Breastfeeding after a caesarean

Breastfeeding after a caesarean - Transcript

It’s really good to know that many women breastfeed successfully after having a cesarean section and if you are pregnant right now, it’s good to get as much information as you can in advance of the birth to prepare for such a possibility. And for a small proportion of you, you may even have a date for an elective cesarean. If this is true for you, then it might be good to consider the possibility of having an epidural rather than a general anaesthetic and this is simply so that you will be more alert and able to breastfeed as soon after the procedure is possible.

And I would also encourage you to learn how to hand express your breast milk before the birth, certainly if you are having an elective session, it can be useful to be able to express a little bit, just may be the day before you have that procedure and this can be given to your baby straight after if necessary. But for the majority of you, you may not have even considered having a caesarean and sometimes that you find yourself in this situation, it may not be written in your birth plan for instance.

So I just want to talk to you about a few points to consider, if this should happen to you.

So first of all, I want to show you that the anaesthetics and the medications that are given to women who are labouring and having caesarean sections will be compatible with breastfeeding, but it is certainly good to have a chat with the medical staff about this and be fully aware of the compatibility of these drugs.

It’s still important that you make an informed choice about the kind of medications that you will have in labour because some can make your baby sleepy particularly at the beginning and it just means that it is going to take a little bit longer to get breastfeeding established.

So, once you have had the caesarean section, you are likely to find that your movements are restricted a little and one of the things that a lot of women find difficult is to be able to hold and feed the baby well and this is usually because you may have an intravenous drip for instance in the back of your hand, you may be attached to hospital equipment. One thing you can do is to request to have your drip to put in to your forearm so that it will just give you that extra movement and freedom to be able to feed your baby.

And it’s wonderful to have a supportive person with you after the birth in those first few hours, somebody, your partner, or another family member just to help, maybe even holding your baby, positioning pillows, anything that is going to help you to get comfortable with your baby and get breastfeed enough to good start.

And we certainly know from studies that, this kind of help with positioning can really make a big difference and you may find that lots of pillows and roll of towels and blankets can just help to make things a lot easier, supporting both you and your baby, but with the supportive person with you, helping you in all of these to work out positions are comfortable.

And if you think about it, because you just have just had a spinal epidural generally, you are still under the effects of these, so getting breastfeed enough to good start right at the beginning when you are not really feeling any particular discomfort at that point can be advantageous.

But if you are not able to bring your baby to the breast straight away, then you can express your milk and the midwives around you will be able to help you to do that.

Studies show that the majority of the newborn babies feed anywhere between 8 to 12 times in any 24 hours and sometimes more than that. So it’s good to learn about feeding cues so that you know what to look for and to know whether your baby needs that milk and then bring your baby to your breast as often as he needs.

The first milk that your body produces is colostrum, so your baby takes very small amounts of that, it’s only produced in very low volumes. But by about the second day onwards, sometimes up to day 6, but generally around about day 3, the volume of milk starts to increase. Now, if you have had a caesarean section, that can sometimes be a little bit delayed and studies seem to suggest that’s because of all these added challenges at the beginning just getting breastfeed enough to good start. So the more frequently your baby comes to the breast, the better.

If you find that your baby is particularly sleepy at the breast, then lots of skin to skin at least a couple of hours per day if possible that will help to boost the hormones that make milk and keep your baby active as well. But also, breast compressions are a really useful tool to help your baby to get more milk even if he does drop off to sleep.

And if at all possible, try not to supplement with formula but instead express your milk every 2-3 hours. When you are producing colostrum you can hand express with your hand only every 2-3 hours and that milk can be given to your baby via a little syringe or a cup something like that. Avoid bottle teats if you can.

But once your mature milk starts to come in around about the third, may be the fourth day, if your baby isn’t latching for any reason, then it’s really important that you do request a hospital grade double pump and let that pump start to tell your body to make milk. So every 2-3 hours, pumping, 10-15 minutes, each pumping session.

And make sure that your baby is latched well and feeding well. Certainly a baby who has latched well will drain the breast better and every time the baby swallows milk, your body makes more in that particular side. So whether you are feeding at the breast or you are pumping, this frequent stimulation is really important. And it’s really good to check with the midwife staff that your baby is latched well. Just ask them to go through those things with you to boost your confidence.

And I would certainly encourage you also to understand fully, how you can know that your baby is getting enough milk because this is one of the reasons why a lot of women start to lose confidence especially if you found yourself in a situation where you have had a caesarean section and you got all these added challenge. Know in advance what those signs are and then this will help you.

And finally when you get discharged home, just make sure that you have got all that practical help, people who can do housework for you and look after you really, so that you can spend as much time as you need getting this breastfeed enough to good start.

Review dates, references & further resources

Review Dates

V1 published June 2017. Next review date: April 2020

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