Tiktol & others, please help! Just had an accident & can't bf my baby. Am heartbroken.

[Maria2007]

Hi Tiktok (and other bf experts), I need your help urgently!

Here's some background: I'm Maria (we've met on these threads before, I think). I'm breastfeeding my 5 & a half month old baby since birth. He's also used to taking bottles once in a while, since in the last 3 weeks we've been giving him one bottle of formula at 11. Under my current circumstances it's good that he's comfortable taking bottles.

So. Yesterday, around 4 pm, I had a bad accident. I fell on my face (onto a plate) & broke several teeth- some came out completely- and other teeth are misplaced. I will need extensive dental work. I also had big cuts all over my mouth, & was given extensive stitching at hospital (I went with an ambulance to A&E). As you can imagine the whole thing was extremely traumatic, I lost lots of blood & didn't know at first what was happening. I'm very relieved that the damage is only on my mouth & teeth, as it could have been so much worse. But it's likely there might be some reconstructive work needed in the future, let's see.

About the medications I'm taking: They gave me morphine at hospital, for the pain. And then lots of local anaesthesia for the stitching. They have now put me on 2 antibiotics (Amoclan & Amoxillin) & one strong painkiller (Diclofenac). Plus, some paracetamol as needed. I will also be doing dental work, starting today, & that too will likely require more anaesthesia & perhaps more painkillers. Hopefully all this treatment will be completed within a week or- more likely- 2 weeks.

In the meantime, I can't & won't breastfeed, not without getting advice (hence my msg here), because I'm very scared of giving all this medicine to my boy through the milk. At the same time, I don't know what to do. Last night after my return from hospital I expressed & threw the milk away (to relieve the engorgement). This morning I also expressed & threw it away. Should I express & throw it out? If so, when? My boy usually feeds every 3 hours or so. At night we give him one bottle of formula at 11 (and I express at the same time) & then we usually give him EBM at 3.30 or so- this too we started recently & it helped our baby's sleep- so he's used to bottles at night. The rest of his feeds have been direct breastfeeds. Should I express on that schedule & throw it out? Could I then continue feeding him- when this ordeal is over- perhaps EBM in bottles if he refuses the breast? (will he, most likely, refuse the breast after 1-2 weeks on bottles solely)? I was planning & hoping to keep up the bf until he's 1 year old or so, perhaps keeping up to 3 feeds a day on the breast. Is that completely wishful thinking at the moment? Should I just give up completely? I don't want to, not in this traumatic & sudden way, but I also need to rest & recover.

Any advice would be fantastic. I can't talk to a bf helpline so easily because- as you can imagine- I don't talk clearly because of my cuts in the mouth. Which is why I'm writing here. I've always got good advice here....

Thanks in advance.
maria

DH works as a development chemist; he's not certain about antibiotics, but I was given diclofenac after section too. He says look them up on www.rxlist.com as that should give you the information (it will link to precautions for each drug), though you would be best to give your local chemist a call and speak to the pharmacist who will probably know the drugs well and any side-effects.

How awful for you. I really hope you manage to get all of this sorted out and start to feel better soon. Good luck .

Sorry, can you get someone to call on your behalf?

DH says that a pharmacist would be your best bet re. the drugs as they often know more about them than the doctors and they have more information to hand.

Hello everyone again,

I really really appreciate all the help & the links. It seems that things are much more hopeful than I thought, so as a first step I'll start freezing the milk & we'll go from there. My parents told me immediately to stop bf (and that there is some kind of pill to do this quickly??) but I really really don't want to do that. They also said 'surely he's gotten all he needs at 5 months from the breast milk, it's time to move on'. However, even though bf has never been easy for me (or maybe I've been too lazy at times to do it 'perfectly'!) still it's very important to me & I would hate to stop in such a traumatic way. I mean, I'm completely shocked & traumatized by the horrible accident (esp. the huge amount of blood & the fact that we didn't know what has happening until the ambulance came)... having to deal with the trauma of abrupt stopping of bf feels too much for me.

At the moment I can't read all through the literature you've very helpfully sent me, I'm simply too exhausted. I'll try calling a helpline actually, I'll do that now, I think they can hopefully understand me through my swollen lips, and maybe they can do the research for me? I just hope they offer sensible advise, based on my particular circumstances, and that they don't start telling me off about using formula...

Anyway. Thank you all SO MUCH again.

