Natural birth for TOF baby?

Donnetta - posted on 05/26/2016 ( 8 moms have responded )

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Hi, I'm new to this community. Was told at 20 week ultrasound that my son has TOF..

I was told I can still have a natural birth, despite birthing center being ruled out. But my question for moms who have went through this are:

1. We're you able to have a natural unmedicated birth at the surgical center?

2. When were you allowed to breastfeed after your child's birth?

3. Did you baby have a difficult time breastfeeding at all? (Pre or post op)

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Sarah - posted on 05/26/2016

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I have seen lots of births with delayed cord clamping, most often with the midwives. I cannot recall a time when a saw that for a TOF baby, but i can't imagine why you could not request to wait until the cord pulses have ceased, or you deliver the placenta. If the baby is in distress, then of course, they will free him from your body and take him for care. If he is delivered without difficulty and begins to pink up a bit, I think it is a reasonable request. Be sure you tell your doctor that you want this and tell your nurse as soon in your labor so she can make a note. When a baby is born things can move very quickly and staff do certain things our of habit, suck out the nose and mouth, rub the baby, and clamp the cord. So just make your desires known. You are in charge of your body and your baby. That said, you do want healthy mom and healthy baby to exit that delivery room. Go in knowing what you want and be prepared for the unexpected. Good Luck, if you have any other questions just ask.

Sarah - posted on 05/26/2016

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As a former L&D nurse I can tell you that many TOF babies are born vaginally (with and without meds). As soon as the baby is born he will change from fetal circulation to self oxygenation. You absolutely will want him born at a hospital with a good pediatric cardiologist on staff and nursing staff who are prepared to help him if he needs it. If the baby can breathe well enough you can try to nurse, but you may find he gets too tired or drops his O2 saturation too low for him to solely nurse. You can pump and supply milk for him to either be bottle fed or in some cases tube feed. Depending on when he has his first (and maybe only) surgery, you can nurse. In my experience, if you are nursing pre op, then post op nursing looks favorable. If the nursing relationship is not well established, you may luck post-op but it may take a bit of practice for him to figure it out. At birth and in the days following even having him nurse for just a few minutes at a time will help him learn to nurse and help your milk come in. Is this a first baby for you?

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Donnetta - posted on 05/26/2016

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Thank you so much Sarah. I truly appreciate you taking your time to explain things and provide clarity! I feel much better about my inquires earlier on. Thank you sincerely.

Donnetta - posted on 05/26/2016

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Wow thank you for clarifying so much and providing some comfort for me!
In your experience (I know this might depend on the hospital policy or so), but could I still request delayed cord clamping once he's born?? Have you witnessed that done for babies with TOF?

Sarah - posted on 05/26/2016

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That is what I had assumed, so yes you can count on a natural unmedicated birth as the baby won't need help until after birth. As you progress you will have more studies of the baby's heart to help the surgeon determine if he will need a procedure right away or if he can wait a bit. If he cannot nurse well enough to maintain his weight, or he is fatiguing or not maintaining his 02 sat. He can still nurse to get your milk started, consume colostrum, for comfort and bonding. You will be able to pump and supply your milk for him. Lots of skin to skin will help with your milk letdown and bonding. Depending on hospital policy you can expect either a neonatologist or cardiologist present at the birth, or they may come see him within the first few hours. Most TOF babies do very well with treatment and live very normal lives. Checking in with a cardiologist once in a while but usually only need one big surgery. Sometimes if baby is just not up to the full surgery, the surgeon will do a small repair to improve oxygen flow and then wait while baby gains weight and then complete the repair at a later date.

Donnetta - posted on 05/26/2016

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I'm talking about Tetralogy of fallot. Sorry for the confusion! Is what you said prior still accurate?

Sarah - posted on 05/26/2016

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I need to clarify are you talking about Tetralogy of Fallot or tracheo-oesophageal fistula; both are called TOF.

Donnetta - posted on 05/26/2016

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@Sarah E
Yes this is my first baby, and so everything including this TOF defect is very new to me. I've been doing as much research as possible to prepare myself for when he arrives. I'm planning on birthing at a surgical center where the NICU is a level 3, but I would prefer minimal intervention throughout the labor and I'm big on bonding.

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