Preventing trauma from infant surgery

Why have I been blogging about surviving infant surgery for nine months now?

Short(ish) answer:  I’d like to explain how I and therefore many others have been deeply affected by surgery to correct infant pyloric stenosis, and I want to do what I can to minimise the possible damage from infant surgery today.

Today (unlike when I first went under the knife soon after my birth in 1945) infant surgery is not necessarily lifesaving and can often be done with minimal trauma.

1940s surgery looked and was different from today's

Early infant surgery in “my day” was an emergency measure and avoided if at all possible.  It was usually life-saving but really quite hazardous, as complications such as shock, infection, wound rupture and even death were quite common.

It was also crude compared with today.  Medical journals show pediatric surgeons were very divided over whether anesthesia (if any was used) should be local, general – or just a sip of alcohol and a sugar cube.  Wounds were sewn up without regard for cosmetics and left scars which were magnified three or so times as the baby grew to adulthood.  Babies were nursed back to health over two, three, four or more weeks, and were often separated from their mother during some of all of this time – as an infection control measure.  Is it any wonder that infant surgery deeply affected sensitive new mothers (like my dear mum) and that it left the minds as well as the bodies of infants scarred by little understood and terrible memories?

Today infant surgery is often an option and not necessarily a final life-saving measure: the repair of a cleft palate is not lifesaving but is certainly life-enhancing.  Medical monitoring, drugs, techniques, and skills have advanced hugely since my operation in 1945, and medical care today is usually far kinder and more aware than it was 65 or even 25 years ago.

And yet, even today we read of trauma caused by much more recent infant surgery.

Many parents are still traumatised by having to surrender their baby to surgery, although the pain tends to be more short-term and its effects far less than they once were.

Some infants and young children today continue to be traumatised by surgical procedures carried out without the use of appropriate anesthetics.  Although general anesthesia is not almost universally recognised as mandatory for invasive surgery, this is not true of intubation, circumcision (almost always a totally unnecessary procedure from a medical standpoint) and the fitting of ear grommets, which are among the surgical measures of infancy or childhood which some people have found continue to affect them.

Surgery that is not actually life-saving or life enhancing can and should possibly be deferred or avoided.  Clearly, there are some congenital defects and conditions of early infancy that must be dealt with by surgery at the most suitable time.  But there are also many conditions that can be treated medically as well as with a scalpel.

Infant pyloric stenosis is one of these.  IPS can be hard to diagnose quickly, as in many cases the symptoms take several weeks to recognisable enough to be treated as such.  But most of these slowly-developing cases of pyloric stenosis can be treated with two or three weeks of medication – before they become life-threatening.  Thus any significant trauma for the baby of the parents can be avoided in the great majority of PS cases: medical journals report that around 80% of all IPS cases are treated this way in many non-English-speaking countries.  But in the Anglo world, the strong preference is for surgery if treatment is required.

It must be realised that some IPS babies survive without surgery or medical treatment. Some of these have ongoing problems with a mild form of PS, some outgrow it, and some need or choose to have a pyloromyotomy in later years.

When surgery is deemed unavoidable for your baby –

  1. Realise that at least some babies will remember surgical pain and other trauma such as intubation and separation.  Check the web or go to some of my Blogroll items (right) if in doubt.
    Raise this issue with your doctor and ask them what they do to avoid or minimise pain and leaving traumatic memories.  Many doctors will be well aware of and sensitive to your justifiable concerns.  Don’t see the doctor alone if it’s possible or likely that your questions and concerns will be treated with condescension or dismissively.
    You are your baby’s advocate and best friend, so do what you can to maximise the care and treatment your baby is given.
  2. Protect, even “smother” your baby with parental warmth and love.  Some infant show they have suffered trauma by their changed behaviour: they show insecurity, they may cry more easily, often or longer than before their surgery, they may show clearly that they need to be hugged, held and sung to more often.  If this is what some parents have actually experienced, it is most unlikely that only some infants would be affected in such ways.
  3. Empower your child to identify any memories and trauma from their infant surgery.  Enable your child to know and understand their story, and help them to work through the ongoing effects of their trauma.  My previous two posts dealt at more length with the ways parents can help their children who are affected by trauma.
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2 thoughts on “Preventing trauma from infant surgery

  1. Wendy

    Fabulous! I love that you put pyloric stenosis surgery, and infant surgery in general, in perspective. I’m going to include this post in my medical narrative unit in my English class at community college. It gives folks some of the background they need to understand infant surgery today.

    Reply
  2. Fred Vanderbom Post author

    Thanks so much, Wendy. That’s a real encouragement for me. I’m sure that with both of us writing and you teaching as well, our stories and concerns are being heard by quite some folk – probably even for the first time. I do hope they are being taken to heart and spread beyond the direct contact so they can make a difference for whom and whenever it matters most.

    Reply

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