Breastfeeding with Pre and Post-op diets! Help!

[shrinknme 0]

Has anyone breastfed in the process of getting the band? my daughter is 10 months old and a great eater, so its not imparative that I continue but I would like to finish the last 2 months out like the American Academy of Peds suggests..

Heres my issue.. for the 2 week pre-op diet I was allowed to be on a diet of regular foods, low carb 1600 cal. becuase all the breast feeding studies say not to drop below that. then today (3 days before my surgery) my Nutritionist said she wants me to do liquids for 2 days before (I know nice warning!) I know its susposed to be low-carb but the low carb liquid diet I have has only 800 cal. you can see my delimma.. does anyone know how much Protein we can ingest in a day? because I am gonna have to have protein if I cant have carbs.

any suggestions for good liquid cals?

second.. I have to do clear liquid for 4 days after and I got Isopure and boost breeze for that but even if I drink 4 boosts, and 1 isopure with 40g protien I am still only at 1000-1200... ahhhhh

I am stressed out!! I cant wait to be 5 days post-op! and hopefully my milk supply wont dry up by then!!

(ps I have pumped a small storage of milk for the 24 hrs post op.. have to pump and dump 24hrs after.. the anesth says 72 hrs.. but I know he is just being very conservative)

[peaches76 0]

did you ever get any answers about nursing with the pre and post op diets? My baby is 11 weeks and I am meeting with a consultant tomorrow about the surgery. I am nursing and would like to continue (since my 1st child wouldn't nurse). When are you doing the surgery?

[Jachut 487]

If breastfeeding is important to you (it was to me), I wouldnt muck around with low carbing whilst breastfeeding personally. It creates ketones in the body. I will argue till I'm blue in the face that being in ketosis is not desirable for us, and many will disagree with me. But it sure isnt desirable to feed out infants our ketones.

This is so hard to tackle when the advice given between one doctor and another is so different and here in Australia, we're not always put on a liquid pre op diet at all (I wasnt) and we're certainly not told to low carb it or even do Protein first. You can indeed be safely banded without having done two weeks of Optifast hell and you can indeed lose weight with a lapband whilst eating bread, rice and Pasta as part of your balanced diet.

So I would play it that way. I would eat a balanced diet from all the food groups for now. I think having lower calories is less of a problem (you have fat stores afterall) than having a very high Protein intake.

Just my take on it.

[shrinknme 0]

did you ever get any answers about nursing with the pre and post op diets? My baby is 11 weeks and I am meeting with a consultant tomorrow about the surgery. I am nursing and would like to continue (since my 1st child wouldn't nurse). When are you doing the surgery?

hey peaches,

I have been working very closely with my nutritionist and lactation consulatant that I had when my daughter was born. I told the doctor that breast feeding was very important to me and that I didnt want to stop.. I told them that I wasnt going to do the pre-op low carb 800 cal. diet that they suggested because all the info says you shouldnt drop below 1600 calories. my nutritionist was great and gave me a lower carb 1600 diet for these 2 weeks, but it was balanced and regular food. Protein, carbs and the like.

I am only on the liquid diet for 2 days before and I am getting in close to 1600 cals on that.. but it is lower carb. I wont hit ketosis in 2 days. She also has done a lot of research for me to give me the info I need to stay balanced after the surgery.. since you do have to do liquids so the stomach can heal. so here are some of the things I did so you can know what to tell them if they are not in the know about BF.

Pre-op:

10 days low carb balanced diet with reg food. meat, starch, fruit, veg, fats

2 days low carb liquid. I am having like 3 low carb slimfasts and drinking glucerna, creamy Soups blended to add up to the 1600 cal. (you can also have boost for diebetics, or other things like that) and then lots of fluids.

Post op:

4 days clear liquid. I have bought Isopure 40g of protien, and then boost breeze which is clear and like 200 cal a bottle.. so in the clear stage I will try to do 1 bottle of isopure and then as many bottles of the boost and other Clear Liquids to get the cals.

10 days liquid. this will be easier as it doesnt need to be low carb.. but my mom who had the bariatric stomach resection recommended (because of taste) the GNC brand of 100 whey Protein which I will probably mix with milk to get more cals and then Soups, milk and whatever else I want thats liquid to get the 1600 cals.

