Anyone XP their breastfed baby going 'nil by mouth' for 2+ days? Advice please!!!

[veryworriedmummy]

Started a similar thread the other day, with some good general advice - but it was more about the general panic I am in about my DD needed to have operations. Really want some info from a breastfeeding expert or someone who has gone through this...

She is going to need, we guess, about three ops. One of which will be to have a colostomy done. We've been told she will need to go nil by mouth for at least 48 hours after the OP and the will have to have measure amounts - so breastfeeding is still out as they wont know how muchshe has taken.

Dreading her crying for the breast for comfort and generally worried about it messing up her breastfeeding. Will she forget how to breastfeed going without it for that long? Is it going to be as bad as I think it will?

Has anyone else had to go through this?

By the way, she is 2 weeks old now and BF very well. We dont intend to introduce a bottle or dummy and she will probably be about three months when they do the 1st op.

I certainly won't be expert enough for you, sorry, but do you have a pump so that you can express during this time to keep up your supply?

If you don't want her to get used to a bottle, which could (but won't necessarily) mess up bf, then I would suggest feeding her with a syringe during the period where you need to know what she has had.

Best of luck - must be a very worrying time for your family.

Agree with what cantsleepwontsleep said.

Between now and then get pumping (even if you dont use the milk you express) although you can freeze it OR donate it to a milk bank so it's not wasted.

Syringe good, and I believe you can still cup feed too. If your baby is poorly I can think of nothing better than giving it b/milk.

I thought that b/milk worked through the system in only a few (4 or so???) hours?

Why does it need to be nil by mouth for 48 hours?

Sorry to hear about your LO. Havn't read your other thread.

DD was very ill with bronchiolitis at 10 days old, and once she was well enough to take milk, it was through a feeding tube initially. All the time she couldn't BF, I was expressing regularly with a hand pump and freezing my milk in measured containers. The nurses the defrosted what they needed to do the tube feeding. After about a week DD was strong to BF and went back to it with no problems. We did give her a dummy for comfort, which i didn't have a problem with as my other DC had them. HTH

Agree it's a good idea to avoid bottles. They shouldn't have a problem with that CantSleepWontSleep. I intend to stay with her at the hospital and so I should hopefully have access to a hospital pump. Does seem like such a long time VVVQV. Think it is something to do with the colostomy having to rest.

Reassuring to read that your DD went back to the breast after all that time and you managed to keep your supply up. That makes me feel better.

Hm...hopefully Tiktok or Hunker will come along....they might know more!
I always thought that you can Breastfeed, even if nil by mouth....however...I only know that this is the case for sure pre -op....and obviously, as your little one is operated on the gut...that might changes things....
Did they explain why they need to know exact intake?

Ask the hospital to provide you with a hospital grade pump - it's faster and easier than a handheld or shop bought electric one.

LilBloodRedWantsGore - I never got on with hand pumps so will definatley make sure they have on available or I'll just hire one.

veryworriedmummy - your breastfeeding will be well established by the time of the first operation at 3 months old. Personally I would start expressing milk for storage about a months bfeore the operation so that you have a storein the freezer. When she is nil by mouth you will need to express probably about 3 hourly to keep your supply maintained.

You might find that she will need the comfort of a dummy at 3 months if she is nil by mouth. Might be worth getting her introduced to one nearer the time. Also might be worth trying teat nearer the time too if they want to give her measured amounts.

My DS2 had meningitis when he was 6 months old and couldn't breastfeed. He needed to suck for comfort though and we got him a dummy when he was in hospital. I got rid of it once he was feeding agagin. When he got better he resumed feeding with no problem. My supply dipped because for a few days I was so worried I forgot about regular expressing. The supply soon came back again though.

The paediatric ward should be able to supply an electric breast pump and individual kit when you are in. At home you could hand express which is easy when you get the knack, or you could use a handpump such as Avent Isis.

It will all work out fine i am sure.

Hi Mears - So you don't think introducing a dummy could potentially mess up the breastfeeding at time when she has been made to go without feeding fo so long? I want to be able to give her comfort, but in the long term it is so important that she breastfeeds because of the protection the milk will give her to her digestive system which is going ti be operated on and helping to protect her against infections etc. Also, constipation will be incredibly difficult for her to deal with because of the nature of the problem that she has. That and all the emotional nurture. So, this is why I'm rather torn on the dummy issue. Don't personally like the idea of introducing a bottle teat as I've been told that they can use a cup for the measured amounts.

bump

Hugs to you, what a lot to go through xxx I had a colostomy done immediately after the birth of my first child and was nil by mouth for a few days afterwards. This is to let the colon rest as being handled during the operation can be quite traumatic for it. After 48 hours I was alllowed sips of water, and the next day i was allowed juice/tea etc. I would imagine they will allow breastmilk after 48 hours though?

During that 48 hours she will be kept hydrated via a drip, and will likely feel very sleepy. I'm not sure on the dummy issue. My second child, exclusively breastfed until 6 months, had a dummy and was completely fine and it was a great comfort to him. It's hard to know, but I 'think' if I was a baby recovering from a colostomy I would want something to suck on. Apart from anything else, it will help stimulate saliva flow so the mouth isn't so dry.

Anyway, I just wanted to add a few words to say that having a colostomy, recovering from the op and dealing with the stoma/bags etc isn't as difficult as you might imagine. I'm sure you must be awfully anxious though, so hugs to you.

xx

Hi spudballoo

Thanks for that . Nice to hear an adults experience of what it might be like for her. Starting to warm to the idea of introducing a dummy shorty before OP time - then she'll know the difference hopefully and I'll be able to give her some comfort. Good point about the saliva stimulation too.

vwm do make really sure about the pump. i was promised one from the maternity ward but when it came to it they wouldn't let it off the ward and i couldn't go to it (different building).

