"Lack of support"

I was recently discharged from Hairmyres hospital ward 4 after being admitted with abdominal pain and spent 2 nights in hospital. Medically with regards to investigations I cannot fault the team at all. They have been very thorough in trying to find out what was wrong with me. However i feel that I need to provide feedback with regards to the lack of support I received as a breast feeding mother. 

They prescribed me oramorph to manage my pain while I was admitted, which took the edge off but I was still In a lot of pain. At time of discharge I was and still am in significant pain  and weary about how I was going to manage my pain at home and continue breastfeeding. Being in close contact with my daughter who needs the comfort and security of breastfeeding, I needed to ensure it was safe for me to feed her.  While I was in hospital I had no choice not to feed my daughter temporarily, and continuously voiced my concerns to medical staff about my need to continue breast feeding when I go home. My daughter was brought to see me while I was in hospital and had to be taken away after 5 minutes as she was so distressed at not being allowed to nurse from me. 

When I was told I was being discharged to come back as an outpatient for endoscopy, I told them I was worried about how I was going to cope with pain and that I need something to allow me to breastfeed as my daughter will get distressed if I’m there and she cannot nurse and this would be distressing for me too. So they said they would get the pain nurse to come and see me. 

The pain nurse seen me very briefly , and advised I would be sent home with cocodamol. I have been told that breastfeeding mothers definitely can’t take cocodamol so I said that I couldn’t take cocodamol. I was told I would just need to stop breastfeeding to manage my pain. I asked if they could give me dihydrocodeine instead, and had to argue my case that cocodamol made me feel sick and i have tolerated dihydrocodeine in the past, as any time I mentioned breastfeeding I was made to feel like I had no choice but to stop. Even when I said I was prescribed dihydrocodeine when my baby was first born, they wouldn't change from cocodamol. But did once I told them I couldn’t tolerate it and needed adequate pain relief, then the prescription was changed.

So I was discharged with dihydrocodeine but was told I was not allowed to continue breastfeeding. I insisted this isn’t something I want to do, but was told that I would need to stop. They did say that she would go and find out about dihydrocodeine when breastfeeding and get back to me after I asked to look into it before I go. But they never came back. The Ward nurse came with my discharge meds and i asked if I could breastfeed and was again told no. 

I had to go home and endure my daughter screaming and distressed because I was at home and she couldn’t nurse from me when she obviously needed this nurturing after missing me while I was in hospital. When the comfort of my breast is all she has known when she is upset since she was born. I had to hide from her in the bedroom and was very upset myself. I spent the whole night in agony as I felt I couldn’t take any pain relief until I know I am safely able to breastfeed my baby. As stopping for us simply is not an option.  

When I woke up this morning I called the infant feeding team at Wishaw general for advice on taking medication. I couldn’t call before as it was out of hours. They spoke to the pharmacist for me to see if the morphine from yesterday would be out of my system and and advised me that I can in fact continue breastfeeding while taking dihydrocodeine and I was right in refusing cocodamol while breastfeeding . I feel that I was rushed out the door with lack of knowledge and support to protect the infant mother breastfeeding relationship and no concern about the emotional stress this would cause for my baby and for myself with pain and feeling unwell on top of it.  My breastfeeding did not feel like a priority to medical staff despite me continuously expressing how much a priority it was to me throughout my admission. 

I was moved to a communal room with other patients and closed my curtains so I had privacy to express. I can’t use an electric pump anyway so have little suction cups to catch letdown and I need to hand express. And because I was away from my baby for so long and on morphine and nil by mouth I had to wear these continuously and try and stimulate milk production in order to maintain a supply for when I was discharged, there was a man in the bed next to mine and lots visitors at the other beds throughout the day. So I wasn’t comfortable having the curtains open to express. I wasn’t comfortable even with them closed and found it hard to relax to express which is an important factor as well. But I had no control over that. All I could do was close the curtains. But on several occasions, staff would walk in and out and try to open the curtains and I had to repeatedly show them what I was doing for them to close them again. I found it humiliating having to repeatedly justify why I needed privacy and especially humiliating that everyone in the room knew what I was doing as they heard me having to explain time and time again. I’m a very private person and having people hear and know that I'm am sitting behind a curtain with my boobs out trying to stimulate them to produce milk is mortifying and I found it quite distressing.

At one point i overheard two staff members outside the room talking about me and I felt it was in a judgemental tone. One asked why I was not opening the curtains and the other said that I was expressing, the first then asked why I was doing that, and the other replied “god knows”.

Any time a clinical support came in for something I felt as though they were ignorant towards me and annoyed at me for not having the curtains open. Although they didn’t say anything, I felt that the way way they interacted with me was cold and I felt as though I was doing something to annoy them. In the end I just looked away and never made eye contact with them. 

Breastfeeding is a huge thing to me as a mother and to my daughter who is thriving having the nurturing and health benefits of breast milk. The world health organisation recommends breastfeeding to age 2 and beyond. There are lots of health benefits to the mother as well. And I especially feel this as it helps my chronic health condition of fibromyalgia and my mental health problems depression and anxiety. It helps me get a deep level of restorative sleep that lacks in fibromyalgia sufferers, and I was greatly affected by not having this restful sleep before breastfeeding which really affected my ability to function day to day. It also helps boost serotonin and oxytocin levels to regulate my depression and anxiety and avoid going back on medication for it while my baby is so young. So it’s not just a case of stopping breastfeeding, it’s the impact it will have on many aspects of me and my daughters well-being. 

The reason I felt I needed to express my opinion is I feel that more knowledge and understanding of breastfeeding within the department is clearly needed. I feel as health professionals you should be able to support breastfeeding as much as possible. Even just knowing to contact the infant support team for advice, who have access to pharmacists who have in depth knowledge about medication and breastfeeding would be a start. I could have been discharged with a plan to support my breastfeeding and control my pain instead of being told to stop breastfeeding due to a lack of knowledge.

The resources are available to you within NHS Lanarkshire and for a breastfeeding mother to be discharged with little regard to the importance of breastfeeding I find it deeply concerning. Especially after such a distressing night of pain and a distressed upset baby which could have been completely avoided.