The Best Pain Relief
Cambridge, Great Britain
From New Beginnings, Vol. 25 No. 6, 2008-09, pp. 24-26
I will never forget the day when my 14-month-old daughter, Rebecca, fell onto her face and badly injured her strawberry hemangioma birthmark. Although she had learnt to walk a few weeks earlier, she was still a bit wobbly on her feet; so my husband Tom and I would take it in turns to hold her hand and walk with her. Late that Sunday afternoon, it was my turn to take her for a quick "spin" round the garden before teatime. We were walking down the drive when she stumbled and, although I had been holding her hand, I couldn't pull her up quickly enough to prevent her from falling. Before I knew it, she was face down on the concrete and there was blood everywhere. I had no need to call for help -- Rebecca's screams brought Tom running to our aid. Although only a few seconds had passed, her face, clothes (and my clothes) were already soaked in blood. Tom took one look at her and the color drained from his face, but I knew what I had to do. I carried our hysterical child over to the lawn, sat down and started to nurse her. Her sobbing began to subside as she suckled at my breast. In the quiet that ensued Tom went to get some water and a bandage.Rebecca remained glued to my breast as Tom cleaned her face and placed a bandage across the wound. It was difficult to get it to stay down over the projecting birthmark, but as long as she was able to breastfeed she didn't mind our clumsy attempts at dressing the wound. After a good long session at my breast she was happy enough to let us take her blood-soaked clothes off, clean and dress her. As would be expected, she was quite clingy for the rest of the day, but relatively cheerful. She didn't even fiddle with the dressing, which was good, as we thought it would be best to keep it on until the next day. I breastfed her to sleep that evening, and when I finally left her room to spend the evening with my husband, I broke down in tears. We spent the rest of the night in a kind of stupor. We were so drained physically and emotionally that we could barely move.
Rebecca awoke the next day her usual happy self and so all my fears concerning her fall vanished. It was only as Tom began to remove the dressing that I realized all was not well. As soon as the bandage came off, the wound started to bleed heavily again and Tom had to hastily re-dress it as I pacified Rebecca by breastfeeding. I was upset and confused by the fact that it hadn't healed overnight and unsure of how to proceed. Maybe the wound was bigger than we realized, or perhaps we had dressed it incorrectly. Either way, we knew we had to take her to the doctor right there and then.
Tom was obviously anxious about "his little button" but sure that the doctor would be able to help us. His confidence reassured me and kept me calm as I explained to the duty nurse what had happened. No doubt Rebecca's happy demeanor assured the nurse that this was a minor graze and that my description of the blood loss was an exaggeration. But as she removed the dressing to take a look at the wound, the blood started to ooze again and Rebecca began to wail. The nurse thrust a fresh bandage into my hand and told me to hold it against the wound whilst she went for the doctor. The speed with which she left the room did nothing to allay my fears but surely, I thought, the doctor would know what to do.
Thankfully, my doctor arrived within minutes but he too was unable to help. I even distinctly remember him recoiling backwards a step as I lifted the bandage away to reveal the full gory mess of the wound (but to be fair to him, he composed himself within seconds). "I'll need to phone the hospital," he said, "they'll know what to do." As he busied himself with making the necessary calls, I sat there dumbly, holding onto my hysterical child, whilst pressing the bandage against her birthmark. All around me were concerned faces, but they weren't able to offer any help, so I did what I could -- I breastfed her.
The room suddenly went quiet as Rebecca received the best pain relief I could offer and I was able to hear the doctor asking the advice of the plastic surgeon at the hospital. It appeared that a "kaltostat" dressing was suitable for this kind of wound, so the nurse got one from the cupboard, removed the soggy bandage I had been holding against the birthmark and dressed it. We cleaned Rebecca up as best we could, while the doctor relayed the information from the specialist. Apparently, injuries to birthmarks are common, but due to the nature of the strawberry hemangioma (which is basically a large collection of blood capillaries just underneath the surface of the skin), what would otherwise be a straightforward wound becomes something much more complex. Stitches or glue cannot be used to rejoin the broken skin. Removing the whole birthmark, or carrying out surgery under general anesthetic could be an option.
The stress and fear that I felt became overwhelming and I began to cry. I didn't want my child to be "put under" and to risk surgery, even if it might be a perfectly safe operation. The doctor assured me that the specialist would know what to do, and that it would be best to go the hospital as soon as possible.
When we got to the accident and emergency ward, a nurse gave Rebecca a brief examination and then called the plastic surgeon. I was concerned about the fact that I wasn't allowed to give Rebecca anything to eat or drink, in case they had to perform emergency surgery. I knew that she was likely to get hungry soon and I wasn't sure I'd be able to keep her content without breastfeeding. Thankfully, Rebecca was so interested by all the books and toys in the waiting area that we managed to keep her happy for what was to be a long wait. At last, after an hour and a half, we were called in to see the plastic surgeon, who immediately set us at our ease by displaying a nonchalant lack of concern.
He explained that surgery was an option, but that this would only be used as a last resort. The kaltostat dressing would absorb the blood and help it to clot, but it would need to be in place for some time to give the wound a chance to heal. The surgeon told us to go home, relax (!), and then remove the dressing after a week. Tom and I were so relieved, and knowing that emergency surgery wasn't going to be performed, I was able to give relief to a grumpy Rebecca, who was by now very hungry and thirsty, by breastfeeding.
The week that followed passed uneventfully, although to me it seemed to go very slowly. I was both dreading and looking forward to the bandage coming off. Finally the "big removal day" arrived, and Tom and I stood our daughter in the bath (more dressing at the ready) and started to take the bandage off. The kaltostat sat in a gooey lump on the birthmark but as we washed it away, no blood came and it was clear that the wound had healed. Rebecca was dried and dressed, and no doubt somewhat bemused by the strange behavior of her parents who were all smiles now.
A few weeks later, we saw the plastic surgeon again, who was able to confirm that surgery does not need to be performed in the foreseeable future. He also said that if there is any "upside" to her injury, it is that her birthmark may start to regress more quickly. Although this would be a happy outcome to what was an upsetting event, I am much more pleased by the knowledge that due to our breastfeeding relationship, I was able to provide my daughter with instant pain relief when she most needed it. Apart from the scar on her birthmark, Rebecca's fall has left her with no after effects. It certainly hasn't dented her confidence. We still walk (or run) everywhere together, the only difference being that I am now a more experienced nurse: I am never without a kaltostat dressing, or the best pain relief a nursing mother can offer -- her breasts!
Adapted from a story in LLLGB's Breastfeeding Matters