Big Decisions: Back Surgery with 6-month baby breastfeeding

[autumn10babe]

Hello,
I have not posted before but would love any feedback anyone might have or stories of similar experiences.

I have just had an MRI for numbness down the back of my left thigh, left heel and the inability to put weight on the ball/toe of my left foot. Turns out there is a big herniated disc at L5/S1 compressing the nerve to channel it through a very tiny gap. The good news is that my previous backpain has been nearly numbed away too ;)...while this may be more comfortable, also more worrying!

I am American living in England and have a 6-month-old baby who has been exclusively breastfed until recently starting some solids. She will not take a bottle but we have discovered she will take formula in a cup because she likes the cup...not sure how much we can get down her that way though. She is also very clingy to me.

I saw a neurosurgeon who said doing nothing IS an option, but I MIGHT have about half the sensation back in about 3 months and if it did all heal it would likely take at least a year. The other option is a microdiscectomy. He said people are generally back at work in about 3 weeks (I am on maternity leave) but I'm guessing most of those jobs don't involve picking up babies all day long!

And one final factorwhich kind of takes a back seat nowI am 41 and we would still like to give it a try for one more. So I figure the sooner I'm sorted out the better....not sure being pregnant while trying to heal from a slipped disc would be any fun at all. But then again, neither would recovery from surgery!

My big decisions:

1. To have surgery or not. Fearing I may risk permanent nerve damage if I don't have it. But also worried about feeling helpless for my baby during the recovery period (can't imagine not being able to pick her up if she cries)

2. Which country to have it: In UK family would come over to help me but our place is very tiny. In US have gotten recommendation for excellent surgeon...prefer US health care, bigger house with family for recovering but would have to deal with packing up my and baby's lives, travel, and being away from hubby.

3. Whether to completely wean daughter from breast. I had hoped before considering all this to keep at least a night and a morning feed. I think that even with surgery this could be possible if I pump to keep up supply and then try to time painkillers to be at low doses when she eats.

Thanks for reading and for any help/insight you might be able to offer.

Can't help much really but I had to have an op when my DS was 3months and wasn't allowed to breastfeed for 48 hours due to anaesthetic in my system. Got back to it quite quickly but all healthcare professionals were amazed as they thought the trauma would have affected milk production more - perhaps one to think about? A the time I didn't see any option as he wouldn;t take a bottle but baby wans't happy for a few days as he was hungry! However, at six months and with just a couple of feeds things are likely o be different.

I then couldn't pick up baby for several weeks though and DH needed to be around a lot. It was quite frustrating and boring as in the end we just lay together on a big bed most of the time so that I could pull him over for feeds. Friends were fab and 16 years on its just a good story though!

Dont know if that's any use but good luck with it!

Thanks pinktele. It's nice to hear of someone else's experience at least having to deal with an operation while caring for a little one and also being able to carry on breastfeeding. I suppose it really could end up feeling quite boring! And I can definitely imagine frustrating. Not looking forward to turning over her care to others while out of commission but still hemming and hawing on whether I'll do it and waiting for a second opinion before committing to the op. Definitely leaning toward having it though as I'm walking with a definite limp, very slowly, and can't get too far. Thanks again for reply!

You could ask for an appointment with the anaesthetist to discuss the BF - I had my CS under GA and was breastfeeding as soon as I was awake enough - many drugs and painkillers are compatible with feeding. And as your baby gets bigger/taking more solids the milk will become a smaller proportion of the daily intake IYKWIM.

I have recently had a very similar operation and can honestly say although the initial recovery is very tough, its much better to just get it over with. The threat of permanent nerve damage is just too high to ignore. Especially if you want to start trying for another baby. Its wonderful that you were able to breastfeed for 6 months, but if the new medication you need to take does not allow you to do so (many pills can cross over to the milk), then so be it. Perhaps she will addjust to a beaker better? We tried numerous beakers before finding one our daughter liked.

As for where to have the operation, I would stay in the UK simply because your daughter wont be able to be held/cuddled by you as much and imagine being away from her daddy as well as that, to be more unsettling. I for one really appreciated having my husband to help me recooperate - both physically and mentally. If relatives can fly over to help then brilliant. Even if your place is tiny you only need one or two relatives to stay over. Because of all the follow up care it makes sense to have it in the country you are resident in.

Theres my two pence worth. Whatever you do best of luck! Hope it all goes well for you.

I had a microdiscectomy and I'd certainly recommend it if your back problems are bad. It feels weird for a while afterwards, but far better than having the pain. And, as another poster says, maybe better to get it over with.

I had surgery in the UK and my care was excellent.

I realise that you want to bf, but the painkillers may well rule that out. (My back was so bad before the op it ruled out getting pg to start with though.) I have had two trouble free pregnancies post-op, so from my experience I'd recommend going ahead.

