WLS while breastfeeding

M M
on 6/25/12 10:43 pm
You'd need to pump and dump after surgery, for several days, and have enough milk stored for when you cannot feed.  Also, I assume it will take you many months to get to this point, so you could have the storage -- and your baby will be much older -- on solids and can handle it.

I haven't read the rest of the thread -- but nursing post op is possible -- hard but possible.  I would not ever suggest nursing exclusively for an infant during massive weight loss.

Please ask a lactation pro and your surgeon.
Michelle G.
on 6/26/12 12:00 am
RNY on 08/15/12
Thanks for your response!  Were you able to breastfeed while having wls? 

Why would I have to pump and dump for several days?  Are you an anesthesiologist or pharmacist intimately familiar with the medications used during surgery and their passing through to breastmilk?

I had 5 c-sections, and never had to pump and dump with the anesthesia or pain medications administered to me.  I was encouraged to breastfeed, actually!  So, I know there are breastmilk-friendly medications that could be administered.  I have not had this abdominal surgery, however, and would love input into the medications commonly administered and why I would not be able to breastfeed while using them and if there are alternate medications that would be better for my situation.
          
M M
on 6/26/12 12:01 am, edited 6/26/12 12:02 am
 I am not a lactation consultant.  It was just what I was told.  Please consult yours.

I weaned my child during my stay in the hospital for my WLS.

She was 3.  Not a big deal.

Also - you could have worded your inital post this way - as you appear to be very well-read in nursing and could probably answer your own question.  :)
happysunshyne
on 6/26/12 4:48 am
RNY on 04/02/12
MM is correct. i just had an RNY two months ago, after I weened my child. Both my OBGYN  and my Bariatric Surgeon told me that I would have to dump a minimum of five days after surgery.

The type of anesthesia is very different from the epidural they give you while having a c- section ( I have had both). They must give stronger anesthesia for WLS because of the time it takes to perform the operation, and the fact that they don't want you to move.   They also administer different types of meds while you are in the hospital, which may be toxic to infants, as well as the barium used in the barium swallow. 

Because my son was only three months, I was not willing to take the risk that I would damage my milk supply and waited until he was fully weened before I had surgery.

 

 

RNY 04/02/2012 HW 262 CW 118 GW 135

Heather :o)
on 6/26/12 12:29 am
Testing....let me see if this goes through, I cant respond to this message despite several attempts, I made a separate post to you here: http://www.obesityhelp.com/forums/amos/4544778/For-the-breas tfeeding-mom-BF-after-WLS/
Believe nothing, no matter where you read it, or who said it, no matter if I have said it, unless it agrees with your own reason and your own common sense. - Buddha
M M
on 6/26/12 12:55 am
 Both worked.
Heather :o)
on 6/26/12 8:35 am
It didnt work how I wanted it lol. First I typed out a long response with a ton of info and resources and it wouldnt post, I kept getting an error message, so I copied it into a new post and just see now that what I copied didnt copy. Weird. Now I deleted that one bc it made no sense and I have to go dig up my resources in history. Grrrr.
Believe nothing, no matter where you read it, or who said it, no matter if I have said it, unless it agrees with your own reason and your own common sense. - Buddha
tripmom02
on 6/26/12 4:41 am - NJ
 I would be hesitant to do it if my child was under one year, but other then that I would treat it like any other outpatient procedure when it came to pumping and dumping etc. The key is going to be staying hydrated after wards, and coming up with nursing positions that are not uncomfortable on your incisions after wards and making sure that you can get all your vitamins in b/c your body is going to pull them to make milk and you could end up deficient sooner then others if you are not supplementing well and with the RIGHT vitamins. 

Good luck! 