I was prescribed amoxocillin while bfing and they gave me diclofenac after my cs (though I didn't need it). Both were fine for bfing mothers. They also gave me a shot of morphine after delivery and said to continue feeding.

It doesn't sound hopeless at all.

I'm so sorry for your accident. You poor thing. Sounds horribly traumatic. Be kind to yourself.

Oh Maria!

I'm so sorry to hear about your accident. You poor poor thing!

Can you get your DH to phone a helpline and see if there is anyone out there who can come round, read through the stuff with you, and advise you and him face-to-face?

Oh, god. It sounds awful. My sympathies to you.

Try to keep going, if you can, and if it doesn't put you through too much. Don't let anyone but you determine what to do. It's not at all helpful your parents telling you just to stop like that, especially after all you've been through.

Take care of yourself. (Un MN ((((((hugs))))))) and kisses - xxxxx

Maria, so sorry to hear about your terrible accident. Just wanted to say that I had an appendectomy when 31 weeks pg with dd2 and took shedloads of ABs, opiates etc by intravenous drip and they did her no harm. There will be less of the drugs getting through to your breastmilk than went over the placenta (I think!) so hopefully you should be fine.

Look after yourself, and I hope you feel better soon.

Maria, after I had one of my dcs I had to have some treatment for my kidney stones which meant I had some medication. The hospital advised that I shouldn't bf for four days and I took their advice and thought that meant I should just give up. Two weeks later, feeling much better and having missed bf (which I didn't think I would) I decided to try again, even though it'd been two weeks eventually the milk came through. So, if for whatever reason you find it best for you to stop for a few days while you recover and get over the trauma, it's entirely possible to start again. It might be another option. Hope you get well.

Maria - get someone else (maybe your parents or dh?) to do the internet research for you. By all means call a helpline as well - and they might do it for you.

A pharmacist may or may not have good info. Too many in my experience take the BNF as gospel and do not think or assess beyond that.

The best info will come from you (or someone on your behalf) doing the web research for you, IMO. Then you will be as informed as any professional, believe me, and a whole lot more informed than many of them.

(Your parents' reaction is not uncommon - telling you to stop bf immediately for no good reason at all. Yes, there are meds to dry you up but you will not get them without serious reason, because there is a risk of side effects - you can check this out on the web if you look for something like lactation suppression. I think you will need the web-based info on your prescription drugs to show your family, though, to ensure they support your continued breastfeeding).

Diclofenac definitely fine (they give it routinely after c-sections).

Amoxycillin definitely fine (I'm on it at the moment, in fact).

i have also bf on diclofenac and amoclan (amoxil is in amoclan so will have the same cautions etc). my gp looked up the antibiotic to ensure it was safe (and i confess to checking to see also.) paracetamol also not a problem if bf.

your poor face. hope you are feeling ok.

Have a look here for the antibiotics.

BFN

It says that amoxycillin and co amoxiclav are both fine.

Diclofenac is also fine, and standard issue post C section.

Maria just to give you some hope dd2 had surgery at 6 months and I stopped bf for 2 weeks (but continued to express) we reinroduced bf and after a difficult couple of days were back to how things had been so even if you really didn't want too give atm ( although it sounds like things maybe ok) it is possible and not that difficult to reintroduce)

Good luck and I hope you're starting to feel a little less swollen soon.

Maria - sorry to hear of your accident. but please seek the advice of a trained medical professional.

It's all very well people googling drugs and saying 'you're fine to take this and BF' remember you are taking a cocktail of drugs together, which changes things.

What a horrible accident. I do hope you can continue breastfeeding if that is what you want to do. I imagine I would feel the same about not wanting to stop in this way. No advice or useful experience to offer but lots of best wishes and virtual support winging its way to you xxx

I don't think anyone has merely googled the drugs, have they, Nancy, or suggested that Maria does this? I don't think this would give rise to much good info, you are right.

The links are to specific sites that discuss evidence-based guidance and which list research studies on drugs and combinations of drugs in relation to their effect on breastfeeding or on the infant.

Anything Maria decides should be as part of a dialogue with her medical advisers but I think one issue is that sadly, medical advice alone on this matter has been seen to be erroneous and misleading - too many women have been told simply to stop or suspend breastfeeding as if there is no other option.

