). Even if you don't actually BF LO, some skin-to-skin will make you both feel better. If you were in and out in 24 hours them it would be different but it sounds like they are forcibly seperating you from your newborn which is Not On!!

Here is some
Info from the (very good) Kellymom website about when mums need surgery.
www.kellymom.com/health/illness/mom-surgery.html

Good luck and get better soon!! Xx

I think they're more worried about the baby catching something from the ward - there's MRSA and something else about that they are really worried about. I keep having gel smeared in my nose and my skin disinfected every 2 min - this morning they even gave me a full antibacterial body wash.

The doctor said if he was a bit older he could visit but 4 weeks was too young to risk him getting an infection.

I just saw him for 20 min in the corridor outside the ward and am now in bits again because I couldn't hold him and I don't think he knew me from just stroking his cheek and talking to him can't wait till I get home, at least we can try skin to skin with DH's help.

And many thanks for all the good wishes as well - the gas is the worst bit as it's pressing on the incision and I am still constipated w piles from the c-section 4 weeks ago!! (sorry if TMI...)

Just to be a bit weird but it could be your smell has changed. Very small babies are quite olfactory based and you being scrubbed with anti-bac within an inch of your life may have just taken away your natural mummy scent and confused him. When you get home and smell of you rather than pine fresh bleach, he'll know you again.

Have some virtual as I'm sure you aren't allowed any on the ward. Shame MN doesn't have a [grapes] emoticon

Hello just wanted to pass on my best wishes from the Dec 2011 thread. Not quite the same thing but I expressed with ds1 while he was in scbu and managed to start him on bf when he was 4 months old.

Good luck but it could be worth lining up a bf consultant to help you reestablish bf ing when you get home. If you are interested think I know one in your area so could pm you their details.

Aww thanks for popping over aethel and hawthers - good idea about the bf consultant, there's one down the road who I will ask DH to call to see when she can come round to see us. Forgot about the resources I have locally to draw on.

Well good news is I am being discharged today - still walking and moving slower than a snail but at least I can get back home to DS and start trying to put all this great advice into practice. Thank goodness my mum can stay indefinitely as I am still pretty helpless. They say it will take 4-6 weeks to recover fully (only took me a week after c-section but the surgeon sniffed "well you had an abdomen full of baby then, this time it was full of muck!")

I wish I could send flowers to each and every one of you - I have read this thread over and over each time I've pumped and it has been so encouraging. I think everyone thinks I am a wild eyed bf-ing zealot to have pumped every 3 hours for an hour since I woke up from the op but I have managed 150mls today, the fourth day away from DS.

I will update again from home - the moment of truth as to whether DS will remember what to do with a real non-silicone nipple!

You sound like such a trooper- I am full of admiration. Very best wishes for your continued recovery at home, and lots of snugletting with your new baby. Hope you get looked after too.

Good luck tyel and well done on getting home : that's a great expressed volume and I'm sure LO will enjoy the snuggles and BF as much as you will!

Good luck Tyelperion - have a babymoon and take to your bed with DS. Lots of skin-to-skin, no top on to allow instant access to boob and hopefully he'll soon get the idea. Try getting in the bath together if your wound allows. Useful Kellymom advice here