WLS and pregnancy

Ok so this post might ruffle some feathers but my purpose is not to upset people but to share info that people might be nervous to talk / ask about. Everyone knows that having a baby so soon after any WLS is a no-no but given the boost of fertility that often comes after weight loss it happens. It happened to me....! My "excuse" is that after years of trying for a pregnancy I was sort of in denial that it could happen at all. It is also hard to use preventative measures when what you want more than anything is a baby - yes more than weight loss even. That being said I didn't intentionally get pregnant - our plan was to wait until 18 months out or goal weight before trying but I do admit I wasn't as vigilant as I should have been. Anyway! 4 months out I got  pregnant and worried that my child would either die or have a lot of problems and that I wouldn't lose another pound. I found a good and supportive OBGYN who told me that new studies actually show that pregnancies soon after a WLS are actually healthier than pregnancies at a higher maternal weight. He also said I was OK to keep losing weight as long as my labs came back good and my baby was growing well based on growth scans! He also said that the biggest reason they don't recommend it is because it slows down your weight loss during the phase when you lose the most - so you don't get as much bang for your buck.

His advice was spot on for me except I still lost a lot of weight in what to me seems normal for a DSer (and a SADI DSEr at that!!!) I lost 60 lbs during my pregnancy (started around 280 and got down to 216 the day I had my son). My son is now 2.5 months old and I have lost almost 40 lbs since I had him!!! Best of all he is completely healthy. He is around 11 lbs and only wakes up 1 time a night to be fed! Breast feeding is awesome for my continued weight loss and my surgery hasn't had a negative impact on my supply. I started my journey at a high of 357 lbs and 15 months later I weigh 179 and want to get to 150. 

So I am not advocating that anyone try to get pregnant until cleared by your surgeon BUT if it happens you can have a healthy pregnancy for you and your baby. Be vigilant about your vitamins and get a lot of rest. Get a good supportive doctor that will monitor things for you. Don't think that because you get pregnant you need to eat crap - stick with the healthy foods we should all eat anyway. 

I love that my WLS allowed my not only to have a healthy pregnancy and child - even if it came sooner than recommended! I am just one case study so I don't know how it would be for everyone but I just wanted to share my story in case there is someone out there who is in the position I was 4 months out from surgery. 

Congratulations on the baby!  

Question - considering the malnutrition risks that go along with a DS do you rely just on your labs or do you also have your son checked?  I bet there's not a lot of research on breastmilk adequacy in WLS moms.  Anecdotally they say the baby gets the best of everything first so maybe just your labs are enough but just curious.  Having the SADI-S I guess it's less of an issue but that's also not proven yet (I'm sadi too).  

So happy for you - i bet you'll loose that extra 30 running around after little one in a few more months.  I wish I had my youngest son's earlier years back - i was too fat to run with him.  But at least I will be able to here soon!

Thanks!

During my pregnancy we only did my labs - but I think you are right on the idea that since the baby takes what it needs first if I am not lacking then the baby wouldn't lack either. Now that he is here they have done all of the usual checks and he is great! I actually had some malnutrition issues with my daughter because I had a lap band that slipped and so I couldn't keep much food down for most of that pregnancy - I had the malnutrition problems and she was perfect and is still healthy as a 4 year old. My malnutrition issues then weren't horrible but it was drained and sickly - though once the lap band was gone my issues resolved (and resolved the too much since I gained 200 lbs after that...!)

As for breastmilk we have checked that out because initially my son wasn't gaining weight. We found out that the breast milk was fine-  the problem was a tongue tie and once we took care of that he has packed on the pounds and is starting to get chunky!

As for the last 30 lbs I am excited! I have been losing steadily since I had him and I am also starting to run outside - along with chasing my 4 year old around. It is the best thing ever to be able to!

A SADI-S is a single anastomis duodenal switch with sleeve.  Also sometimes called a SIPS of Loop DS...  there is just one cut of the small intestine and its looped around the pyloric valve to allow food entry much lower into the intestine (malabsorbtion).  Because of the way it's structured to work with just one cut,  it usually has a much longer common channel (200-300 cm) but on the positive side half of the intestine is still bypassed, so I like to think of it as a sleeve and a half...  

The jury is still out on whether or not this procedure will match the traditional DS in terms of long term weight management.   Currently stats show in the short term it has the same success, but that might also be due to the relative small french size of the sleeve (32-38) whereas traditional DS is usually performed with a bigger french bougie - sometimes as high as 50.

Supposedly the benefit is less chance of malnutrition.   That said, malnutrition is not really a problem for a properly managed DS' er and there is so much more research on the traditional route.  Huge benefit in terms of less post operative complications since it's a MUCH simper surgery.  Still costs the same though ...

Myself I have a SADI-S.  I am happy with it but also wonder if I took too big of a gamble versus traditional.  Talk to me in 5 years.  Right now I malabsorb fat lime crazy but have no idea if or when my long channel will adapt.  That's probably the crux of the long term question.

So really they are two different surgeries and it would be great to have a seperate forum but for now the DS is the closest so those of us in that category kinda meet up here since it's similar enough - at least a closer match than either the RNY or just sleeve boards.

You will find much debate on the boards - here and the others - ranging from support to vitriol but for the most part here on OH everyone is great about it.  

It will be 5-10 years before anyone really knows enough to compare the two and make intelligent extrapolation on the success but short term it looks very promising.