Saturday, 11 February 2012

How our breastfeeding survived my four week hospital stay

Why I was in hospital

On the 13th December 2011 I was admitted to hospital with gallstones. The plan was to stay in until Friday 16th, while having I.V. antibiotics to clear up an infection in my gallbladder. I was then going to have a tube down my throat to take a gallstone out of my bile duct before being discharged to await an appointment for the rest of the gallstones removing. However, as is usually the case where I'm concerned, it didn't go to plan. I had the tube down the throat procedure on Friday lunchtime. The gallstone was too stuck to get out. But I was still discharged and was going to go back the week after for another attempt, under general anaesthetic. I had started getting discomfort before I left the hospital but assumed it was just soreness from the tube. So I went home. The pain got worse and worse. I'd only been home about an hour when I told my husband to phone for an ambulance. I thought I was having a heart attack.

Back at hospital, I was re-admitted to the same room on the same ward. I had been diagnosed with acute pancreatitis. Before the procedure, I'd been told that it carried a 5% risk of pancreatitis, amongst other things. I thought the procedure sounded simple enough and focussed on the 95% chance of not getting pancreatitis. It wasn't actually explained what pancreatitis was though. I thought I might just get a "sore pancreas". Nobody told me it was life threatening.
So there I was, critically ill in hospital on the morning of Lucinda's birthday party - which I had spent many weeks preparing for and which had now been postponed until a later date. It was now that I started worrying about Lucinda...

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How hospital affected breastfeeding

Up until four days before, we had only been apart while I went to work. I had been the only person to ever put her to bed at night. I had always been there when she woke in the night and I had always been there in the morning. She had been breastfed on demand for a week short of three years. The first four days of my hospital stay were a gentle build-up to what was to come. Lucinda had been coming to visit. My mum had brought her in for a morning feed and then in again for either afternoon or evening visiting. She'd been feeding well. Although I was on antibiotics, they can't have affected the taste of my milk at this time. Now came the challenge...

I was so ill and in constant pain. I was on as much morphine as I was allowed for the pain, which wasn't enough. I couldn't get out of bed, couldn't even sit up myself. I was attached to I.V antibiotics, I.V fluids, had weird slop going down a tube in my nose and had a catheter. (Note to anyone thinking of having a tube/camera stuck down their throat - Don't! This is what can happen!). I couldn't cuddle Lucinda when she came to see me. I couldn't even see her properly unless someone picked her up at the side of my bed. For four days I deteriorated, until I was moved to intensive care - on Lucinda's third birthday. I didn't see her on her birthday, I was too ill. It was while I was in intensive care that I asked a nurse to arrange for someone from the breastfeeding team to come and see me.

I know the local breastfeeding team attached to the hospital from when I worked with them as a Little Angel peer supporter. One of the ladies came to see me and she was very reassuring. She said it was possible that Lucinda would still want to breastfeed when I got home but if we had any problems, someone would come out and work with us to get her feeding again. I also asked for an electric breastpump so I could express to keep my milk supply up, once I was feeling a little bit better. She arranged for me to borrow a breastpump from the maternity department.

I was in intensive care for a day and HDU for four days. I moved back to ECU on Christmas Eve. There still wasn't anything I could do in respect to breastfeeding. I was very weak. Had no strength at all, after laying flat on my back for so long, so needed help to get to the bathroom and couldn't sit upright to use the breastpump. But over the next few days, I built up a little bit more strength and started hand expressing in the shower and my husband helped me get set-up with the pump when he came to visit. But I wasn't just worried about my milk supply, I was also worried about Lucinda losing her latch. Fortunately, she did still want her "mama" (her word for breastfeeding). Every time she came to visit me she asked for it. So, as I wasn't on the morphine anymore, I let her have a little suckle. Just enough to allow her to latch on. I didn't really want her to feed properly because of being on antibiotics as I didn't want us to develop thrush on top of everything else. But although she could still latch, I didn't have to worry about her drinking a lot as she pulled off after three or four sucks and said it tasted "yacky". I was in hospital for another two weeks and almost every day when she came to visit me, she asked for "mama" and every time she suckled for a few seconds before saying it was "yacky". I explained to her that it was the medicine I was taking that was making my milk taste yacky and that when I came home and stopped taking the medicine it would start tasting nice again. I was very worried at this point that I'd been in hospital too long and that we just weren't going to salvage our breastfeeding relationship.

