Many mothers birth their babies by cesarean section and, while this can make breastfeeding more challenging, it is absolutely possible to successfully breastfeed after a cesarean section.

Here is what you need to know to get you off to a flying start.

Start Breastfeeding Early After a Cesarean Section

Any mother who has a stressful birth, such as a cesarean section, may experience their milk coming in a little later than what is considered in the range of normal. For most, milk transitions from colostrum (early milk) to milk coming in by 72 hours of birth.

After your baby and your placenta are birthed, your milk-making hormones go into overdrive and cause the cells that make your milk to switch on into production.

Research tells us that early and frequent sucking helps to switch on these milk-making cells, and mums who are able to feed or pump in the first hour have been shown to start lactation earlier, breastfeed for longer and have greater milk production compared to mums who start feeding or pumping later. By putting your baby to the breast as soon as they are born, you will maximise the switching on of your milk making cells.

Even if you have had an epidural or spinal anaesthesia, you may be able to breastfeed as soon as your baby is born. If you have a general anaesthesia (GA), you may be separated from your baby for a brief period while you wake up from the anaesthetic. Many hospitals now have breast pumps in theatre and recovery and the nurses and midwives will be able to assist you in expressing within the first 1-3 hours after birth.

If you are anaesthetised for a long period or take longer to recover, a nurse or midwife may be able to express you while you are unable to do so. Once you are reunited with your baby, feed your baby often.

Zero Separation

Many hospitals realise the life long benefits of keeping mother and baby together and employ extra nurses or midwives so that if you do have a cesarean section, your baby can safely remain with you. It is the nurse or midwives role to ensure that your baby is safe while you are affected by the medications given to you during your cesarean.

If your baby does remain with you while you are affected by medication, it is vital that you are not alone and that you and your baby are under constant supervision.

After your baby is born, they will be placed on your chest in the skin to skin position and will remain there while the doctors stitch your cesarean wound. Evidence on skin-to-skin contact suggests that newborns that are placed skin to skin with their mum immediately after birth and breastfeed within the first hour after birth have better breastfeeding outcomes. This includes a reduced risk of the delay in your milk coming in, improved milk production, and increased breastfeeding duration.

It is therefore important that the mum is given the opportunity to breastfeed and have the baby skin to skin immediately after birth in the delivery room. Avoiding any maternal-baby separation in the first hours is recommended. Zero separation ensures that you and your baby can stay together. The allocated nurse or midwife will be able to assist you to safely put your baby to the breast even if you are groggy from the medication.

If you are unable to have skin-to-skin contact, have a backup plan for someone who can, and make sure the hospital team knows your wishes. When choosing a hospital to birth at, ask them what their policy on zero separation is and let them know your preferences.

Feed and/or Express Frequently

Regardless of the type of delivery that you have, it is important to feed your baby often. Feeding your baby frequenly will help to boost your supply and help switch your milk supply on.

Typically, newborn babies will breastfeed eight to twelve times per 24 hours, with the interval varying from two to three hours on average. However, this varies widely between babies.

Offer your baby the breast every time that they signal to you that they are ready to feed (stirring, rousing from sleep, licking their lips) and let them feed at the breast for as long as they desire.

If your baby is unable to feed effectively or is separated from you, it is important to start expressing, a minimum of 8 times in 24 hours, until your baby is feeding effectively. If you are concerned that your baby is not feeding effectively or if breastfeeding is painful, ask your midwife/nurse/lactation consultant for assistance.

Post Cesarean Section Pain Management

While you are recovering from your cesarean section, it is likely that you will experience some pain. Pain from the incision site is common, and you may also experience pain from your uterus contracting (after pains) back down to size. Pain can make breastfeeding a little more challenging.

Many pain medications are compatible with breastfeeding, so don’t be afraid to ask for pain medication. If you are on top of your pain control, your recovery will feel smoother, and it will be easier to position your baby to feed effectively.

Different breastfeeding positions such as the football hold can take the weight of your baby off your incision site and make breastfeeding easier while you are healing. Make sure you ask for help with positioning if you are having any difficulties

Have you or anyone that you know gone through a cesarean section? What did they tell you about the experience – and how they recovered from it? Let’s have a chat and support each other.

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