I have also been drinking the mothers milk tea and drinking lots of fluids.. and so far its working. I will keep you updated on how it goes.. I am just nervous. :thumbup: I also have introduced new things into my daughter diet like some meat, cheese,eggs, fats.. just so i know she is covered.. she seems to be fine.

my surgery is on friday! eeeek!

[shrinknme 0]

If breastfeeding is important to you (it was to me), I wouldnt muck around with low carbing whilst breastfeeding personally. It creates ketones in the body. I will argue till I'm blue in the face that being in ketosis is not desirable for us, and many will disagree with me. But it sure isnt desirable to feed out infants our ketones.

This is so hard to tackle when the advice given between one doctor and another is so different and here in Australia, we're not always put on a liquid pre op diet at all (I wasnt) and we're certainly not told to low carb it or even do Protein first. You can indeed be safely banded without having done two weeks of Optifast hell and you can indeed lose weight with a lapband whilst eating bread, rice and Pasta as part of your balanced diet.

So I would play it that way. I would eat a balanced diet from all the food groups for now. I think having lower calories is less of a problem (you have fat stores afterall) than having a very high Protein intake.

Just my take on it.

Jacqui,

thanks for your response. Yes I told the docs I wouldnt be on anything less than 1600 cals because thats what is recommended for BF. So I will not hit ketosis on that.. I am however doing liquids for today and tomorrow before the surgery friday. But I am getting 1600 cals.. even though I am drinking, drinking , drinking :thumbup:.

and my weightloss may go slower at first because I am gonna try like heck to get 1600 calories.. I think thats why I am nervous because I know its gonna be hard to get all those cals in at first.. but I will force myself!

I have also done a lot of research for after and during the 4 days liquid stage I even have a powder that has your intake of 7 vegs and fruits, and a clear liquid Calcium drink! trying to be as balanced as possible on Clear Liquids :smile:

anyways.. how long ago did you have the surgery.. you look great! and what part of Aussie do you live.. my husband and I may move to Perth in 5 or so years so I can do a midwifery school:thumbup:

[shrinknme 0]

did you ever get any answers about nursing with the pre and post op diets? My baby is 11 weeks and I am meeting with a consultant tomorrow about the surgery. I am nursing and would like to continue (since my 1st child wouldn't nurse). When are you doing the surgery?

peaches, I forgot to tell you I also found a liquid calcuim drink near the boost for the clear liquid phase and also a powder from whole foods that has the 7 fruits and veggies you need, that u can mix with Water or juice.

[Shinyhappymommy 2]

Wow, you've certainly put a lot more thought and research into the whole thing than I did. My baby boy turned one later the same month I was banded. I nursed him all throughout the pre and post op stuff, even a few hours after surgery when I was unable to get anything via the pump and dh was taking him to our friends' for the night. Dr. Sears' website had an article which said that it was safe to nurse as soon as you were able after surgery, so I didn't worry too much.

I've had no problems nursing my little guy since surgery. I haven't felt like I have a whole lot of milk, but it was like that well before surgery, I just never leak or feel full, but I see milk on baby's mouth, etc. after nursing, so I know there is some. I'm still nursing him at almost 18 months old and he's doing great. My milk isn't a very large part of his nutrition, he eats lots of table food and drinks plenty of milk.

Good for you for your dedication to breastfeeding.

[shrinknme 0]

thanks for the encouragement! and for sharing! it makes me feel alot better. I too noticed a decline awhile ago too and my lactation consultant said it was because my supply tailored to her needs.. we will see how things go!

[Luv2prayz 0]

Wow, you've certainly put a lot more thought and research into the whole thing than I did. My baby boy turned one later the same month I was banded. I nursed him all throughout the pre and post op stuff, even a few hours after surgery when I was unable to get anything via the pump and dh was taking him to our friends' for the night. Dr. Sears' website had an article which said that it was safe to nurse as soon as you were able after surgery, so I didn't worry too much.

I've had no problems nursing my little guy since surgery. I haven't felt like I have a whole lot of milk, but it was like that well before surgery, I just never leak or feel full, but I see milk on baby's mouth, etc. after nursing, so I know there is some. I'm still nursing him at almost 18 months old and he's doing great. My milk isn't a very large part of his nutrition, he eats lots of table food and drinks plenty of milk.