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Back at home

I was discharged on the 11th January 2012, four weeks and one day after I was originally admitted. The first few days continued the same, a few sucks then pulling off because it was yacky. I reminded her often that as soon as the medicine had worn off my milk would taste nice again, but told her it was really important that she kept having "mama" until it came nice again because it was helping the yacky mama go away. However, she then had four days when she refused any mama at all. She even told people "mama's horrid" and "I don't have mama anymore". I felt very sad for her then and angry that someone else had caused a situation that had forced her to possibly wean before she was ready. But I knew I wasn't going to let that happen if I could help it...

We have been having lots of cuddles, skin to skin and baths together since I've been home. We are also co-sleeping. Lucinda hadn't slept with me since she was 11 months old. We co-slept before then but then she couldn't settle in the same bed and moved to her cot and then own bed. But now she needs to snuggle next to me to go to sleep. She tells me several times a day how much she missed me while I was in hospital, even now as I'm writing this four weeks after discharge. It has affected more than breastfeeding in that respect.
But spending as much time as possible together, skin to skin, and allowing Lucinda as much or as little contact as she likes with my "mamas" has been very beneficial. While she was having her four days of complete refusal she still wanted to snuggle into my chest and twiddle my nipples until she went to sleep! We've spent an hour most mornings snuggling up in bed. In the beginning she'd have one or two quick suckles, but by the time I'd been home for two weeks she'd gradually built that up, having more feeds that lasted longer. She also resumed her bedtime feed and was asking for daytime feeds.

Talking to her and explaining what has happened and what will happen has helped so much. Fortunately, she understands a lot for her age and speaks well, so we have discussed how milk is made and supply and demand, etc. She actually asked about this a few weeks before I went into hospital so I reminded her about what we'd talked about. I purposely started the same conversation over and over again.
I'd say how sad it was that I'd had to stay in hospital for a really long time and that she hadn't been able to have her mama, but that I was home now and we could have mama again and I knew how much she had missed it. I said I knew it still tasted a bit yacky but all the medicine was nearly out now and next week it will be yummy again. But she had to keep having a little bit of mama until it came nice again because if she didn't there wouldn't be much mama there. I explained to her that when she sucks my nipple it sends a message to my brain to send a message back to my booby to make more mama! I said how lovely it would be when I had lots of yummy mama again and we could have lots of mama cuddles like we did before.

I also encouraged her to feed when she was tired, hurt, sad, etc, reminding her that it made her feel better. I talked about her friends who still "have their mama". I found breastfeeding photos on the internet and showed her them. Every time there was a baby animal on TV I pointed out that it was having it's mama.
We have also watched "Babies - The Movie" about ten times in the last four weeks! There is loads of breastfeeding in that and I especially wanted her to see the Namibians as they breastfeed as toddlers, so she could relate to the bigger, older babies like her.

I feel like I have had to do an awful lot of persuading. But there was no way I was going to let her wean prematurely due to a situation out of our control. She loves her mama and had never even shown any signs of cutting down at all. She feeds more than some newborns! Unless she is going to self-wean very abruptly, she's not going to wean naturally anytime soon. When she came to visit me in the hospital and asked for "mama" every time it was clear how important it is to her. I had to let her try to feed, knowing she was going to say it was yacky and I felt so bad about that. All she wanted to do was reconnect with her mummy in the way she liked best, but she couldn't.

The good news is that for the last two weeks she has certainly been making up for lost time. She must ask for "more mama" atleast a dozen times a day and pulls my t-shirt up every time I sit down. Yes, it can be annoying, but a month ago I could only dream of that! I am so pleased, for both of us, that we are back to where we are.