You poor thing. When I had my hysterectomy I had some sort of injected anesthetic in my side and a general and morphine and antibiotics and some other pain relief after the morphine. I can't remember what this was but diflowotsit sounds familiar.

I was very anxious about his all getting into breast milk but they assured me it was fine and that I was getting the things which are compatable. I am sure you will be able to move on to things which are comptable for you if you're not already on them. Good luck and hope you feel better soon!

Agree that medical professionals can be misinformed about the impact of drugs and breastfeeding. I was badly misinformed about general anaesthetic and breastfeeding when I had to have a restitch when dd was 7 months. Ended up having a local anaesthetic so could carry on with feeding as usual and it was the worst experience.

I think the point about anaesthetic is that if you are conscious, then the anaesthetic is out of your system (or you would still be unconscious ). And if it is out of your system it is no longer in your milk....

This is rough and ready I know - but it's always a good question to ask any anaesthetist or surgeon who says 'no breastfeeding' .

Mothers have GAs for sections, and no one tells them they cannot bf when they come round after the GA.

Maria,

am an anaesthetist (on mat leave!)

Diclofenac, local anaesthetic, morphine, paracetamol and antibiotics you are prescribed are all OK if breastfeeding.

All these drugs are given to babies if they need them. Your baby obviously doesnt need them, however the quantities your baby will be getting will be minute. If you only had a single dose (e.g. the local anaesthetic was a one off) it will be completely gone from your body, and hence not entering your milk now.

None are harmful to your baby in these tiny doses, despite the fact that your baby doesnt need them.

If you require further general anaesthetics discuss with anaesthetist before you have op (you will see them as routine) as there are techniques that can be used that will minimise the use of drugs that transfer in breastmilk. They will be able to avoid the drugs that are really not recommended in breastfeeding (which are actually very few).

It may be that if your mouth is a total mess, you may have to have a gas induction to get you to sleep anyway. This is one technique that minimises the number of drugs used, hence avoids a lot of the questions.

Please, for yourself, keep on taking your painkillers. The mouth heals amazingly quickly, you will only need them for 2-3 days.

Tiktok- just a little a note of caution GA actually stays in the system for a long time after having one ( I can't remember exactly but I think in terms of months rather than days), but it is in such small quantities it normally should not matter . However in addition to this there is also the length of time that you are actually under the GA for to take into consideration i.e. the volume of drugs recieved for the body to process. CS is a relativly short op, but the surgery maria may need may differ.

I stand corrected

Doris, I think you are wrong about GA staying in the system:

www.anesthesiologyinfo.com/articles/01052002.php

There is also a useful pdf from the Breastfeeding Network on the topic of day surgery:

"General anaesthetic agents have very short half-lives and are redistributed in the body within
minutes, which is why they have to be infused continuously. Some is stored within the fat of the
body and gradually released over the following 24 hours but the levels of these on single short scale
use are unlikely to cause any greater effect than drowsiness in the baby.
After the majority of minor surgery the patient is awake within a very short period. Once a mother
is awake enough to recall that she has a baby and the need to breastfeed, the level in her milk is
likely to be minimal. "

I don't understand about GA remaining in the body for 'months' - yikes!

Just seen rempy's useful post - great stuff and straight from the right source

Maria, to hear of this. Glad you are feeing a bit better and can continue bf. Make sure you are sat on a sofa/bed with ds and someone else is feeding you/getting you tea, choc and mags! And sending you lots of happy sleeping-baby vibes too...

Good luck, let me know if there is anything we can do.

Thanks again everyone

I'm really getting worse (so can't write much). The swelling has become horrible. Hence I cannot eat a thing. I haven't had anything to eat since yesterday morning. Just now I managed a couple of baby-spoon mouthfuls of mash, and am very proud of myself. Went to the dentist, he said there needs to be extensive work on the teeth- but not yet, since lips are so swollen.

As for the breastfeeding. As the day has passed by, my expressing has become more difficult. In the morning I expressed loads and very easily. But at 1 I couldn't get anything out (even though I was engorged) & ended up crying. Then (after the dentist) at 6, I just expressed 120 ml or so. But still I'm getting more & more pain under the arms & across my breasts.

What do I do? I'm desperate & really scared. Will call NHS direct. My baby is crying a lot too, and he was trying to root poor thing, trying to latch on. What do I do?
The pain & the swelling & the lack of any food is just making me completely, completely exhausted & demoralized.