Being sick while breastfeeding
Being sick in the postpartum period is no fun. If you are breastfeeding and get covid, the flu or another illness, in most cases it's best to still keep on breastfeeding. Try to stick to your normal feeding routine as much as possible.
If your baby's appetite is down because they are also sick, pump if possible. If it's not possible to pump enough to replicate your baby's normal intake, do your best so that you can a) avoid mastitis and b) maintain your milk supply. Once you and baby are recovered and back to your normal routine, your milk supply should bounce back.
If your baby is not sick, you can still be around them. Take care to wash your hands and cough and sneeze away from baby.
Keep yourself hydrated, rest and take care of yourself. Your baby needs you to be healthy.
When you and baby are feeling better, do lots of skin to skin, and nurse as much as possible. If you can, take a "nursing vacation" and just focus on nursing and resting with baby.
Try not to get discouraged. It's common for your milk supply to have ups and downs and when your body receives signals to make more milk, it will.
Stress can lead to decreased milk supply so it's really best to stay positive. Reach out for lactation support if needed!
For medication questions, Infant Risk has a helpful page: https://infantrisk.com/content/cough-cold-
medications-while-breastfeeding
As far as your baby goes, they don't need anything extra like pedialyte or other fluids as long as they are nursing. If their appetite is significantly down and/or you see any signs of dehydration (lack of wet diapers, dry lips, orange crystals in diapers, sunken soft spot) -call your pediatrician.
When babies get sick they will need a lot of extra comfort and snuggles. Fortunately just being with you takes care of that
Has your baby had a cold yet this fall? Hang in there mama!
Information on common medications while breastfeeding:
Elderberry: no research available
Sources:
Drugs and Lactation Database (LactMed®)
[Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-.
Elderberry. 2021 Jun 21. PMID: 30000895.
Mother To Baby | Fact Sheets [Internet]. Brentwood (TN): Organization of Teratology Information Specialists (OTIS); 1994-. Seasonal Influenza (The Flu). 2021 Aug. PMID: 35952219.
My incision story
Warning— this post is a little gross! If you are not interested feel free to skip/move on.
As you may know I've had three c-sections. My first pregnancy I had placenta previa, so I knew early on that I may need to have a scheduled c-section, and it became more and more certain that I was going to as the pregnancy went on.
My second and third, I tried for VBACs, but it didn't work out. Neither one ended in a true emergency c-section but they weren't planned like the first. I don't think this is necessarily relevant to what happened after, just thought I would mention it.
My first two recoveries had zero complications and I even remember anytime I was checked I heard
"your incision looks great!"
The third was a different story.
While in the hospital postpartum I had some drainage from the area. Multiple midwives and finally an OB came and checked on me, but none wanted to do any intervention.
I went home on Tuesday and was feeling good with no issues for a few days, then Saturday came and that night I felt some drainage. We went right to Labor and Delivery Triage. They opened it up a little and decided the treatment would be to pack it.
I went home on Tuesday and was feeling good with no issues for a few days, then Saturday came and that night I felt some drainage. We went right to Labor and Delivery Triage. They opened it up a little and decided the treatment would be to pack it.
The open area was only a 2cm or so portion of the incision. Small, but stubborn. As this time it seemed to be something that would resolve within a few days to a week. Ha.
At first I was going to the doctor every few days, but then I was able to get my husband to learn how to change the dressing and I went down to *only* having to go once a week.
My husband was such a good sport, he changed that dressing and repacked me every day for about six weeks. Unfortunately the wound didn't change much at all during that time. Eventually the doctor I was working with decided we needed to change it up. I was referred to general surgery, but they rejected me! I never got a clear story but it was because they didn't do the surgery themselves and/ or they were too busy. Thankfully my doctor made a bunch of calls and such and got me set up with a home visiting nurse program to start on a wound vac.
A wound vac uses negative pressure to encourage new cell growth and the wound to close from the inside up.
I finally got the wound vac from the medical equipment company and the visiting nurse came to set it up. It is a similar process where there is this sponge material stuffed into the wound, and then it's connected to a tube which goes to the pump. It's kind of like a breast pump. In fact the one I had was made by Medela!
The pump is continuously pulling air and drainage through the tube into the collection canister at the pump. the pump and tube stay connected to you 24/7. You can disconnect the pump (but not where the tube is connected to the wound) to shower but that's about it.
Finally after 4 weeks on the wound vac I graduated.
At that time my wound nurse said the wound was the size of a pencil eraser. It was only one more week with a special dressing before it was completely closed. That was right around almost 11 weeks after she was born. So long!
Research:
A UK study found that 14% of c-sections had wound healing complications. 84% of those complications happened after discharge(!) Not surprisingly, the research says that better postpartum care is needed and wound complications are one way this need is highlighted.
Another study found that preeclampsia and premature rupture of membrane are risk factors for wound complications.
Sources:
Lusher J, Djatmika C. Living with a non-healing caesarean section wound: A mini-review. Int Wound J. 2020 Aug;17(4):1094-1096. doi: 10.1111/ iwj.13373. Epub 2020 Apr 15. PMID: 32293102;
PMCID: PMC7948895.
Carbonnel M, Brot D, Benedetti C, Kennel T,
Murtada R, Revaux A, Ayoubi JM. Risks factors FOR wound complications after cesarean section. J Gynecol Obstet Hum Reprod. 2021 Sep;50(7):101987. doi: 10.1016/j.jogoh.2020.101987. Epub 2020 Nov 16. PMID: 33212324.
When will my baby sleep through the night?
This might be some bad news...but baby sleep is HIGHLY irregular, not just baby to baby but night to night for the same baby.
It makes sense when you consider that even adult sleep can vary so much from one person to another or one night to the next.
Your baby might sleep an 8 hour stretch one night, and not do it again for days or weeks. And that is completely ok and normal.
In my opinion the best thing to do is adjust your mindset to go with the flow and keep your expectations low— this way it will be easier for your baby to meet your expectations. Also, sleep when you can! Naps are your friend.
Despite what you may see on social media, there isn't a "normal" age for infants to start sleeping through the night. And sleeping through the night can mean different things to different people.
One baby might sleep straight from 11pm to 5am and that could mean "through the night". Another might sleep 7pm to 7am in total with one wake-up
—and that's pretty darn good if you ask me!
Some babies who are having trouble gaining weight will NEED to wake up to eat. Others may be totally fine to go a long stretch without eating.
Ok but really Margo, when does it get better???
If your pediatrician has said to wake baby up every X hours (usually 3 at night), they will likely say it's ok not to once they are two weeks old and back to birth weight. That's good because having to set an alarm to wake up your baby is pretty brutal. So that will be the first hurdle.
Hopefully after those first two weeks, your baby will steadily increase their longest stretch of sleep.
This means it's ideal for you to go to bed when this long stretch starts.
Sources:
Pennestri MH, Burdayron R, Kenny S, Béliveau MJ, Dubois-Comtois K. Sleeping through the night or through the nights? Sleep Med. 2020 Dec;76:98-103. doi: 10.1016/j.sleep.2020.10.005. Epub 2020 Oct 10.
PMID: 33130350.
Zimmerman D, Bartick M, Feldman-Winter L, Ball HL; Academy of Breastfeeding Medicine. ABM
Clinical Protocol #37: Physiological Infant Care-Managing Nighttime Breastfeeding in Young Infants. Breastfeed Med. 2023 Mar;18(3):159-168. doi: 10.1089/bfm.2023.29236.abm. PMID: 36927076;
PMCID: PMC10083892.
