Tuesday, 26 November 2013

Triumphant Tuesday - Breastfeeding with Osteoporosis

Pregnancy takes its toll on most mothers – piles, heartburn, water retention, backache – all are par for the course. What you don't expect however, is for pregnancy to deteriorate your bones leaving you so chronically immobile that when your baby arrives, you can’t even carry him. That’s what happened to this mother. Diagnosed with Transient Osteoporosis of the Hip (TOH) during pregnancy, she clung to hopes of breastfeeding despite her health - quite literally - crumbling away. Read on to discover how she coped with the pain, the frustration, and the logistics of nursing a baby through debilitating disease.


“Up until 29 weeks my pregnancy progressed without problem, I had mild morning sickness but felt full of energy along the way – even running a marathon at 10 weeks!

The pain begins

My hips started to hurt so I stopped running and began walking instead for a week or so, until even this became too painful. Hip pain is common during pregnancy but the type of pain I felt, right in the hip socket, didn't match the SPD symptoms I could find online. Nonetheless many well meaning friends were quick to tell me it was normal and how they or a friend felt just the same in pregnancy. Now I'm no wimp and like to think I have a high pain threshold so I wasn't convinced by these tales (though I am aware how painful and debilitating severe SPD can be). By 33 weeks pregnant, upon the advice of my physio, I visited an orthopaedic consultant.

X-ray reveals trouble

By this point I was hobbling on crutches, unable to take a step for myself and in a great deal of pain. Very confused and scared, I was relieved when the consultant took me seriously and sent me straight to X-ray (a single low dose X-ray with a lead apron protecting the bump meant there was minimal risk to the baby). The results showed a decrease in bone density at the femoral head so within days I underwent an MRI - swiftly providing the diagnosis of a very rare disease called Transient Osteoporosis of the Hip (TOH), caused by pregnancy.

Spot the baby!

Initially, I felt relieved to have a diagnosis. I had known something serious was wrong but had no idea what. The fact that it was fully reversible was music to my ears. Yet, after the initial elation I became pretty depressed at the realisation it would take months and not weeks to get better. Every day stretched on like a week before Reuben was born.

"Crutches were my saviour and my nemesis."
I had two questions, could I give birth naturally (the disease increases the risk of hip fracture during birth) and could I breastfeed and still recover? The first question was answered with a spontaneous early and swift labour at 36 weeks! 5 hours from start to finish, I naturally gave birth with the aid of hypnobirthing (a wonderful tool to relax and let nature take its course). Reuben was born healthy and alert, and the midwives quickly helped us to have our first successful breastfeed. We were discharged the same day with the advice to feed at least every three hours as he was slightly small (6lb 7oz).

Feeding a newborn whilst immobile

Ha ha every three hours! Reuben had other ideas and fed at least every two hours, often every one. We had well meaning advice from family members (at a week old) to try and space feeds out so he would go longer at night but I'd had long enough time stuck on the sofa googling to know otherwise and fed him whenever he showed the slightest sign of needing it.

For the first four weeks I was unable to hold my baby while standing. I couldn't dress him, change his nappy, pick him up at night or put him back down. I couldn't even make a cup of coffee and carry it through to another room. Every time I tried to take a step it felt like my hip bone would give way in its socket and there was a searing pain.

Initially I adjusted my gait in order to protect the joint, but as the disease progressed this was impossible and I physically could not take a step without taking my body weight through the crutches. After a while I couldn’t lift up my leg to get into bed - Id have to bend over and pick it up. The scariest point was the middle of the night, I’d need the loo a couple of times a night. It was difficult to find my crutches without taking a step (they inevitably fell down off the wall they were balanced against at this point). Id then have to slowly make my way past the stairs (no banisters as we were in the middle of house renovations!) in severe pain and very unsteady to get to the loo. I felt I was going to topple over every time and break in two. If I sat still there was no pain, so I wasn’t in pain all of the time. The problem was at night it hurt to lay down, and it hurt if I tried to do anything for Reuben which involved picking him up - even if only to move him from his basket (right next to me) to being with me on the sofa. Crutches were my saviour and my nemesis.

Breastfeeding protected my confidence


I felt entirely useless except for one thing. Breastfeeding. I could do it and could do it well. This is despite every time Reuben woke in the night I could not get back to sleep for the pain, so I was a super sleep deprived zombie! After four weeks my husband returned to work and I stayed in the lounge all day, a prisoner with my baby, barely able to pick him up and put him down still. Sadly during this time my second hip became diseased and whilst one recovered, the other became bad.

By nine weeks I could take a few painful steps without crutches, and gradually improved over the next couple of months. I increased the miles I could walk (carrying Reuben in a sling) until we regularly covered four miles each day and I had built my legs muscles back up. After five months I got the go ahead to begin running again and the day before Reuben's first birthday raced a half marathon. The postman has seen me most mornings ranging from walking on crutches with Reuben in a sling, to walking using the pram as a support, to walking with Reuben in a sling no crutches, to running past with Reuben in a running buggy. He must think I’m bonkers!



Baby thriving


Reuben continued to feed ALOT and put on weight at a crazy rate. He has never had a drop of formula and by 6 months had jumped from the 5th percentile to the 91st on my milk alone. He looked quite fat but I felt sure he was just storing it up ready to grow! At his 12 month check he was on the 98th percentile in weight but also balanced in his height - I was right to trust my baby and, baby led weaned, has taken just what he's needed to grow to his full potential so far.

During our breastfeeding journey I have learnt so much about its benefits and am very enthusiastic to spread this message, it was also quite possibly my saviour in the dark early weeks. Transient osteoporosis is very rare and there is next to no information about it in terms of lactation online - but our experience shows it's entirely possible to both recover and breastfeed, whilst being therapeutic and rewarding.”


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