Many studies have noticed the comparative difficulties in breastfeeding between those who experienced surgical and natural births.
One study found that “women who had a cesarean section experienced a significant delay in initiating breastfeeding compared with women giving birth vaginally, with or without instrumental assistance.”
Another paper concluded that “the inability of women who have undergone a cesarean section to breastfeed comfortably in the delivery room and in the immediate postpartum period seems to be the most likely explanation” for decreased rates of exclusive breastfeeding among surgical births.
The key to a sustained future with breastfeeding might be getting through the recovery period, which is usually more grueling and physically limiting for those who have undergone major surgery. That said, those wishing to breastfeed can feel encouraged that an emergency or elective surgical delivery mustn’t necessarily and negatively interfere with their plans.
In fact, Dr. William Sears believes a cesarean section should not dramatically impact breastfeeding, and those who birthed surgically can be as successful as vaginal birthers “as long as their commitment to breastfeeding remains high” (see these other Dr. Sears tips). In other words, breastfeeding people need to be thoroughly informed about what they can expect.
So what can be done to ensure a solid start to breastfeeding?
You may strive to accomplish skin-to-skin breastfeeding as soon as possible after surgery and should make arrangements for this as a ‘just in case’ directive even if you’re planning a vaginal birth. You can prearrange with their provider to initiate the first feeding while being sewn up, which is entirely possible if given an epidural rather than general anesthesia.
Expect to be lying flat on your back and to not have full range of arm motion at your disposal (a nurse or partner should be appointed to help hold your baby’s head upright, and assist for safety reasons if you’re experiencing medication side effects such as involuntary shaking).
Research Gentle C-Section to see if this more family-friendly type of surgical birth is right for you. With a “family centered cesarean,” a clear partition can replace a solid one just before delivery so you can see your child being born, if you’d like. EKG wires can attach to your back, freeing up your chest for skin-to-skin bonding. Find out more in this informational video.
TIPS
- Have whoever will be assisting you at home (partner, mother, etc) watch how the professionals (nurse, doctor, doula, LC) help you.
- Your partner should also learn to do the ‘lower-lip flip’ technique at a moment’s notice and continually assess latch for you, as your view may be obstructed in certain nursing positions.
- Side-lying and clutch/football hold positions may be the most comfortable (though for a while, you may feel that no positions are what you’d call ‘comfortable.’ Hang in there — you just had major surgery!).
- After a cesarean section, expect to stay at the hospital for two to four days. Your initial recovery period will continue for weeks, however, so you’ll need to rally all the help you can get to take care of day-to-day things.
- Don’t skimp on pain meds as breastfeeding works best when you’re experiencing minimal pain. There’s no reason for you to suffer. Be aware that using post-operative pain meds to excess can make you and baby too sleepy to establish breastfeeding well. BabyCenter advises about what to expect in regard to postpartum pain relief:
“If you get an epidural or spinal for your c-section, your anesthesiologist may add morphine, which can provide excellent postpartum pain relief for up to 24 hours without the grogginess that comes from systemic narcotics. Some anesthesiologists leave the epidural in for 12 to 24 hours after surgery so you can get more medication through it if needed.
After that, you’ll be given systemic pain medication, usually pills containing a narcotic and possibly acetaminophen. It may help to take ibuprofen, too. You’ll also be given a stool softener to counteract the constipating effect of the narcotic.
If you have general anesthesia for your surgery or you don’t get a dose of morphine through your spinal or epidural afterward, you’ll be given systemic narcotics for immediate postpartum pain relief. You’ll either get a shot of pain medication every three to four hours or you’ll use a system called “patient-controlled analgesia”: You push a button when you’re feeling discomfort and medication is delivered through your IV. A machine controls the doses so you don’t get more than the safe amount.”
DID YOU KNOW?
- Another challenge is lower oxytocin patterns in a newly-postpartum cesarean birther as compared to an individual who birthed vaginally. You can prepare for this by seeking natural ways to boost your oxytocin after birth if necessary.
- Greater populations of harmful bacteria such as E coli and C difficile are present in a child born via cesarean section, which means that breastfeeding (without supplementation) can be especially beneficial. Have you considered a vaginal swab? If it’s safe in your condition, you can mimic the bacterial environment of a vaginal birth by swabbing your vagina (and/or rectum) and wiping on your baby’s skin. This will introduce the right healthy flora into your baby’s system. Don’t be afraid to discuss it with your provider!
- Milk may take a few days longer to come in due to anesthesia and medications, the stress of surgery, and especially if you and baby have been separated. Try to have patience and focus on frequent feedings or expression. Alternative feeding methods such as cup, syringe, and finger-feeding are better options than supplementing with a bottle, if breastfeeding isn’t possible.
Links:
- “Breech Birth Stories and Resources” – Paa.la
- “C-Section Scars are Beautiful and So Are You” – Jade Beall
- ICAN’s Facebook page
- International Cesarean Awareness Network
- “My First Birth: Cesarean for Breech” – Paa.la
Mama's Milk, No Chaser 