Hi worried mum,
Good luck with everything. I just wanted to add that my breast fed baby was given a bottle of expressed milk from the age of 3 weeks at his 10pm feed, by his dad so I could get more rest as I was very anaemic. Baby had no problem going from one to the other and still is very happy with both now at 8 months! I let him chew the bottle as he knows not to try my nipple!
I hope this gives you a bit of hope. Perhaps you could try getting her used to having expressed milk in a bottle from time to time before the op. Then it won't be such a shock when she is not feeling well.

hi very worried mummy my dd2 had to have a laparotomy and bowel resection at 3 days old i was desperate to breast feed and so used the hospital pumps to express (much better imo as couldn't express with hand pump for dd1) dd2 was nbm for about a week post op then slowly had ebm introduced via a syringe 5mls 4hrly to start gradually increasing we did use a dummy for comfort and she did take milk from a bottle (when volumes got too big for the syringe) had a bad first day getting her back onto the breast at 2 1/2weeks old (as she'd never really had a proper breast feed) but we mastered it and she goes great guns now ....felt really helpless for that day tho' ( kept asking for help which didn't appear) but persevered!! HTH

Just to reinforced what mears said - your supply will be quite settled by the 3m point. Check with the Hospital about bringing in BM as they may be worried about infection control etc. Find out now so you can be prepared. By 3m you won't (hopefully) have a problem with a few bottles of EBM in fact it was a life saver here every once in a while!

Good Luck with the op. Hope DD gets better soon X

A dummy is not a problem for a baby who is well established breastfeeding. It is in the early days that they should be avoided. Same with teats. I have breastfed 4 babies and none of them had a problem taking EBM from a bottle which they had when I was at work. I didn't give it on a daily basis and only introduced the bottle a couple of days before starting work.

Your DD will probably be so desperate to suck after the op that she will take EBM from a bottle. A cup can be used.

My DS never had a dummy till he was actually in hospital so it isn't vital to introduce beforehand. Once he was feeding again and discharged home I stopped the dummy.

My situation was a little different in that my ds was 9 months when he had his surgery, although was still breastfed. I was so worried that it was going to be the end of breastfeeding for ds as he was NIL by mouth for about 55 in the end. DS2 never really took to a bottle and hated dummies and has never sucked his thumb, so his only form of comfort was from the breast.

It turned out he was very well sedated and had an NG tube to keep him hydrated. I pumped every 4 hours or so to keep up supply and so that they could put breastmilk down his tube. What didn't get used by ds (which was most of it as it was drip fed at the rate of 1ml per hour) went straight to thier milk bank for the other poorly babies. If you are really worried about bottles or have a child like mine who just couldn't get to grips with one, then cup or syringe feeding will work.

A few hours after ds took himself off the ventilator (little monkey!), he went absolutely beserk, I have never seen so many nurses rushing in one direction, lol! The sedation wasn't touching him, so they said I could offer him the breast. It was a little iffy as they wanted him on 25% of his normal feeds, which is hard to tell for a breastfeed baby, but although he did have a little feed, it was mainly for comfort and he fell asleep within 2 or 3 minutes. It was like he knew somehow that he couldn't have big feeds, so he feed in little spurts a bit more often. He didn't forget how to feed at all, like riding a bike, they don't forget.

I really hope that your DD's op goes well and that because breastfeeding will be so well established that she will get straight back to buisness when allowed. Hugs

veryworriedmummy, just to reassure you a bit re. the forgetting to breastfeed - my dd2 had heart surgery at 7 weeks. She had a lot of complications afterwards and in total was off the breast completely for 5 weeks, she was fed with TPN for a week and then a special formula down the ng tube.

She did have a dummy - even for the first two weeks following surgery when she was on a ventilator, the ventilator tubing went into her nose, leaving her mouth free for the dummy .

Once she was allowed back on the breast it took only 3 days to get back to feeding well and without any supplementation by ng tube , and considering she has Down's syndrome which makes feeding a bit trickier anyway, I hope this gives you some encouragement.

just to add that the dummy was introduced in the intensive care unit after surgery, she'd never had one before (or after). She took to it instantly, even in her rather sorry state.

Thankyou all so much for your posts. They are so reassuring and I feel much less worried now. I will let her have a dummy because I agree that she'll need it. We're seeing the specialist at the end of this month and that's when they'll decide when her OP is. I'll post back on this thread and let you know how it went. Thanks again. x x x

Hi I xpressed for the first few weeks as ds2 was v prem, he was fed TPN via a long line IV & then NG tube.
I found xp at the hospital difficult, although they had a room set aside like a little milking parlour

If the babies needed measured feeds but the parents did not want them bottle fed they were given their feeds in a cup, they just lapped at the milk, amazing to see these tiny babies drinking from a cup but apparently it works.

Yes, again we were advised to use a dummy, (dc was NBM much longer) we never got the cup feed to work went everywhere if they want measured amounts they/you might not be happy with cup, if it gets spilt it can be difficult to get official sanction to give same volume again.
They may put feeding tube in at op?
You may find most of the help/advice/equipment/freezer etc is obtainable via the neonatal/postnatal wards rather then paed one which will be used to older children. (unless GOS or similar!)
Good luck with it