Unable to breastfeed newborn for 12 hours because given medication contra-indicated whilst b-feeding. Should I complain?

[Lcy]

My DD was born in August by emergency c-section, after going 15 days over and being induced. Unfortunately the c-section epidural went wrong and I ended up with a post dural puncture headache. This is basically a severe migraine only relieved when lying down. I was in hospital for over a week and was unable to care for my babies physical needs (e.g. nappy et..). Despite being very ill I was determined to breast feed and learnt to feed lying down. By day five I was no better and an anesthetist prescribed medication for the headaches (same one that botched up epidural). I was not asked if I was breast feeding so I told the doctor I was and asked if the medication was ok to take whilst b-feeding. He said yes in quite an uninterested manner so when he had gone I asked the midwife to double check. She did not return and another midwife gave me my meds which I took assuming they were ok. An hour later I was feeding my baby and the first midwife came rushing in asking if I had taken the medication - apparently she had found it should not be used by b-feeding mothers. Consequently, my newborn baby had to be monitored by a paediatrician and I was unable to feed her for 12 hours (till the drugs were out of my system). I will never forget how horrific that night was - my milk had come in, my baby was screaming with hunger and rooting and I was desperate to feed her. The midwife had to take her away from me because I was so distressed and as she would not accept formula she cried/whimpered all night. Breastfeeding was the only thing that had gone well since giving birth and

I am still very upset 10 months on, I never complained to the hospital about the doctor prescribing this medication, although the impact was documented by the midwife in my notes. Do you think I should make a complaint or should I just try and let it go?

On a happy note, ten months on I am still breastfeeding my milk monster DD.

Sorry post is so long!

Glad the breastfeeding worked out so well in the end.

I think in your place I would complain. It's not exactly rocket science to expect doctors to consider that new mothers may be breastfeeding, and certainly not rocket science for them to check when they are specifically asked.

Yes. I am not say sue the hosp for billions -but def write a strong letter. Well done for getting through it and still BF.

Oh dear Lord Definitely complain.

I think in your shoes I would complain too. As much as anything to get it all off my chest, and hopefully receive an apology. Am also glad that it all worked out and you are still feeding. I had a rush of relief when I read your last line.

I am sorry to hear you had such an awful time .

Can you tell us what the medication was? There's a lot of conflicting info out there, and it is possible that it may in fact have been OK, despite you being told it was not. You might consider contacting the BfN drugs in breast milk helpline (either by email or phone) to discuss the appropriateness or not of the prescribing. It would probably be helpful for you to talk it over with someone who really understands these issues. The line is run by a pharmacist who is also a BfN Supporter (breastfeeding counsellor equivalent).

Either way, what happened was rubbish and you should complain, as one of the professionals was wrong and you should not have been given conflicting advice nor been prescribed a drug incompatible with breastfeeding, if indeed it was.

Thanks for all your replies - I feel better just for writing it all down.

Grendle - Thanks I will give them a ring. I can't recall the name but the midwife checked the Bnf and then spoke to the on call paediatrician who advised her to stop me b-feeding for 12 hours and to monitor my dd for adverse effects. I think it was the case that the medication had not been tested on newborns so could not be deemed safe. What upsets me is that no one discussed risks / benefits with me, and the team obviously were not in agreement.

I must say the midwife who was with me that night was fantastic. But everyone else I have been in contact with has dismissed it and made me feel as if I am over reacting.

Sheeeesh, no way are you overreacting. I can imagine so vividly how that must have felt being unable to breastfeed your DD, and I would have spent hours sobbing my heart out and then wanted to hit someone.

Lcy - not excusing appalling behaviour by anaesthetist (sp?) but I'm not sure if any drugs are 'tested on newborns and so deemed safe'. There may be a degree of professional difference here. I would still pursue a complaint if I were you, if only to get a better understanding of why this happened to you and (if nec.) stop it happening to someone else.

Of course you aren't over-reacting! Anyone who treats this dismissively just isn't using their brain. Quite apart from what Port said, how about the distress caused to your newborn baby and you? And the danger - what if the first midwife had been called away to something else and then gone off shift without checking? (This kind of thing does happen...)

Yes.

I agree with Grendle as in working practice there are few drugs truly incompatible with feeding.

If this was the case, then an even bigger YES!

Complaints don't have to be seen in the light of getting people into trouble and being over the top [but they can be if that's what a person needs to gain understanding and closure]. Complaints can be a good thing, highlighting issues, lack of staffing, lack of direction, and serving as evidence when managers go to secure funding for training etc.

Many a midwife has bemoaned the lack of training available for themselves or related others - to be told prove it. Your complaint could help do just that.

{angry] for you, and delighted you were able to establish a feeding method to suit you.

It wouldn't have bothered me tbh. With my first baby I ff in hospital (3 days), started to intermittently bf from day 2. By the end of the first week he was fully bf. Had no problems just as you don't appear to have.