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The future

Unfortunately though, it's not over yet. I still need to go back into hospital for the gallstones actually taking out. The gallstones were put on hold once I developed acute pancreatitis! I'm waiting for the appointment at the moment but sometime within the next two months I'll be back in hospital for another 10-14 days (Yes, I know they usually remove them by keyhole surgery and you're discharged the same day but I have to be different! It's complicated in my case and it might have to be open surgery).
I'm not as worried about being in hospital next time. I'll have a sore tummy but I shouldn't be too ill to breastfeed, so as long as Lucinda's gentle with me we should be fine. And now we've got over such a big obstacle I feel like we can survive anything :-)

Friday, 3 February 2012

Unplanned first night ever away from breastfed toddler

I wrote this on Wednesday 14th December 2011...

As I write this, I have just spent the first night ever away from my little girl, who will be three next week. It was the first time anyone else had ever put her to bed at night. I've always said that I'd never leave her for a night until she had self-weaned. But this didn't happen through choice, I was admitted to hospital yesterday (Tuesday) with gallstones and have to stay in for I.V. antibiotics to get rid of an infection before they can remove the gallstones. So it looks like I'll be here until Friday.

My mum has just been to bring her in for her morning feed. As soon as she saw me she ran over, climbed on me and asked for "more mama". She couldn't get to my "mamas" quickly enough! I was so pleased that she had a good feed because a few weeks ago she wasn't well and didn't feed for about a day and the next time she fed she said it was yacky and I had to talk her into feeding again. My milk must taste a bit different when she's missed a few feeds. So this morning, before she came, I hand expressed some milk out just in case. I really worry about being apart because my brother weaned when my mum had to leave him for four days. It would be so sad if something out of my control led to the premature end of our breastfeeding relationship.

Also, this morning, I experienced my first ignorant comment about breastfeeding an older toddler. And, probably not surprisingly, it came from a doctor (well, surgeon). Funny how nobody sees any reason to comment until you are in a medical establishment that ought to know better! In almost three years I've only ever had positive responses to my intention to allow my daughter to self-wean. Until today.

As I am having antibiotics, I told them I would need something that was compatible with breastfeeding, like Amoxicillin, and that I would like them to have some Nystatin and Daktarin cream ready for if we got thrush (I like to make sure they know what I'm talking about!). I also said my baby would need to come in for morning and bedtime feeds, at least. All this was written on my notes. So then people started asking how old my baby was and I said "Three next week"!

This morning, a surgeon came into my room to discuss the procedure and brought with him a team of junior doctors and nurses. There were about seven or eight of them in total. The first thing the surgeon said was "This lady is very interesting"! and then went on to say that I was still breastfeeding my three year old. Then he said to me "You'll be spoiling her". Nobody has ever told me I'm spoiling her before. I was actually quite shocked because I've heard other people say that they've been told they're spoiling their babies for one reason or another, but it's not something I've experienced before.
So, my response was "Erm, excuse me! You're supposed to breastfeed for at least two years. (surgeon looked surprised at this point) I'm following the World Health Organization recommendations to breastfeed for at least two years and I would expect you to know that, being a doctor." To which he replied that breastfeeding wasn't in his repetoire.
Well, at least he knows now. As do the junior doctors and nurses who were there.

Although I think the scenario this morning was quite amusing as it's not often that I am called "very interesting", it also makes me angry that such a basic fact should be omitted from doctors', surgeons', nurses', etc, training. This surgeon was genuinely surprised that it was recommended to breastfeed two year olds. When I think of all the articles I've read from publications such as "The Lancet" about the scientifically proven evidence for breastfeeding older children and the health giving properties of breastmilk, etc. A publication that's for the medical professionals to read. It's not really aimed at Mac Operators like me! Yet I wonder whether they ever keep up with research. Health professionals should be taught about natural duration breastfeeding. Afterall, it is the baseline of human health. The significant factor in a human reaching their optimum physical and mental potential. Something which impacts their jobs.

At least today, I have educated a small group of people. Shame I couldn't go into more detail with them! But my proudest achievement to date is that, as of next Wednesday, I'll be breastfeeding a three year old :-D