Courtney - Lap band to VSG revision
      

    
Heather :o)
on 6/27/12 8:33 am
I am an RN and IBCLC. I have had a TON of training in this area and recertification is in a month so LOTS of recent training.
    I can not count the times I heard health care professionals including OB's pediatricians, maternity nurses give incorrect info. If I had a dime every time I heard wrong info id be pretty wealthy. I wouldn't ask your bariatric surgeon or PCP's opinion about breastfeeding, this is most likely a very foreign subject to them, of course mention it so they know you are lactating, but expect to hear the pump and dump myth. Anesthesia has a very short half life, I have consulted on post op gall bladder removals, appendectomy's etc and was able to confer with their surgeon utilizing resources like Dr Hales book or forum located at ibreastfeeding.com so that we could agree on the safety of the breastmilk/resuming lactation.
    Contact the hospital IBCLC before surgery, she should be able to hook you up with a hospital grade pump while you are inpatient as well as storage containers and a place to store milk. She should also be able to review your post op orders and see that meds are compatible with lactation. A lot of the same meds given after WLS are given after a c-section, pain killers, anti nausea, benadryl, etc.
  More info here: http://kellymom.com/category/bf/can-i-breastfeed/meds/ Meds approved for lactation by American Academy of Pediatrics (Not all meds have been evaluated yet by AAP, this does not mean they are not compatible, you can look at Dr Hales site and/or book, call local IBCLC or La Leche league, they can not "Approve" a med but can read to you the information word for word so you make your own informed decision: http://kellymom.com/bf/can-i-breastfeed/meds/aap-approved-me ds/

    As far as any scan after surgery, barium swallow etc, this is what breastfeeding expert Dr Jack Newman states in his myths about breastfeeding:
    begin quote "by Jack Newman, MD, FRCPC

 

1. Nursing mothers cannot breastfeed if they have had X-rays.

 

 

Not true! Regular X-rays such as a chest X-ray or dental X-rays do not affect the milk or the baby and the mother may nurse without concern. Mammogramsare harder to read when the mother is lactating, but can be done and the mother should not stop breastfeeding just to get this done. There are other ways of investigating a breast lump. Newer imaging methods such as CT scan and MRI scans are of no concern, even if contrast is used. And special X-rays using contrast media? As long as no radioactive isotope is used there is no concern and the mother should not stop even for one feed. Herein are included studies such as intravenous pyelogram, lymphangiogram, venogram, arteriogram, myelogram etc. What about studies using radioactive nucleotides (bone scans, lung scans, etc.)? The baby will get a little radioactive nucleotide. However, as we often do these very same tests on children, even small babies, and the potential loss of benefits if the mother stops breastfeeding are considerable, the mother should continue breastfeeding. The exception is the thyroid scan. This test must be avoided in breastfeeding mothers. There are many ways of evaluating the thyroid, and only very occasionally does a thyroid scan truly have to be done. Check first before taking the radioactive iodine, the test can wait until you know for sure. In many cases where the scan must be done, it can be put off for several months." end quote

Dr Jack Newman is a renowned breastfeeding expert, you can email him personally here and ask him his opinion on WLS while breasttfeeding http://www.breastfeedinginc.ca/contact.php

My concerns would be your health, you would need to be especially vigilant about nutrition and vitamins, discuss plan with bariatric nutritionist, your body will make milk but if you are lacking it will take from you making you feel run down. Also id ask about ketones from rapid weight loss entering into breastmilk and if they are safe for your baby, I can not find much updated info on that so that's definitely a question for Dr, Newman.

Believe nothing, no matter where you read it, or who said it, no matter if I have said it, unless it agrees with your own reason and your own common sense. - Buddha
Michelle G.
on 6/27/12 11:14 am
RNY on 08/15/12
WOW!  THANK YOU!!!!  This information is awesome.  Especially the links!

When I went for my evals, the nurse said I definitely had to stop, but the nutritionist didn't think I would need to.  I am aware that the concern is more for my health than the nutrition in the breastmilk and I would absolutely be hyper-vigilant about my vitamins and hydration.

I will definitely check out the information you provided and I am so glad I can go into my meeting with my surgeon armed with some real research to make my case for continuing to breastfeed throughout recovery. 

Thanks again for retyping everything and sending this info along!!

          
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