Pumping and Dumping after Surgery
Brianna Van Der Veen
Sacramento, CA, USA
From New Beginnings, Vol. 28 No. 3, 2009, pp. 4-7
Labor and birth were short and uncomplicated when my third son, Anthony, was born. We came home from the hospital healthy and happy. A week later, my postpartum bleeding suddenly turned into a dizzying gush, punctuated by large blood clots. My husband, Aaron, shuttled us back to the hospital. An ultrasound confirmed a piece of placenta was still lodged in my uterus and I was tucked into a sterile, cramped, blue and white hospital room awaiting surgery. The doctor and anesthesiologist visited me to explain the Dilation & Curettage procedure that would clean out my uterus. They motioned with their hands and discussed the effects of the anesthetics on my system—big-worded medical language at which I mostly smiled and nodded until the phrase "won't be able to nurse" reached my ears.
"For 24 hours," the anesthesiologist replied calmly. "You won't be able to nurse because of the anesthetics." He smiled, "Pump and dump!" I wasn't amused and sidled a glance at my little bundle snuggled contentedly in his car seat next to me. "Nurse him one more time," he continued, "and then we'll take you in." The doctors shuffled out.
I was tense as I tickled Anthony's tiny lips and begged him, "Nurse, little one, nurse." He drank a meager amount and settled back to sleep, undisturbed by my encouraging hands and voice. I swallowed a pang of guilt, obediently buckled him back into his car seat, and handed him to Aaron.
Immediately, the room was abuzz with nurses and doctors and I hardly had time to think about the baby; a blessing in disguise I realized later. As surgery goes, in a blink I was waking up shaky and confused. "Good morning," smiled a friendly nurse. "You're all done. Everything went well. Your husband is on his way to pick you up."
As we drove home the fog in my head began to clear. Aaron explained that our church group leaders were at our house watching the children. With their help, he had arranged for my good friend, Kimberly, who had a nursing one-year-old, to take Anthony and nurse him until I could again. I ventured a relieved smile but it fell as I walked in the door and spotted my tiny son suckling desperately on his pacifier. Our helpers gently handed him to me, said a quiet prayer, and bid us goodnight. I tried to rock my baby, but he began almost immediately to root around and cry for milk. I started to cry, too.
"He's hungry." I told my husband, "Take him to Kimberly." I kissed him, smelled him, and kissed him again, and once again obediently buckled him into his car seat. My husband squeezed my shoulders and pressed his lips to my forehead. "I'll be back in a few minutes," he said. "Lock the door behind me?"
That's when I crumpled. My brain reasoned that life would be back to normal before I knew it but it was difficult to contend with the painful emptiness that resonated inside me. If nursing connects a mother and child in a deep, spiritual way then, temporary as it was, I was experiencing the wrenching apart of that connection.
I pumped my milk and stared at the little bottles with a gray face while dumping their contents down the kitchen sink. My husband returned home and we crawled into bed shortly thereafter; but the exhaustion of the day couldn't win out against the strange hollowness and loneliness I felt. I tossed and turned for a few hours before getting up to pump milk again. "Pump and dump!" I could hear the doctor's cheery voice above the mechanical hum of the electric pump. "Easy for you to say," I mumbled, pouring out two more bottles of "tainted" milk.
The next morning, Kimberly brought my baby over. I was thrilled to get to hold him and cuddle him but still sad to hand him over to her when he was hungry. The end of the day brought tremendous relief when my good friend hugged me goodbye and I slipped into the bedroom to nurse my darling son. I cradled him softly and helped him latch on, closing my eyes and smiling at the tremendous wave of relief and joy.
I learned later that I probably could have nursed my son right after surgery. Since this was an emergency situation, I did not have time to do any research but I encourage all expectant and nursing moms to be informed and confident on the issue in case they find themselves in a similar situation.
My baby is a happy, healthy one-year-old now and I still adore cuddling up to nurse him to sleep at night. As might be expected, our night and day apart had no long-term ill effects on our relationship or his ability to nurse. If anything, it taught me to treasure more that brief and precious connection between mother and child.
Thank you Brianna for sharing your story. We sympathize with you over what must have been a very distressing situation. It might be helpful for other mothers who are faced with similar situations to be aware of the following.
General anesthesia should not prevent a mother from nursing. As soon as she is awake and alert enough to hold her baby following the procedure, the amount of medication in her bloodstream will be low enough so that the amount in her milk will not be significant. She might want to nurse just before the procedure in case she's unconscious for a while or too groggy to hold her baby when she wakes up.
Physicians have an obligation to respect a mother's feelings, values, and concerns about breastfeeding. Aside from the nutritional and immunological benefits of breastfeeding, even a temporary weaning affects how a mother comforts and cares for her baby. If there are compelling reasons a mother must take a drug that has been shown to be dangerous to her infant, weaning may well be necessary. But often, if mother and physician seek out more information, they find that there is little reason to worry about a particular drug or that there are alternative ways to treat the mother's medical problem.
American Academy of Pediatrics: The transfer of drugs and other chemicals into human milk. Pediatrics Vol 108 No. 3 September 2001; 776–789.
Gotsch, G. Maternal medications and breastfeeding New Beginnings March–April 2000; 55–56. http://www.llli.org/NB/NBMarApr00p55.html
Schneider P, Reinhold P. Anesthesia in breast feeding. Which restrictions are justified? Anasthesiol Intensivmed Notfallmed Schmerzther 2000 Jun; 35(6):356–374.
Cross nursing. While La Leche League International fully supports the use of human milk for babies, it does not encourage or suggest wet nursing or cross nursing of infants. If a mother wishes to discuss these options, an LLL Leader will provide information about the risks and benefits so that the mother can make her own informed decision based on her situation.
A mother who is unable to use a human milk bank is encouraged to use the services of a doctor who is knowledgeable about managing human milk donations. See the policy regarding the donation of human milk: http://www.llli.org/Release/milksharing.html