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The Effect of a C-section on Breastfeeding

Camilla: One important and significant impact is the impact of intravenous fluids administered >>> likelihood of breast edema after c-sec with subsequent latch difficulties; delayed lactogenesis 2 (mature milk typically comes in a day later, but colostrum is usually still enough;  increased birth weight and subsequent increased weight loss.

As many of us have repeatedly heard, the type of birth can potentially affect the breastfeeding relationship and journey of a mother and her baby.

Nowadays, an increasing number of women have started to prefer home births and natural (with no to limited medical interventions) births. However, C-section births are still widespread. Sometimes, they are elective, sometimes they are essential and sometimes they could be misguided or enforced. In any case, the breastfeeding journey that follows post childbirth needs some special care, attention and in some cases, intervention. Therefore, it’s important to educate oneself about them from before. 

The effect of a C-section on Breastfeeding:

The impact that a C-section birth can have on breastfeeding is multifactorial. Below mentioned are some of the factors and specific concerns associated with C-section.

1. Anesthesia and other medication

  • Anesthesia

Anesthesia given during the C-section should not affect the milk.

  • Pain relievers

There are lots of breastfeeding friendly painkillers available which should be used. If there is excessive or more than required consumption of the pain relieving medicines, it can cause sleepiness not just in the mother but also in the baby, which can be a challenging situation in the first few days. Thus, it’s better to limit the usage of painkillers on a need basis.

2. Initiation of Breastfeeding

General Anesthesia is becoming less common with C-sections. Mother is awake during birth when spinal/epidural is administered. In such a case, the mother can nurse the baby right after birth. If the mother is under general anesthesia, it’s recommended to try to initiate breastfeeding as soon as the mother is conscious. It may not be possible to initiate breastfeeding within the first hour in that case. But it is recommended that it should be initiated within the first 4 hours of birth, latest.

3. Nursing Positions for C-section moms

There are a few positions that are very specifically compatible in case of C-section births. They are as follows.

  • Baby on chest, across breasts
C- Section Nursing (4)

Image created by Sangeeta A Shenoy

In this position, the mother is lying down on her back and the baby is placed face down horizontally on the mother’s body i.e. across her breasts. This way, there’s no contact between the baby and the incision. This looks like a cradle position, but while lying down flat. It requires another person to support and hold the baby.

  • Modified natural nursing position
C- Section Nursing

Image created by Sangeeta A Shenoy

This position is where the mother is lying down flat on her back while the baby is placed face down vertically on the mother’s body – but the feet of the baby are on the mother’s shoulders. This prevents any kicking to hurt the mother’s incision. This position is very useful in the first few hours to the first couple of days after birth. It requires another person’s help in holding the baby.

  • Side lying position

This position is possible once the mother is able to turn over. It’s the common side lying position. But, it needs to be achieved with a lot of care and patience. The mother needs to turn over very slowly to avoid any kind of pressure on the abdomen. Lots of pillows can be used to support her back once she has turned. Pillows can be put between her legs too. The incision could be covered with pillows or a blanket in order to avoid the baby’s kicks touching that part. Baby needs to be lying next to the mother, turned fully toward the mother and is pulled closer to the mother for latching. (Link to positions article)

  • Football position

Image Source:

This position works once the mother is able to sit up and nurse. It prevents any contact between the baby and the incision. (Link to positions article)

  • Additional position

Image created by Sangeeta A Shenoy

4. Support System

A mother who has undergone a C-section usually needs more help and support from the partner in the initial days. This support is essential in holding and supporting the baby while nursing, providing support to the mother in getting to the nursing position and back to comfortably lying down, burping the baby, changing the baby and a lot of other things that the mother will be unable to do in the first few days. It is important to seek help from other family members or even hired help if required.

5. Milk Supply 

There have been a lot of myths around C-section births and milk supply. A lot of women believe many of the following things –

-If the baby is born through C-section, the mother produces less milk.

-In case of a C-section, there’s no milk immediately after birth.

-In case of a C-section birth, it’s unavoidable to supplement with formula in order for the mother to get rest.

It’s important to realise that these are all myths. Milk production starts during pregnancy, so milk is definitely available immediately after birth. The hormonal changes that occur at the time of a vaginal birth (due to expulsion of placenta) also occur with C-section as the placenta and uterus are separated. Thus, the mother will have milk irrespective of the kind of birth she has. What may come into the picture in case of C-section births is – stress due to surgery, pain etc inhibiting the let down reflex. This slows down the milk ejection to some degree. But it has nothing to do with the actual supply. Some relaxation techniques like soft head/back massage, calming music, company of the supportive partner and other loved ones can work wonders.

Certain ideas to tackle any supply issues are as follows –

-Nurse often. Minimum 10-12 times in 24 hours.

-Nurse at the earliest hunger cues. Don’t wait for the baby to cry.

-Co-sleep with the baby and give unlimited access to the breasts.

-Avoid supplementing with breast milk substitutes.

Breastfeeding after a C-section birth can be challenging for the first few days or weeks. But with above discussed methods and strategies, it is absolutely possible to have a long and successful breastfeeding journey.