Need an op tomorrow under general but EBF and no expressed milk

[turquoisediamond]

Hi,

I gave birth three weeks ago and it's been nothing but complications since.

In a nutshell:
48 hour labour for to 9cm
C section due to failure to progress
Got Paralytic ileus (my bowels stopped working post surgery) was hospitalised for a week. Vomiting green bile, tubes down my nose, cannulas, antibiotics, suppositories, laxatives, scans etc

Got home and have had horrendous tummy cramps for 3 weeks. Assumed to do with the bowel issue but would resolve itself eventually.

Last Thursday a massive bit of placenta fell out and I went to A&E. They sent me for a scan today.

Turns out I have retained placenta - why they didn't get it all out in a c section I don't know.

Options:

1. Do nothing (but high chance of infection and unlikely it will come away as it hasn’t in 3 1/2 weeks
2. Take medication to get rid of it. Again they said it might not work so I still need surgery anyway. She said I’ll bleed quite heavily
3. Surgery. I just felt like she was saying surgery is my best bet.

I've agreed to surgery and I need to go under general. They want me in at 7am tomorrow. If no other emergencies and they get to me in the morning I'll likely be out by 4pm.

The issue is I'm exclusively breastfeeding and have not expressed yet. I can't leave my baby from 7-4. I've said I can't do tomorrow so they've moved to Thursday. Any advice on how I can express enough milk?

I'm thinking I'll just demand that I keep my
Baby with me until I go in to theatre and try to express as much as I can tonight and tomorrow.

It's an operation for post natal mothers but they seemed completely clueless about breastfeeding. Just kept suggesting formula which I really don't want to give.

Any ideas or advice welcome?

I'm so scared of more complications. 1% chance they'll damage my cervix and 5% they'll perforate my womb.

Anyone else had placenta left after a c section?
Anyone else had this procedure?
Any advice on what to do about breastfeeding my baby?

Gosh, that sounds like you’re going through an awful lot, you have my sympathies.

do you know if the hospital locally offers any sort of milk bank service? Is that something you’d consider if so?

So sorry to hear you’re going through this - would you consider donated milk if that was an option? Otherwise could you express before you go in / as soon as you feel up to it after and have someone take the milk to your baby?

And have you got a Haka? (It’s a silicone pump you attach to the other boob while feeding) People seem to have varying success with it but perhaps a way to maximise milk collected before your op.

Can you get in touch with the local hospital infant feeding team or lactation consultant? You may need to go via your health visitor.
It’s maybe not ideal for you but if you have to use formula for a day or so to protect your own health and so baby isn’t hungry then just do that? Formula is a perfectly adequate substitute for breastmilk, and yes I’ve breastfeed three babies.
you could try expressing now, after every feed, and express overnight too, you may get enough, especially if you express right up til surgery and have someone collect the milk for your baby.
Get DH to look at cup feeding or at least paced bottle feeding.

Tbh with a retained placenta it's unlikely your milk supply will keep going at the right level.
Definitely get the placenta out asap.

Your baby will be ok on a very small amount of formula if you cannot express any.

Ask the hospital if they run a milk bank and if you can get some.

If you can’t get donated milk, don’t worry about giving formula. My son had three formula feeds aged 3 weeks, no impact on my supply, never had another and bf to three years. You can get premade bottles of formula so you don’t need to learn how to mix it.

Blimey you poor thing.

You need to take a breath for a moment.
I would keep baby with you feeding until you're given 10/15 mins notice you're going in.
Have baby back as soon as you're able to comfortably feed (although the pain has probably been awful anyway).

Get those ready made milk in a glass bottle that they make for newborns.
When baby needs a feed they can have that.

Honestly, for the sake of your sanity and the stress and pressure of expressing and then possibly not expressing enough and making yourself sore, it's not worth it.

Baby will have the goodness of your milk later on in the afternoon.

You must look after yourself emotionally and physically to be well as you can be for baby.

Agree with this. Try a haaka on the opposite boob during every feed between now and the op. 3 week olds do not actually take much milk at each feed so don't be put off by not getting much out. And then get some ready made Kendamil or similar and use that if needed. Absolutely do not stress about it, it'll all be ok OP. When you're ready after the op, have some skin to skin with baby and offer frequent feeds, but focus on getting yourself recovered. It'll all be right OP, and congrats on your new baby - I'm sorry you've been through the mill!! Oh and I've BF two babies one for 2 years and one for nearly a year and still going. The first I never would have offered formula. The second gets one every now and again and it has no impact on our BF journey at all. If you're wanting support, contact your local IBLC consulatant and I'm sure they can offer advice.

Thanks everyone. I will contact the infant feeding team that's a great idea.

The reason I don't want to give formula is that my first son had CMPA and I had to totally cut dairy from my diet.
I'm already worried this one has it too as he cries all the time but didn't want to cut out dairy for no reason so I'm just seeing if he settles.
I don't want to give cows milk formula as it might really hurt his little tummy.