I would put it behind you as an unfortunate thing that happened. You needed the pain relief. 12 hours later (not even a full day) you and your baby were happily bfing. Please try to put it behind you.

With one of my babies I had to express for 24 hours and dump as I had to take worming medication (thanks to my other children
). I couldn't take it while pg and so in the first 7 days of my baby's life I needed to get rid of the worms. We were fine.

Let it go, imo.

But Lcy's DD didn't ff in hospital -- she screamed in hunger for twelve hours. Twelve hours of your newborn baby screaming in hunger and being unable to help them, when you have specifically tried to avoid that problem by asking the doctor "is this medication compatible with feeding?" and been told that it is. Apart from anything else, if the medication really was incompatible with breastfeeding then Lcy could easily have breastfed her baby after taking it based on the information that the doctor gave her. And if it wasn't incompatible with breastfeeding then those twelve hours of starving Lcy's DD was all for nothing. It's not unreasonable to expect to be given consistent advice, at the very least.

juuule, I think its more a case of the fact that the op's baby was put into a situation of being endangered by the medication she was prescribed. Depending on what the medication was her baby could potentially have had breathing, cardiac or other problems caused by this doctors lacksydaisial attitude. If the op had not requested a second opinion on the safety of breastfeeding with this medication then potentially this could have been very serious.

~Yes ok. The baby is fine, the op is fine and she succeeded in breastfeeding in spite of the dificulties that the doctor landed her with.

However, ultimatley the doctor cocked up. He put a new born baby (potentially because I don't know what the medication was)in danger, caused the baby to not get fed properly for 12 hrs and caused a lot of distress to the op and her newborn baby.

I think that warrants at the very least a letter to the PALS for that hospital to ensure that this idiot doctor does not make the same mistake again.

OP in your situation I would be livid and I would go ahead and complain to make sure that it doesn't happen to someone else. At the same time I would majorly praise up the midwife who was so on the ball.

"Starving"?
I was always under the impression that a newborn's fat reserves would keep them going for at least the first few days (around 3-ish) until a mother's milk came in. I hope so as although most of my babies suckled ferociously for a couple of days my milk never came in until day3 -4.
In fact, some of mine mostly slept for the first 24 hours absolutely shattered presumably from the hard work of being born.

I would agree that it was wrong to prescribe the medication and not have warned beforehand about it being contraindicated with bfing. The baby should not have been put at risk.

Most human adults have enough fat reserves in their bodies to keep them going for 3-4 days without eating as long as they continue to drink water. This does not mean that you wouldn't be hungry in this time Newborns have been used to food on tap 24 7 and so many are v hungry within hrs of birth.

Also just because fat reserves will keep you going doesn't mean that should be relied upon as a means of getting a newborn through a 12 hr period.

I am on preg 4 and my milk has always come in before I went into labour, I have never had a situation of not having milk for my babies and the described situation would distress me beyond belief.

Your milk's come in before birth? I thought it was the separation of the placenta that triggered milk production. Colostrum can be produced before birth and before the milk comes in but I was unaware that the milk itself could be produced before the baby was born (or rather the placenta detached).
Well, you live and learn,as they say .

Surely you mean colostrum kitkatqueen?

Juuule I had to take worming medication (threadworms) recently thanks to DS1 but according to the BFN website it is totally safe to take whilst BF. I hope you weren't misled too. There is so much misinformation out there.

Provinciallady - it was Pripsin and I thought it best not to take any risks. It was 19years ago so probably worming medication has progressed since then

Sorry - Pripsen.

I think my community midwife felt the same as you Juuule - no lasting problems so let it go.Unfortunately it was a very traumatic event for me (even though others in the same situation may not of found it so). My baby was five days old, my milk had come in and I was engorged and leaking, she was left crying and rooting on me and I could do nothing. She was taken away for a few hours at my request because I was so distressed, but was then returned to me hungry and distressed.

This in the context of first baby, a very difficult and scary labour, being in alot of pain, and an inability to move from a lying position - so I felt very helpless.

Anyway thanks for the input everyone you have given me the confidence to write to the hospital.

If only they vould find a permanent cure

you can encourage milk production before the baby is born by nipple stimulation - which I was reccomended to do by my midwife because my babies get so overdue colostrum / milk either way there is something there for them. This time i'm still feeding ds and its deffo milk atm

It reverted to colostrum at about 12 weeks pregnancy and has gradually returned to normal milk since.

There are several cultures (I have been told) where it is standard practise to begin hand expressing towards the end of the pregnancy and apparantly one group of people ( i know not where so please don't ask) have the mother of the pregnant woman begin restimulation when her daughter gets into late pregnancy so that she can cover the night feeds. Sounds like a fab idea to me LOL! a solid nights sleep with a newborn!!

Oh If only, Provinciallady.