Breastfeeding and Surgery

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It is a challenging thing, meshing the natural healing realm with standardized medicine. People choose one path or another for a variety of reasons, and often there is not a lot of overlap. I lean towards the natural side. I prefer to use homeopathics and essential oils instead of prescriptions, and I prefer to let a fever kill a virus instead of mellowing it with a fever reducer. I will go to a chiropractor before a general practitioner in almost any non-emergent situation. I put a great deal of trust in the fact that God created our bodies to heal themselves – whether it is through how we eat, the amount of rest we get, our mental state or another method.

Among many in my friend circle, doctors are discounted, questioned and often ignored.  Whether it is about money, or maybe because of how many times as patients WE have been questioned and ignored when bringing up real issues, I don’t know, but the reputation of doctors in their past almost-god-like shadow is on a downhill slope. After being bitter and distrusting towards the medical world for a period of time, it is easy to forget that doctors exist for a reason, their knowledge is valuable, and they really CAN help. While the natural is always a  preferable first step IMO, it is important to recognize the real value of trained doctors, surgeons, and nurses. It is important to recognize that the practice of medicine saves lives every day. It isn’t just a war with Big Pharma. It is all about balance.

It is hard to maintain that balance when you have had bad experiences within the medical industry. I am one of those who have a hard time trusting. Last Friday I had to have my wisdom teeth taken out, something I had put off for years due to extreme (irrational – I know) fear surrounding the procedure. It needed to happen, and while I am generally a drug-free person, drugs were going to be necessary. Keeping that in mind meant it was time for me to do my research.

Breastfeeding is high on my priority list. This was my first and foremost concern regarding my wisdom teeth removal.  I needed to work together alongside my doctor to find a surgery solution that would allow me to safely continue to nurse my 6 week old baby. At my consultation I was told by an office assistant that I could not nurse on the post-op antibiotics at all until they were finished and out of my system. I knew better, so I let it slide until I personally spoke to the surgeon. I was ushered into the exam room and was left alone to wait my turn to be seen. On the wall I was shocked to see this poster:

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I practically started jumping up and down after noticing it. While my position on vaccinations is not relevant to this post, seeing a surgeon questioning the necessity of some of these things we are told we have to have dumped into our bodies put me at ease. It made me feel like he would cautiously prescribe medications and only use what was necessary. I also felt much more comfortable to ask questions of him regarding the surgery after seeing said poster.

He came into the room and we discussed my upcoming surgery and set an appointment. He was friendly, he fully understood (and cared about) my anxiety over the procedure. However, he also told me I couldn’t nurse for 48 to 72 hours post op and I needed to pump a significant amount for baby. (He also mentioned mixing formula with extra water and then combining with my stored breast milk to prevent dehydration… which is NOT a good thing to do and I still am confused by this recommendation.) This was shocking to me, because I had hoped there was a solution that would allow me to nurse sooner.

I left feeling a little bit stressed out. Happy with the surgeon, stressed about the drugs. Only being 6 weeks postpartum was intimidating since my breastfeeding relationship with my baby was/is still pretty new. We have struggled with latch issues, and we have reason to be concerned about future nursing success. Doing anything at all right now with a bottle is not something to take lightly. I have already had mastitis as well so not nursing for 2 days would put me at risk yet again for it, since pumping does not empty the breast like a baby does.  It was time to come up with a real game plan.

Kellymom.com is a great resource for breastfeeding mamas. They have a section specifically addressing IV sedation for dentistry. In it, there were only 2 drugs, Valium and Morphine, that were listed as not recommended for breastfeeding. They have a very high half-life – 43 hours, as compared to the several other drug choices that have only half lives of 1.5-5.5 hours. Maybe there is something I do not understand, but it doesn’t make sense to me why  if a mother is breastfeeding, she isn’t automatically given drugs with the shorter half-life? I found out from my oral surgeon’s office that I would be given Valium, Fentanyl and Versed. I discussed what the appropriate course of action would be with my IBCLC, (bless her heart for letting me bombard her with millions of questions) and the best case scenario would have been to see if we could swap out Valium for something more breastfeeding friendly.

I showed up at 10:30 for my surgery appointment, ready to get the show on the road. (Although I was totally panicking about having to get an IV.)  I brought up my concern to the assistant setting up the room and she brought the surgeon in to talk to me. As I was wrapped up in a blanket with oxygen tubing in my nose, almost ready to be put under, I explained once again that I was breastfeeding. My biggest concern was the compatibility of the sedation cocktail, the antibiotics, and the pain meds after. I brought up the half-life of Valium, and with no questions or hesitation, he said sure, we just won’t use Valium!

Um. OK?!

I couldn’t believe it was that simple and that easy. I am REALLY glad I did my research and spoke up when I did.  I was able to have a complication-free surgery and then my baby took four bottles without any argument. We went back to nursing 8 hours later with no transitional issues.

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What I didn’t (and still don’t) understand was why removing Valium from the mix wasn’t standard protocol for a breastfeeding mom. I think we need to encourage our medical professionals to have more education about the compatibility of medical procedures and medications with general breastfeeding – and the importance of that compatibility. Sure, a mom can pump. A mom can supplement with formula. It isn’t the best case scenario and the nursing relationship between a mother and child needs to be treated respectfully. I luckily got through the procedure with my breastfeeding relationship intact.  It may not have turned out that way had I needed to pump and dump for two to three days. I wasn’t automatically given the option to take a more breastfeeding friendly course of action with my surgery. I had to request the option myself. The lesson in all of this: don’t be afraid to do your own research. Don’t jump into bed with Dr. Google, but find reputable resources for nursing, like Kellymom.com or your local LLL leaders and lactation consultants. If I hadn’t spoken up when I did, I wouldn’t have gotten the result we needed. I hope you will find the motivation to do the same!

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(Apparently I look about 12 years old post-op.)

laney

 

3 Comments

  1. Christina -  May 30, 2013 - 5:57 pm

    Lol I must agree you look very yyoung. But I agree more reaserch should be done and more doctors should consider breast feeding more important.

  2. Hannah -  May 30, 2013 - 6:11 pm

    Omg you look so young! But it’s done now and you never have to worry about it again! I’m so happy to have mine out

  3. janny -  June 1, 2013 - 2:35 pm

    Yay! Yes research is needed! Every time you have the opportunity to do so ahead of time. Proud of you.

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