I don't do things by half. Having surgery for broken ankle on thursday. 33wks pg and still nursing older ds. What should I be asking and is it OTT to make a plan in case they have to deliver baby?

[mawbroon]

I broke my ankle last weekend and am having surgery on thursday to repair it.

DS is 4.2yo and still nurses. He has been especially clingy just now (not surprised, he is being shunted round all the family because I am not able to look after him on my own) and wanting to nurse a lot more. I have no problem with this, it's about the only thing I can do for him at the moment

What do I need to be asking the docs in terms of meds that are compatible with breastfeeding ds?

And what should I be thinking about in terms of the worst coming to the worst and the baby having to be delivered early?

My sister would probably donate breastmilk (no milk bank here) but if I am out of it, then how best can I communicate this to them?

And, as if I haven't got enough on my plate, I heard from nursery this morning that there's bloody head lice there. Don't suppose breast milk would kill them?

Don't have many of the answers, but wanted to bump for you.

Only thing I have experience of that you need help with is prem babies. I have had 3 babies at 35 weeks, and always give strict instructions to DH to go with the baby, not stay with me, if they are taken to SCBU, and then to insist that they get fluids through a drip, not ff, until I can bf them. Is it possible for your sister to be at the hospital during the operation in case you do deliver then (depending what the odds are on likelihood of this happening?) ready to express and donate? I guess they will have a peadiatrician on call; ask if you can talk to them before the surgery about what to expect if baby is born now, and enlist bfing support. SCBU may well have a dedicated bf advisor, ours did.

What the surgeon and aneasthetist come round to examine you before the operation you need to discuss the bfing. They may well not know, so having someone with you with a blackberry or other device for going online would be very helpful. I'm sure some mnetters will give you a link for looking up medication advice.

Ok, I can help with some of this, but not all.

The general advice that I've heard about bf + anaesthetics is, if you are alert enough to hold your kid, then the anaesthetics are out of your body enough, and you don't need to worry.

Given that your DS is 4.2, it's likely that whatever meds they give you for your ankle, are ones he could have himself, directly, iyswim. So I would tend to just breastfeed and not stress about it. (Unlike a tiny baby, too, the amount of breastmilk, and hence medicine, that he would get, would not be that high a proportion of his daily intake, iyswim.) That being said, if you have names of specific meds, there are plenty of good sites out there on breastfeeding and meds. The only family of meds that I know is no good at all with BF are some anti-cancer meds.

Maybe I am just overly mistrusting of HCPs, but I wouldn't even mention I was still BFing your DS, unless you were sure they were sympathetic.

I don't know what to say re: early delivery. I would ask at the hospital about how likely that is to be. A 33 week old baby would be tiny, you might need to express and tubefeed or similar? I'm not good on preemies, I'm afraid. I would mention the bit about your sister to your partner, and to your midwives.

Head lice won't kill anyone, I wouldn't worry about it at all until after all the rest of this is sorted out. If someone in your family is willing to comb through your DS's hair, then let them!

Thanks for your replies.

I was also thinking along those lines for the anaesthetic NQC, it's more the painkillers for afterwards. But, I guess they are only going to give me stuff that's any good for being pg, so is quite likely to also be ok for breastfeeding.

I will contact the infant feeding advisors I think. I volunteer with them as a peer supporter so they already know me which might help.

I am sure the chances are very high that things will be just fine. I am reasonably calm and rational about it, but my subconcious must be churning away because it woke me at 5am today.

I just wish it was all over.....

No advice but lots of best wishes.

thanks

I think which drugs are safe in pregnancy and which are safe in BF aren't really the same - but yeah, most things that are safe in pregnancy are fine for BF. And painkillers are generally fine for breastfeeding, anyway. I guess codeine might make your DS groggy - I'd bet that BFing just before you take any pills was the best for him.

I've had a quick look at some stuff, but guess it's all theoretical until I know what they will be giving me.

None of it really distinguishes between different ages of babies though.

My sister said she will express some milk tomorrow to put into my freezer. I think I will try to express some colostrum to freeze too.

I just want this over and done with.

The midwife has organised some syringes for some colostrum. My sister has pumped a wee bit of milk for me and I will get expressing colostrum later on.

Feeling more positive about it all today and am fairly sure that I will wake up from surgery and everything will be fine with baby.

LOL, expressed for about an hour painstakingly sooking up colostrum into the syringe drop by drop. I got.....wait for it.... one ml!!

Will try again after tea. A couple of mls is worth it for such a teeny baby if he does have to be delivered.

And my sister gave me 25mls of milk which would be a banquet!!

Hopefully I will be laughing about this tomorrow when my surgery is done and baby is still safely inside me.

People call EBM 'liquid gold', by which standards colostrum is what, liquid diamonds? Seriously 1 ml is quite a bit of colostrum. Well done!

I've done a bit of digging, and apparently ankle surgery is unlikely to trigger labour. Good luck today, anyway!

Good luck today.

I have heard Tiktok say that NQC mentioned about once you were awake, the anaesthetic drugs are no longer in your system and breastfeeding can start straight away.

Re painkillers, I would mention to the medical staff that you are breastfeeding. As not all pregnancy safe drugs will be breastfeeding safe. That said I agree that your DS is older enough that he'll be old enough to cope with more meds in your milk than a baby.

But there is so many alternative painkillers it is worth asking for a suitable one. Maybe take the painkiller list from here (if you are still around reading Mumsnet)

I have got everything crossed that baby stays blissfully unaware of your op and that you are healed fully before his/her arrival.

Best of luck, mawbroon!

Hope it all goes well, baby's fine, DS gets some milk and you get some relief and on the road to recovery.

Thinking of you today.

Ha, well. I am home now, baby is still safe inside me. Everything went well and now I have 2.3mls of colostrum and 25mls of my sisters EBM in the freezer should there be any emergency when it comes to the baby arriving.

Ankle surgery under a spinal with no sedation is not something I would recommend if you can avoid it. Even the surgeon said it was "quite impressive", not that I was out to impress anybody of course.

So pleased it's over and that I am home now. There was no tv/internet so I managed to read the whole of Ant and Dec's autobiography (nice light, fluffy reading is what I needed!) and all of another paperback that DH brought in yesterday.

Thanks for all your good wishes.

Well done, mawbroon!

Wishing you a fast, smooth recovery.

Oh yey, glad you are okay(have only just seen this)

Yeah, glad to hear everything went well.

Thank you. The pain has subsided a great deal. I have had no painkillers today, and only had two doses of paracetemol yesterday. I guess it makes sense that now it is fixed, the pain will lessen.

DS doesn't seem any the worse for our first separation, but he is asking to nurse a lot more, but that is to be expected I guess.

Maybe by next week, I will be able to get out and about a little bit on my crutches. I have either been in the house, or in hospital for over two weeks now. Luckily I don't mind staying home.

Very pleased to hear that it went well mawbroon. You did well to get that much colostrum expressed - I couldn't get any when I was trying to store some in case ds needed it due to the diabetes. Which reminds me that I might need some this time as well - bugger!

Thanks CSWS. It was painstakingly slow when I was expressing. We are talking sucking one drop up at a time into the syringe. Good job I was sofa bound with nothing else to do or I might have given up long before even getting half a ml. DS's feeding has gone through the roof since I broke my ankle, so I am sure that will have helped too.