Good luck.

Notmyownname, that is a good idea to speak to the anaesthetist.

H2ohno thank you for the encouragement and the suggestions for feeding and location. I'll take all the two pence I can get at the moment. :)

And Chaotica, thanks for sharing your experience about the surgery. And as you have had the same surgery, if you get the chance to reply again, may I ask how limited you feel I might be in terms of caring for my baby during recovery? For example, it seems I am reading that sitting will be uncomfortable for some time. And I know I will need to avoid lifting, bending and twisting for at least 3 weeks? Will she be able to sit on my lap for a cuddle? I intend to have "helpers" around for about 6 weeks. I would love to hear any ideas on recovering with a baby that you can offer. Thanks so much again.

I had a gall bladder op under GA with a weeks stay when DD3 was 9m and a weeks stay with pancreatitis when DD3 was 6m and bf through out (expressing or DD3 was brought in a few times a day for a feed). DD3 is now 18m and bfing with out any problems. She had only had a bottle once (refused it as well) when I had the pancreatitis and was EBF as per her paeds orders so had a mi of formula/ebm and direct bfs when I was morphined up enough well enough to bf her.

Twice was I told I couldn't feed her after a med and that turned out to be wrong both times - one was safe to bf on and one was a 4 hour wait to feed not a 24 hour wait to feed.

The vast majority of drugs are safe to bf on, even general anaesthetic is safe as long as you are conscious (if you aren't then the drugs are still in your system), morphine is safe too as is tramadol, diclofenac, ibuprofen and paracetamol. Codeine has some questions hanging over it at the moment though (well last time I looked it up) but there are plenty of alternatives. Though obviously some of those meds might not be appropriate for you/your circumstances.

Where ever you have the surgery you can ask for a list of possible medications that would be used and get the Drs to look them up in Dr Thomas Hale's Medications and Mother's Milk 2010 edition (the textbook for bfing & drugs). Or if you opt for the US you could go to the LACTMed database which is US based. If in the UK and they check in the BNF (British National Formulary) ask them to check M&MM as the BNF is very conservative (said midazolam had a 24 hour pump'n'dump time yet M&MM said 4 hours before the levels were safe for bfing).

As your DD is 6m+ and might well be on solids by the time of the op that is much better from a meds/bfing stand point than if she was an EBF 2 week old.

If one of the medications they usually use is contra-indicated for bfing then ask for an alternative to be checked. They will have alternatives as some people are allergic to med A or med A interacts with med B which they have to take for a pre-existing condition so will need med C instead. It's not you being awkward to bf and be ill though I have had Drs admit it would be easier for them if I wasn't bfing/lactating at all.

Good luck for where ever you chose to have the op and whether you chose to carry on bfing or stop. 6m is great but an op doesn't have to be the end of bfing unless you want it too (and there is nothing wrong with that).

I had the same surgery when my DS1 was nearly 2. Before the surgery I was on strong pain killers and the worst effect after surgery was going through cold turkey from these, that doesn't sound like an issue for you though. I stopped the painkillers almost straight away, the after op pain was an immediate improvement on what I had put up with for 3 months before op.

It was v uncomfortable for a few days and I could feel more minor discomfort for a few weeks after (5?). I had pins and needles and some numbness in my foot for about 6 months but all back to normal now.
My DH went back to work after 5 days so I was on my own with a 2 year old and I did manage although I wasn't doing lifting that you have to do with a baby.
I went back to a fairly physically demanding job (primary school teacher) after 5 weeks and by the time I had a 12 week checkup I was 6 weeks pregnant with DC2. I am now expecting DC3 and apart from minor niggles I have not had further back issues in my pregnancies.
I had physio and have been careful about lifting and twisting since the operation and done pilates to strengthen my core muscles to support my back.
I wasn't BF at the time. I would seek advice from docs re drugs in your milk. You may need to pump and throw away milk for a few days then I would assume you can carry on BF. Maybe if your DC wont take much milk during that time, give her milk in her food e.g. Cereals/rice made with milk, yoghurt, cheese sauce based foods if she will eat them?
I had private health care and had the op at a private hospital in London. The care was excellent. PM me if you have any further questions.

My recovery was similar to Zipitydoda's. I was in hospital for about a week, and felt a bit odd/fragile for another couple of weeks. After about a month I was fine but needed physio. I was mobile from the day of the op. (which made a change as I wasn't before it). I didn't regain all sensation, but I can live with that. I was back at work after about 4 weeks, although I couldn't slouch for months.

I think if you've got helpers (esp for 6 weeks) you could manage with a baby. You could probably have a baby on your lap etc quite quickly. (Do this fast before she gets crawling at speed!) Much of the physio you could do while caring for a small person - the exercises I was given were designed to be done anywhere (according to my physio).