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dilaudid post c/sec

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  • #1

    dilaudid post c/sec

    Would you advise feeding or not the colostrum of a just sectioned mom whose baby is a 37+3 in our nicu with TTN, currently NPO. The mom is having issues with pain control and is being put on PCA pump of dilaudid. She is expected to be on the dilaudid 24 hrs, but really wants to get pumping and her baby to get her milk asap. If advising not, how about pump and store to be mixed with colostrum/transitional milk after the dilaudid is dc'd, lowering the total relative dose, so she doesn't feel it's "wasted"?.

    Or do the risks of the formula introduction (which in our nicu is virtually always by bottle, sorry) outweigh the dilaudid? Thanks! She really doesn't want to use formula if it can be avoided, especially as first feeds.
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  • #2
    Kay:

    I doubt there is much risk of breastfeeding during this colostral period, simply because the amount of colostrum is so low. Mom could pump and store, but I would not advise using the milk, its simply not worth the risk. If the infant is on formula, I'd suggest she transition the infant to the breast as soon as her dose of Dilaudid has been reduced or discontinued. I'd then discard the milk.

    Tom Hale Phd.

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    • #3
      Thank you, but I'm still a little confused... The baby has been on TPN until earlier today, when mom pumped for the first time and the baby was BOTTLE FED 3ml of EBM. Having now "proved" it can "tolerate" bottlefeeding, they are now "allowed" to go to breast. Mom has just been taken off the dilaudid pump, switching to percoset. As a multip, I expect her milk to come in fairly quickly. With a T1/2 of 11.1 and a Tmax of .27, how long would you want (if at all) to not want the baby to feed directly at breast if her milk seems to be coming in. No formula use so far. As an L3, "moderately safe" and supposedly low milk levels, I'm not getting it. The nicu nurse just informed me (like I was clueless) that the baby is "term". You said you would transition to the breast when the dilaudid was dc'd, but then you said you'd discard the milk - you meant stored while on dilaudid? (we don't have any - they fed the 3ml).

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      • #4
        Kay:

        Go ahead and let the baby breastfeed. Observe the infant for sedation which is unlikely.

        Tom Hale Ph.D.

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