Also I have allergies and eczema. I know it's largely genetics but because I EBF my first son for over a year he doesn't have any allergies and so far doesn't have eczema or asthma and I wonder if breastfeeding helped protect him. So I really want to do the same for my second without giving any formula.

God it's been such a horrible three weeks. I just really want to feel normal. Thanks for all your sympathies x

Gosh what an absolute shit show I'm so sorry you are going through this OP.

I had to have surgery to, ahem, repair things, when DS was about 8 weeks old and found a similar response from the health professionals re breastfeeding which I was really surprised about too.

Make sure you ask to speak to the anaesthetist to make sure you aren't given any drugs that mean you can't feed afterwards. Slightly different for me as the issue wasn't so urgent but I said that I wouldn't be going in unless I could bring baby with me and feed up until and immediately after my operation. I did have to bring DH with me as obviously he needed to watch baby while I was in theatre, and at the time a private room had to be organised for me because of this (but it was during covid so not sure if that was why).

Hope that is in some way helpful, good luck for the surgery and hopefully a speedy recovery afterwards!

Agree with the poster above. Will not be a problem if baby has a bit of formula over a couple of days rather than stressing out with pumping, storing milk etc. Would be a bonus if they combi feed, I've never been able to despite trying! My DS1 took one bottle a day for the first couple of months then started refusing it.

You'll probably still need to pump a bit if you're away from baby for more than a few hours.

Have they said how soon afterwards you'd be able to feed? How long till the anaesthetics are safely out of your system? Sorry you're going through this, it sounds awful.

Rent a hospital pump they are so much better than home ones. Pump as much as you can, drink plenty of water.

If you can't get enough baby with have to have some formula. It is disappointing but not the end of the world. Just buy a few ready made cartons you don't have to get a whole tub of powder.

It is a good idea to have some ready made formula available for emergencies anyway. I was rushed to hospital when DS was little and couldn't take him with me because of covid. He had the little bit of milk I was able to pump before being taken in around midnight then nothing the rest of the night until the shop opened.

Go to gp and ask for dairy free formula just while your in having op? Or ask on Facebook if anyone has a spare tin of dairy free going.

Yes it's such a shit show. Sorry you had to have an op too.

I asked about drugs and if I'd be able to feed. The gynaecologist said "you need to speak to the anaesthetist" so I said "ok can I speak to them please?" And she basically said you'll only get to speak to them on the day! I said but I need to know before hand if I will have any drugs that means I can't feed my baby and she just shrugged and said they're all busy in emergencies.

I have since googled it and found I can feel after general. Some women have general for a c section and are encouraged to BF straight away. It's more if there's any other drugs I should be aware of but I'll make sure to say I can't have anything that doesn't work with breastfeeding

Yes I have a Hakka and an elvie. I'll start using both now. I was just waiting for 6 weeks to properly establish breastfeeding and make sure I didn't pump and get an oversupply. But now I'm just gonna forget that and pump pump pump!

I think how soon after depends on how soon I wake. I don't think it depends on the amount of time passed since drugs because new mums are encouraged to feed straight away even after general. But I will check with the anaesthetist

Can your DH be there and advocate for you? I had very similar concerns (CMPA, family history of multiple allergies etc) but after an emergency C section I couldn’t advocate coherently and strongly, and it took DH formally refusing formula to get them to find a midwife who would hold the baby and latch her on to me (I was physically unable to at that point, this was in the recovery room post-op).

Sounds tough so soon after birth. Have you explained that your ebf? I had 2 operations within my daughters first year and on both occasions they let me come with my partner and baby. I a given a private side room and feed right up to going for the op - for which they put me first or second on the list.
Everyone was told I was feeding and it was explained that I could feed immediately after waking up - no need to pump and dump anymore.
Good luck 🤞

Also I have allergies and eczema. I know it's largely genetics but because I EBF my first son for over a year he doesn't have any allergies and so far doesn't have eczema or asthma and I wonder if breastfeeding helped protect him. So I really want to do the same for my second without giving any formula.

My DS had nothing but my milk until he was a year old, has terrible eczema and uses a asthma pump every day. These things just happen for some people and not others. A couple of formula feeds are not worth worrying about.

Yes he will be there to have the baby when I'm in theatre. Yea he can advocate for me. It's just if the baby needs to be fed and I'm not back / haven't expressed enough I don't know what to do!

Sorry to hear your child has to live with eczema and asthma. Like I say I know it's more likely genetics and could happen anyway... I just want to do everything in my power to only breastfeed if at all possible.

Would really appreciate all advice on how to express enough milk / advocate for myself brining baby in etc etc some great suggestions on milk bank, infant feeding team so thank you. I really don't want advice to just use formula / one bottle doesn't hurt etc as that's not what I've asked here 😊

This is useful https://www.breastfeedingnetwork.org.uk/factsheet/anaesthetics/

May I ask where you got this information that my milk supply won't stay with a retained placenta? Is this spoken from experience or do you have a medical background? That's really worrying as at the moment my baby is feeding well and putting on weight and I wouldn't want to do anything to negatively impact that.