WLS before or after children

[BMC blogger 38]

Hi all-

I've been lurking for a bit, but could use some advice on WLS and children. I'm almost half way through my 6-month requirement, but during my first visit with the surgeon I was throw for a curve. I went in expecting to discuss sleeve, but due to my issues with acid reflux that was tossed. I know it's the gold standard but I'm struggling with the malabsorption pieces, especially since I'd be looking to get pregnant shortly after I get the "ok."

I'm curious for those starting or who have gone through the process. Would you wait (or have/did wait) to have WLS until after you've had children? Or do you go for it before?

Full disclosure, we haven't started trying yet so I'm don't know if we'll face challenges or not. I know WLS can help improve fertility, but assuming for a minute fertility isn't an issue, what do you do?

[SeaShells82 96]

I can't really help you because I had the sleeve and also don't have kids yet but I sympathize because the malabsorption (and concerns about its impact on potential future pregnancies) with bypass was my main sticking point as well and a big part of why I went with the sleeve. Hopefully others will be able to give you some advise based on their experiences but just a thought - it's possible to convert a sleeve to bypass. Would your surgeon be willing to do the sleeve and convert it to a bypass if/when reflux became a problem? Not sure how bad your reflux issues are now so this may be a shot in the dark but I figured I'd ask.

[asantiago 89]

Hello SeaShell82

Hope all is well. I also wanted the sleeve but due to very bad acid reflux had to have gastric bypass which it helped me and saved my life from getting Barrett's syndrome. I am not having more kids but I have a friend who was very successful getting pregnant after she lost her weight. She tried many time and took longer to get pregnant and after she lost the weight, and waited a year, she got pregnant and had a healthy baby. She was taking Prenatal Vitamins which her surgeon recommended to her and she did find and all her blood work was normal. From what I know if you decide to have Surgury before, the recommended time is to wait 1year after Surgury. Of course that is a personal decision that you have to make. You can always have the sleeve first and see how it goes with acid reflux and than have bypass.

[BellaItalia088 21]

Hi I haven't had my surgery yet, and I do not have children yet but this was a topic that I looked into as well because I would like to have children in the future.

I actually found an article (if I can find it again I'll share it with you) that stated that children who are conceived after the mother has WLS are significantly healthier and less likely to be obese when they grow up due to an activation of certain genes during the fetal growth. Also WLS reduces the risk of needing a c-section.

I have a friend who had kids after and her children are healthy... however she got pregnant before the 18 months was up with her first child and she had a few complications with nutrition because her body wasn't ready. Her second child went smoothly like a normal pregnancy.

I also know some who are waiting because they don't want to have to lose the weight again after child birth.

[Berry78 4,259]

Even people that have always been thin put on weight during/after pregnancies.

I would highly consider waiting until after baby (s) before getting the surgery.. that way a pregnancy won't sabotage your once-in-a-lifetime surgery.

On the other hand, healthier babies are always good... but there is no guarantee with that being the case, and malabsorption might be a problem for the baby too.

Hard choice! But I still vote.. have babies first.

[asantiago 89]

I agree with Berry78. It makes a lot of sense. You have to weigh the pros and the cons but it makes sense. 😀

[Torriluv87 300]

I have no children yet but decided to do this for my current health for my future children. I didnt want to be diabetic and pregnant. Not if i could help it. Even though im no longer diabetic, that's not to say gestational diabetes is off the table but i didn't want to go into my thirties just as fat and miserable as i was the rest of my life. I'm not getting any younger and what ever children i may have in the future deserve the best version of me that i can give and getting the sleeve and getting healthy has been the hardest thing I've ever done but it was so necessary. My whole family can benefit from this healthier me. Just make sure whatever decision you make is right for you and at the right time. That's the only thing that'll make sense to you and make you happy. I didn't realise this was the right timing for me until months after the surgery. I knew it was what i wanted but didn't know how right the timing was until later. Yeah i wish i had done it earlier but no way was i mature enough to handle all the mental work i need to do. Its hard and kids complicate things. I get distracted easily. I can barely eat while caring for my mom, trying to get my eating on track while also caring for a small child would have been a recipe for disaster lol. But we are only given as much as we can handle.

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[Delete my account 22]

I have a child and I am currently 1 week post RNY. Like you I wanted a sleeve but my reflux was too bad and I wanted to avoid another possible surgery in the future to correct it or convert it since it's not just that easy as oh just get a revision. My husband and I are not planning to have more kids per say, but if after my waiting period something happens then we would be thrilled!! We had to endure trying, expensive, and frustrating fertility treatments in order to have our child and while I wouldn't change it for the world, if I had to do it over I would have had surgery first. I'm reading some misinformation on here in regards to malabsorption and by no means am I an expert and truthfully that is the exact reason I was afraid to have RNY, but truth is your body may not receive as many calories or nutrients from foods that aren't the greatest for you. That is the benefits to malabsorption. Your stomach doesn't just dump everything the second you ingest it unless in most people it's pretty unhealthy and in that case you're not receiving nutrition from something like that anyway even if you didn't have the surgery. My very good friend had RNY almost 6 years ago and while she still had issues getting pregnant she is currently pregnant with her second child in less than a year lol! Actually her children will be 1 year and 9 days apart if baby 2 stays in there that long ha ha! She had zero complications as it relates to her surgery and was substantially healthier and more readily able to carry a child because of it. The only thing that's common in terms of a normal pregnancy and RNY is having your glucose testing done differently and finding a dr that had treated and delivered babies to mothers that have had RNY just in case. Back to the malabsorption, as long. As you are eating correctly and being religious about taking your Vitamins as directed by your bariatric program/surgeon you shouldn't ever be malnourished. This requires follow up blood work and specified intervals forever and reporting to your doctor if you feel off. Also eating for 2 is not healthy and it's not a thing, you literally only need 100 more calories a day when you are pregnant and that essentially an extra, healthy Protein filled snack. I would not be concerned about malabsorption since there is a big difference between malabsorption and malnutrition and as long as you stick to the plan and take your supplements and get in your protein you would be fine. I know a lot of people do research into the things they want to do and their surgeries but I kind of go over board on it before doing anything and for me this was the right choice! All of the research I read about pregnancy after WLS showed significant higher numbers of healthy babies and healthy mothers with a drastic reduction in pregnancy/higher weight related complication such as GD, PreE, bed rest, etc.. I was lucky I had a healthy pregnancy and a healthy daughter and while I wasn't as big as I am now I only gained 20lbs my entire pregnancy, ate healthy, and kept active. I however was always worried and I actually switched doctors about 12ish weeks in because my weight was an issue for them and I would leave every appointment crying. You need to make the choice that's right for your life, but word of advice I don't think I will ever go back to regular vitamins you swallow even though they say 6-8 weeks after you can take pills like normal. I think it's better to have the nutrients available almost immediately for absorption by allowing them to dissolve or using chewable.

[blondie66 271]

I think you have to wait 2 years post op to start trying for a baby. I had a Vitamin D deficiency at 9 months post op. Deficiencies can come on quickly in the first 2 years. So it's advisable to wait. I have a niece who has spina bifida which is caused by low folic acid levels during first weeks of pregnancy. Folic acid you get from the b Vitamins. It's important to get your vitamins in and have your digestive system settled before trying to get pregnant.

It depends on how old you are if you want to wait to do the bypass before or after pregnancy since you'll need to wait 2 years. I would think that it would be easier getting pregnant after surgery as it balances your hormones and takes extra stress off your body.

[BMC blogger 38]

Thanks everyone, I really appreciate all the thoughtful comments.