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Hospital breastfeeding on an adult surgical ward – Gina

Story abridged from Patient Opinion addressed to the treating hospital

In January 2015 I attended my GP with pain located at the bottom of my back just below my tail bone, the area was sore to touch and was of a red colour, before I could even explain myself my GP told me that I have a a pilonidal sinus/Cyst. This is a small hole or "tunnel" in the skin. It usually develops in the cleft of the buttocks where the buttocks separate. I was told that I would need antibiotics and this would sort the problem out. I left feeling relief and thinking within 48 hours my painful behind will no longer hurt. I was prescribed Flucloxacillin for 7 days 4 times a day, along with ibuprofen and paracetamol.

The next day, although I was on pain relief the pain was getting worst. As a breastfeeding mummy I couldn’t feed my baby girl without being in tears which resulted in me being in bed with a hot water bottle and my other half would tend to the baby and bring her to me for feeds. I physically couldn’t do anything without crying out in pain. Mid-afternoon there was very little pain until the pain relief had worn off. In the evening I again was in tears due to the pain and sleep was very little.

The following day the pain was unbearable and I felt deflated and upset as I was promised 48 hours of effect of the Flucloxacillin would have occurred by now. With having a baby who is exclusively breast fed I was trying really hard to cope and not have to worry about going to the hospital but after talking to a GP who I know through a social media website she advised me to attend hospital as soon as possible. At 7pm after being in tears again I decided I needed to go but thought I would ring Aintree A&E to see what the waiting time was currently and if I would be seen quicker due to having an 18 week old baby. I spoke to the A&E consultant on at that time who asked me to explain my problem and she explained that she would need to talk to the head surgeon and get back into contact with me. With a call back within 15 minutes I was told the surgeon had sympathy with myself and my situation and explained that if I was to attend the Surgical Assessment Unit (SAU) tomorrow before 8am I would be seen early / first as I’m on the list due to me having a baby and needing to get back to her needs. Finally she told me not to eat anything from 6.30am so I had a little dinner once of the phone that evening 8pm. Why were my expectations not more properly managed with regards to when I was likely to be seen and for how log would I be away from my baby?

The next day I attended the SAU stated my name and the nurse said I wasn't on the list. I explained I spoke to a consultant yesterday and followed her instructions. She had another look in the same pile she just looked at and again said no, she went on the explain that I needed to go to triage and get referred to the SAU ward but before she could finish I began to get upset again I couldn’t bear the thought of waiting in triage or even sitting down and leaving my little girl for a long period of time this needed to be sorted to which another nurse said that’s fine but If I have an emergency they are more important than you (which I agree but there wasn’t any need to be so rude) he promised triage would take 2 minutes and I would be seen quickly as they do have a spare bed. Walked down to triage/ A&E and spent 15 minutes giving my personal details to the receptionist, but I didn’t have to be seen in triage I was told to go straight back up to the SAU ward. I must admit once being admitted back to the SAU I was seen very quickly, blood taken, questions asked and 3 doctors who came to assess my pilonidal cyst which I was told was an abscess and was more serious than that cyst and would need draining and lancing as well as removing. Surgery would take 15 minutes I would be put under a general anaesthetic

I was then taken to a room with other ladies in and told it was just a waiting game now. I asked the nurse if I was safe to breastfeed my baby through the day on the drugs I was given and she said “I'm not 100% sure but I would say not as you're on codeine”. Feeling upset that I can't feed my baby me and my other half agreed for that time being she would be put on formula, I felt awful and like a failure of a mummy. Why were alternative medications not investigated at this point? Why was codeine given when breastfeeding was clearly a priority for me?

I then waited until 630pm for my surgery. Why was I not given any advice with regards to how often to express in order to maintain my supply?

After surgery I woke crying in pain and was given morphine to help with the pain, I was then taken back to the ward and recovered very quickly and was showered with endless supplies of tea and toast. I was also told I would need to stay in overnight to make sure I didn’t take a funny turn. Pain relief being given was 2. 5ml of oramorph and painkillers every 4 hours. 11.30pm I was given 2. 5ml of oramorph and painkillers and I began to express with my electric pump which was hard work as I was still very fragile and in pain when moving and could only lay on one side and the plug for the pump was on the opposite side, as I pumped the nurse came running in and told me I cant pump here its too loud! ! ! ! ! Not only embarrassed but shocked I asked her if she could see if the maternity ward had a hand pump. She said why would they have one they are an antenatal ward so that’s before baby but she would ring and ask, in the mean time I was asked to go into the family room where I would stand crippled in pain trying to express and hidden away.... She did put a do not enter sign on the door! Why was I made to feel guilty and like an inconvenience for expressing in order to maintain my supply of breastmilk and guard against mastitis? Why was I not helped to find a way to express comfortably? Why was a quieter hand pump not found for me if my electric pump was indeed inappropriate for the ward?

The following day I woke up very sore and engorged due to not pumping enough milk during the evening, again moving from the bed was difficult but had to be done as milk needed to be expressed. Again, why were none of the staff concerned about my risk of mastitis from not expressing enough, regardless of the maintenance of my supply for continuing my breastfeeding journey?

I did ask if I could have anything else as the pain relief wasn’t working to well to be told no because your breastfeeding. So another night was spent away from my baby and my expressed milk was being thrown away as they said they didn’t have anywhere for them to store it (a fridge?) but it was not clear as to whether or not it was safe to feed my baby or not. Again, why were none of the staff concerned about my risk of mastitis from not expressing enough, regardless of the maintenance of my supply for continuing my breastfeeding journey?

The following day I was sent home with cocodamol and oramorph. I asked if I'm breastfeeding my child is this ok. Yes I was told. The nurse I pulled to one side and asked her if there was anything stronger I could have before my dressing and she said she would go and ask. With her returning she told me the doctor has said this is all your allowed, I explained that yes I was breastfeeding my child but I have been talking to someone I know on twitter who had spoken to a number of people on twitter but specific people who were professionals in the industry when it came to medication and breastfeeding and upon showing him a document he spoke sternly and said “pharmacy said this is what your having so that’s all your having I’m not willing and will not up your dosage and this is not reliable”. And walked off. The breastfeeding professionals I was in contact with were well known experts. Why are your doctors and pharmacists not aware for the breastfeeding network's drugs in breastmilk helpline and their expertise? Why was I dismissed out of hand when i tried to discuss the advice i was being given by breastfeeding professionals both online and over the phone?

The nurse arrived back and said listen in understand your in pain but your breastfeeding and we can only give you so much, I asked her if I wasn’t breastfeeding would you be able to give me more and she said oh gosh yes you could have 5ml of oramorph and codeine as well as painkillers! ! ! She said you've done so well feeding your baby up to 18 weeks you've given her the best start in life but your in pain.. I'll leave you to think about it.... I was heartbroken, I didn’t make any sense at all... my baby girl was at home on formula and my milk being thrown away so whilst i'm still in hospital why could I not be given the full 5ml orapmorph, codeine and painkillers? Why was it allowed to come to the point where a nurse was encouraging me to give up breastfeeding Why was it presented to me as a choice between breastfeeding and pain relief?

Why, despite it clearly being a priority for me from the start, and despite the importance is has for my health and that of my baby, was breastfeeding not prioritised by the hospital in any way?