General Anaesthetic & BFing

[TruthSweet]

I'm due to have my gall bladder removed as I've got gall stones which have been causing pancreatitis (ow!) and I'm bfing my 7 month old and my 2.6 y/o. DD2 is only feeding between 2x a day to 1x a week so may well not need to nurse whilst I'm out of action but DD3 is only just starting on solids (on advice of paed).
I obviously wish to keep feeding after the op but have yet to have any advice on how long bfing will have to cease for after a g/a.

I'm assuming I would be out of action for 2 days at least so am trying to express a stockpile in the freezer (formula makes DD3 poo army tank paint that also doubles as a bio-chemical weapon [blergh]) but don't know if I will be pumping and dumping milk after the op.

Any advice?

It shouldn't be a problem at all. Generally, once the mother is awake from the GA, the meds are largely out of her system. The meds are cleared from the breastmilk stores at the same rate as they are cleared from the blood. (So no pumping and dumping required.)

Here is a good webpage that says the same thing.

How long will you be in the hospital? Are you ok for support and help with the kids while you're in? Will they be able to visit you?

Is it keyhole surgery? Or will you be under the same restrictions as a CS mum? No lifting afterwards for six weeks? Worth looking into before the op!

Thanks NQC!

I think I will be in for two days and will be having keyhole surgery so will need to get DH to practice latching DD3 over my shoulder! My mum and mil will be watching the children and DH will be bring DD3 up as and when allowed.

I've got a pre-op appointment this afternoon but wanted to be prepared for a 'discussion' re my bfing. It really hacked the cons. off when I was in for a week with the pancreatitis that going from fully bfing a 6 m/o to only being able to express twice a day meant that I kept spiking a fever, was engorged, was expressing green milk and needed anti-biotics to hold mastitis at bay .

I was only able to express twice a day as maternity didn't want to give up a pump more than that (a mum of a 6 month old doesn't need an electric pump she can exclusively pump using a hand pump/hand express ). It took serious haranguing from me to get the pump more frequently (also took me walking the length of the hospital to maternity to use the pump and nearly collapsing in the pump room too). Being on morphine meant I could have just drifted off with the fairies but instead I had to butt heads with bureaucracy. Buzz kills

Ack. At least getting this sorted will mean you won't have to go through that again? I hope?

At any rate, keyhole is better than the alternative. Would feeding lying down be an option? Depending on how mobile/self-latching your DD3 is, and what positions are comfortable after the op, you could just lie on your back and leave her to it, or lie on your side, with her on her side next to you. I would try out whatever position makes most sense, with your DD3 before the op, to get her used to it, maybe? (The consultant or whoever could tell you whether side or back is more likely to work ok postoperatively.

Oh no - could you hire an electric pump from somewhere, NCT perhaps?

I wouldn't have thought that the meds would be a problem as mums who have had a section under GA aren't advised not to feed, and their babies are much younger and more vulnerable.

NQC - I've been to pre-op appointment and I'll probably not get the op until August! I got told by the Day Surgery Unit Nurse that it's at least 24 hours before I can bf and that they give 'special' meds to c/s mums (I've asked for those meds instead ). I did make it very clear that I wasn't intending on ceasing bfing either of them before then (though if DD2 stops so be it ) as I don't parent by minimums (all very politely of course - I tried to keep the ranting to just a few hours ) and I don't want to be fighting off mastitis as well as recovering from surgery.

Bertie Botts - The breastfeeding group I volunteer with very very kindly offered to pay for the hire of a hospital grade pump for my stay in hospital as we couldn't afford to hire one ourselves. I can't use a Medela Lactina as I don't 'produce' for it (at one point I had to use that pump and made 15mls in total after pumping both sides and had a meltdown at the nurses' station [got me a symphony though and I made 70mls). We'll just have to scrape enough together to hire it again.
DD3 will be 10 months by then so hopefully she'll be established on solids and won't be feeding every hour!

I had surgery under GA in March of this year and was also told by the pre-op nurse that 'they' advise not bf for at least 24 hours after a GA. I asked her to check the details and she called me a couple of days later to say that actually the GA doesn't present any problems, just some painkillers. Most painkillers are fine - codeine is the main one to be avoided. I can't do links for some reason, but if you google the Breastfeeding Network you can find downloadable leaflets about GA and painkillers and bf. Basically, as soon as you're awake you're okay to bf (though probably won't feel like it immediately), and get them to check the BNF for the correct meds.
My ds was 9 months old and I found hand expressing when my breasts filled up and he wasn't around easiest, tbh.
Hope that it goes well.

Codeine you say? Fab I can't take codeine as it gives me screaming nightmares (only time I'm pleased to get a side effect!) Strange though they really wanted to give me codeine in hospital and tramadol (can't have that either as it sends me sky high and is contra-indicated for epileptics [i.e. me]). It's oramorph for me

I would love to be able to hand express but it only has worked when DD3 was being tube fed due to bronciolitis and Maternity wouldn't give up a pump (got 200mls that time) the rest of the time I get bruised breasts and just a little milk. I suck at expressing .

no idea where the pre-admissions nurse gets the 24 hr figure from. she probably doesn't know and is being on the safe side. most HCP do this (i am one, and my colleagues drive me mad with this - i'm not sure so lets just say stop feeding attitude). as soon as you are awake you can bf. post-op you will probably get ibuprofen and paracetamol +/- codeine which are fine for bf. generally no antibiotics needed.

make sure the anaesthetist knows you are bf and that it is written on your drug chart.

After keyhole gallbladder surgery you often go home the same/next day, you will have 4 small incisions (2x1cm, 2x3cm) and shouldn't be too uncomfortable bf. feeding lying down good idea. small chance of having to have open surgery, generally 5% is the quoted figure for conversion.

well done for continuing to feed/express during your pancreatitis, not a pleasant thing to have and it sounds the hospital wasn't too helpful either. is there an infant feeding co-ordinator at the hospital who you could get on your side ready for your hopefully short admission?

oh, and if you do want surgery earlier, phone up your consultant's secretary or admissions dept and say that the national guidelines are that after gallstone pancreatitis you should be offered surgery within 2 weeks! and say you think the wait is unacceptable.

Weasle - that's very interesting about the 2 weeks. I was admitted with pancreatitis on 24th of April and I still haven't had my MRI!

Pre-op nurse said it's the anaesthetists who impose the 24hr wait.

I'll have to have an overnight stay as I have epilepsy but to be honest the last thing I need after an op is to have a seizure and rip my stitches open whilst at home. Plus I luurve hospital food

There are two infant feeding co-ordinators who I am on first name terms with (also my bfing support groups HV is on a committee with one of them) plus I'm 'known' as I only finished feeding my 3.5 y/o DD1 one month before DD3 was born. I'm notorious for it . They both really wanted to help but their hands were tied by matron/ward policy. Trouble is hospital wants to go baby friendly