Good for you for your dedication to breastfeeding.

I noticed that you had a little one that you were breastfeeding prior to being banded. I have an 18 month old whom I still breastfeed and I will be having surgery in less than 4 days. My question and concern is well since he isn't a tiny little baby anymore, will I still be able to continue breastfeeding? My concern isn't the quality of milk especially since he gets it from other things but more for myself. 10 months is quite a difference from 18 months but did your baby at the time weigh more that 10 pounds and how long did you wait to breastfeed him or did you. I was told not to lift anything that weighs more than 10 pounds? I am kind of freaking out because I don't know what I am going to do with my little one. how did you get through it. Especially the first few days/weeks. Any advise would be greatly appreciated. Anyone been through the same thing?

[Shinyhappymommy 2]

What are you concerned about exactly? Why wouldn't you be able to continue nursing since he's older? Now, you might not get the kind of support and enthusiasm you would from the hospital staff about nursing a toddler (versus a smaller baby) because people don't generally expect that, or even sometimes understand it.

If you want to keep nursing, there's no reason to stop just because of this surgery. I nursed my little guy right up until they were ready to take me back, and then I nursed him again maybe 4 hours after surgery. I was supposed to pump and dump, but pumping yielded only enough to maybe drip into the sink, there was no dumping. So then I nursed him and he did fine. Dad said he slept like a log through the night which was a blessing for Dad. :biggrin:

Here is a link to one article and the text of another small article on the topic. It really looks like nursing after anesthesia isn't a big deal--especially where your little one isn't so little.

Breastfeeding and Anesthesia

And from the Ask Dr. Sears website:

"I am having surgery in a few weeks and am breastfeeding my 7-month-old. She still nurses quite frequently and I am worried because my doctor says I can't breastfeed her for 24 hours after surgery because of the anesthesia medications. What can I do to make this easier?"

You actually CAN breastfeed within 2 to 4 hours after surgery. The reason most doctors say to wait 24 hours is that they were trained before anyone every studied anesthetics in breast milk. Well, this has now been researched and shown that the levels of anesthetic medication used in general anesthesia do not significantly persist in the breast milk beyond a couple hours. The little that does remain for the rest of the day is so minute, that it will have no noticeable effect on the baby.

My wife went through gallbladder surgery when our second son was a year old and still an avid nurser. Here is what she did. She pumped her breasts 4 hours after surgery and we threw this away. She then breastfed him on demand after that. Why "pump and dump" at four hours? There is really no good reason. We just did it to be extra safe. In reality, any medicine that gets into the milk during this time will move back out of the milk by four hours. But to make your doctor and the nurses happy, I suggest doing the 4-hour pump and dump.

Any pain medications you receive after surgery are also safe during breastfeeding.

For younger infants who will need to feed during or right after surgery, pump some milk beforehand to be fed through a bottle.

(end of article)

As far as how to deal with the lifting thing, I'd check with my surgeon, because nursing or not, you will need to be able to lift your child. I got clearance to lift my 20 pound baby as soon as I needed to. I did have a lot of help, though, and dh did most of the lifting for the first few days. Do you have someone who can help? Holding your son isn't the same as lifting him. If someone hands him to you, you can hold and nurse him. The only thing that bothered me was that he was laying across my incisions, so I put a pillow on top of my stomach and he lay across that while nursing.

Did I answer your questions? Were there any other concerns? Good luck with everything!

Edited August 24, 2008 by Shinyhappymommy
silly ad in the middle of the article

[shrinknme 0]

Hi I have to disagree with the nursing immediately after surgery thing.. I spoke with 2 different lactaction consultants and they recommended 24hrs after not to breastfeed.. it does depend on the type of anesthesia and the childs reaction may differ.. but the 24hrs is across the board and partly this is because you dont know how the child will react to even the little anesthesia that will come through your milk. so many people have allergies to them I wouldnt risk seeing how my baby would react to it..

what I did was I pumped at least a 24hr supply for my baby and when I tried to pump I didnt get much.. I thought I would need to pump all the time but it wasnt like it was when my baby was solely nursing.. so I just waited till I felt like they were full and then I got like 5 oz out to dump.. if you cant get any out with the pump if you wait long enough you will be full enough to get some out. I only ended up pumping like 2 maybe 3 times in the 24hrs after.. and I was quite relieved because I had bad gas pains and nursing and puming was the last thing I wanted to do!! 24 hours later I was happy to nurse my little one. and I guess I found the 24hr thing worth it because it gave me some time for just me to recooperate. instead of constantly looking to the needs of my little one.. (she was at the clinic the whole time with me and my husband on the day of the surgery and even walked the halls with me after :hurray:. ) and it gave me one less thing to worry about. the 24hrs wasnt so long to wait, easier than I imagined, and I didnt feel scared that something might happen to her.. the pain meds are fine.. they usually just give you tylenol with codine anyhow.

