Breastfeeding after a C section
It is possible to breastfeed successfully after having had a cesarean section.
If you are pregnant right now, it’s useful to get as much information as you can in advance of the birth to prepare for such a possibility.
For a small proportion of you, you may even have a date for an elective cesarean.
If this is true for you, you may wish to consider the possibility of having an epidural rather than a general anesthetic, so you will be more alert and able to breastfeed as soon after the procedure as possible.
It is also worth learning how to hand express your breast milk before birth.
It can be useful to express a small amount of milk the day before you have the procedure, and this milk can be given to your baby straight after the birth, if necessary.
For the majority of you, you may not have even considered the possibility that a cesarean birth may be necessary. Sometimes, however, this situation may arise for various reasons – so here are a few points to consider.
First of all, be assured that the anesthetics and the medications given to women who are laboring and having cesarean sections will be compatible with breastfeeding.
However, it can still be beneficial to speak with the medical staff regarding your options.
It’s vital to be able to make an informed choice about the kind of medications that you will have in labor because some can make your baby sleepy, particularly just after birth.
If your baby is sleepy, it can often take longer to establish breastfeeding.
Once you have had the C-section, you are likely to find that your movements are restricted a little.
One of the things that a lot of women find difficult is to be able to hold and feed their baby well, because you may have an intravenous drip in the back of your hand, and you might be attached to hospital equipment.
It can be helpful to request to have the intravenous drip put into your forearm instead – this will give you extra movement and freedom to be able to feed your baby.
It’s also really wonderful if you can have a supportive person with you in those first few hours after your birth, whether that’s your partner, friend, or another family member, to give you extra help.
They could help by holding your baby, or positioning pillows, or generally doing anything that will help you to get more comfortable with your baby and get breastfeeding off to a good start.
We know from studies that this kind of help with positioning can make a big difference.
You may find that lots of pillows and rolled up towels and blankets can help to make things a lot easier, supporting both you and your baby.
Your support person can help you to work out comfortable positions for breastfeeding.
If you have a spinal epidural, you are very likely to be still under the effects of the medication.
Therefore getting breastfeeding off to a good start right at the beginning when you are not feeling any particular discomfort at that moment can be advantageous.
However, if you are not able to bring your baby to the breast straight away, you can express your milk and the healthcare staff will be able to help you to do that.
Studies show that the majority of newborn babies feed anywhere between 8 to 12 times in any 24 hours and sometimes more than that!
Learn about feeding cues so that you know what signs to look for, helping you to know when your baby needs milk, and then bring your baby to your breast as often as needed.
The first milk that your body produces is called colostrum, which is produced in very low volume, and your baby takes tiny amounts of this.
By about the second day onwards, sometimes up to day 6, but generally around day 3, the volume of milk starts to increase.
If you have had a cesarean section, you may find a small delay on this. Studies seem to suggest this happens because of the added challenges at the beginning.
The more frequently your baby comes to the breast, the better.
If you find that your baby is particularly sleepy at the breast, lots of skin to skin with your baby (at least a couple of hours per day,
if possible) will help to boost the hormones that make milk and keep your baby active as well.
Additionally, breast compressions are a useful tool to help your baby to get more milk even if he falls asleep at the breast.
If possible, try not to supplement with formula, but instead, express your milk every 2-3 hours.
While you are producing colostrum, you can hand express with your hand (not a pump) every 2-3 hours, and your milk can be given to your baby via a little syringe or a cup.
Avoid bottle teats if you can.
If your baby hasn’t started to latch at the breast yet, once your mature milk starts to come in around the third or fourth day, it would be good to request a hospital grade double pump.
Using this pump will cause your body to make milk. Pump your milk every 2-3 hours for about 10-15 minutes at each pumping session.
Make sure that your baby is latched and feeding well. A baby who has latched well will drain the breast better.
Every time your baby swallows milk, your body will make more on that particular side. So whether you are feeding at the breast or you are pumping, this frequent stimulation is important.
Ask your healthcare provider to sit with you and support you while latching your baby, to boost your confidence.
Also, build up your knowledge regarding how you can know that your baby is getting enough milk.
The key signs are being knowledgeable about what to expect regarding wet and dirty nappies and normal patterns of weight loss and gain in the first few weeks.
Many breastfeeding mothers start to lose confidence in their milk supply when they don’t have this knowledge.
Finally, when you are discharged home, make use of all offers of practical help, utilizing family and friends who can help with household chores and who can also look after you so that you can spend as much time as you need to get breastfeeding off to a good start.
Review dates, references & further resources
Version 1.1 published in March 2019. Next review date: Jan 2022
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