I think the 2-4 hour thing is for gas anesthesia.. I just did a lot of reasearch (please no disrespect intended shinyhappymommy. I have a lot of respect for you because you helped me a lot before my surgery.. I was freakin out!!! just another opinion though :banghead:)

with any advice you have to do what you feel is best.. your the mommy and its ultimately your decision.

Also with the 10lb thing.. my husband is in med school and I planned my surgery on his 3 week break. My baby is like 24lbs and I did not lift her for at least the first week.. the second week I tried very hard not to lift her and by the 3rd I was lifting away.. the doc just told me that if I need to lift its better to sit down and do it from that position. I had no problems obeying the docs because I had a c-section and 4 weeks later ended up having surgery again because I didnt obey the docs and my incisions opened and I got a major infection that hospitalized me for 4 days.. so ya.. no telling me twice.. the other thing is your port will be sewn to your abs and you need time for the stiches to heal before you do anything major.. just so it says attached.

I just made sure I had the hands around to help.. its difficult if you dont have someone around.. maybe you can hire someone? a college student perhaps?? just to be around when the other hands in your life cant be?

also I agree with shinyhappymommy.. I have had no problems continuing to BF my little one.. it kinda helps you lose faster.

well I hope shinyhappymommy and I have helped! :thumbup:

[peaches76 0]

My baby is 3 1/2 months. I just got banded 2 weeks ago. You will need to pump 24 hours after surgery and dump. You need to get the anethsia out of your system. My baby is 15 pounds and still hard to carry. I had help for 3 days after surgery. Just try to limit the lifting and the way you lift. Good luck.

My baby is solely nursing and they just bumped my calorie intake by 500 so I would not be so weak.

[Shinyhappymommy 2]

No offense taken.

There are various answers you can find out there regarding breastfeeding and anesthesia. It seems that recent research has been done and has shown that the anesthesia isn't as dangerous as once thought. Also, the point was made that infants are given the same anesthesias for surgery. Of course, you'd have to take the size and age of your baby into account. I wouldn't have been so confident in nursing a much smaller baby so soon. Whatever the case, it doesn't hurt to err on the side of caution.

However, it would have really overwhelmed me not to be able to nurse for 24 hours, so I found information that worked for me. Each person should do the research and decide for themselves what is best for them and their babies.

Also, that's good advice about lifting. My surgeon was very lax about it, but I've since figured out he's lax about a lot of things, some of which are pretty serious. So in retrospect, I probably should have exercised more caution there too.

Whatever you do, good for you for breastfeeding. I'm a huge fan!

[Luv2prayz 0]

My concern wasn't so much about brestfeeding, as much how it would work with all the sticthing and all on my stomach and being able to get in a comfortable position in able to breastfeed. My son is 18 months old and is over 20 pounds so I was a little worried about how it would hurt me and how you managed to do it so soon. But thanks for all your answers.

[aremers 0]

i was just banded a wk ago. my lactation consultant said it was fine to nurse him that night which i did. i didnt take the hydrocodone b/c of nursing but instead took tylenol which was fine. my son is 12 months old and 21 lbs. i lifted him about 5 days after surgery and have been fine (although i have my husband do most of the lifting). good luck!

i might add--my doctor didnt allow Protein drinks the first week that weren't clear liquid but i wish i would have known about Isopure. unfort i didnt know about it last wk and in the first wk i only got 5g Protein each day from the special K Protein Drinks. my calorie intake was only about 500 calories each day as well. my son still nurses every 3-4 hrs around the clock so i had ZERO energy! now i'm on Protein Drinks and yogurt and cream Soup so i feel better.

make sure you get more protein in than i did!

Edited August 27, 2008 by aremers