Breastfeeding after a C-Section

by Star Rodriguez, IBCLC- this post made possible by the generous support of Rumina Nursingwear.

 

During my pregnancies, I planned for a natural childbirth.  No medications, vaginal, et cetera.  It was going to be awesome.

Except that then I wound up with two c-sections.  So that was unexpected.  And scary.  And threw a big wrench in the whole breastfeeding thing.  I’d planned to have my baby skin to skin minutes after birth and after a natural delivery where I’d have a vigorous, hungry baby.  Now I was exhausted and itchy and pukey and I could barely move.  I had no game plan for this scenario.

My first c-section led to a lot of problems with breastfeeding.  The lovely IBCLCs who helped me fix my breastfeeding relationship actually inspired me to begin this career path.  In this article, I will pass along information that will (hopefully) help you if you are going to be having a c-section and plan to breastfeed.

With most c-sections, mom will get a lot of fluids.  This often translate into an inflated birth weight for baby.  Subsequently, your baby may pee a lot and appear to lose a lot of weight as it gets rids of the fluid (this can also happen if a mom has a lot of IV fluids and delivers vaginally; it’s just even more common in c-sections, though.)  Most doctors and nurses are aware of this, but some are a little less familiar.  Most hospitals have a cut off on weight loss for babies but not all hospitals take the inflation into account, some don’t.  If your hospital does not, and you are asked to supplement, bottles are not always your friend.  Nipple confusion and flow preference are real things.  Not all babies will have an issue, but we don’t know which ones will.  So instead of a bottle, try finger feeding, cup feeding, spoon feeding, supplemented at the breast with an SNS, or something of the like.  You can also ask if your baby can be supplemented with your milk.

Some c-section moms experience a delay in their mature milk coming in.  C-sections are not linked with delayed copious milk production, but traumatic births are.  Some c-sections can be very traumatic.  Also, c-sections are more likely to offer longer separations between mom and baby; some theorize that the less stimulation in the early hours can delay things slightly, too.  The moral of this story is to try to get your baby to the breast as soon as possible.  More and more hospitals are having skin to skin in the operating room for non-emergency c-sections.  If not, ask that your baby be brought to you right away when you are in recovery.  If your hospital has a lactation consultant or breastfeeding expert, see if they can come see you as soon as possible, too, to assist in that latch, especially since you might be tired or not feeling well.  If you still have issues with delayed milk, pumping can help.  Sometimes a 24 hour burst of pumping after most feedings can ramp up milk production and make your body get its act together.

C-section moms can have a lot of soreness.  First of all, don’t ignore the medications that they offer if you’re in pain.  The normal pain relievers prescribed in hospitals are fine for breastfeeding moms to take.  If you’re worried, ask your doctor or nurse.  They will be happy to check for you.  If you are sore and tired, it is often tempting to have someone else feed the baby while you sleep.  No one but you can make that decision, but in those early weeks, skipping feedings can be a problem.  If you do need someone else to feed your baby, again, I highly suggest not using a bottle.  When soreness is a factor, trying an alternate position can also help moms more comfortable in those early days.  C-section moms are often told to use the football hold, and while it is a hold that I love, every mom is different.  If you nurse in a different hold or position that works for you and your baby, great!  In my experience, about 50% of moms that love the football hold post c-section.  The side lying hold is also a great one (where you lie down and pull your baby in to your breast – Miranda Kerr famously released a Tweet of her nursing her newborn this way) but is not always possible right away, since you are probably going to find it hard to impossible to move.

Miranda Kerr breastfeeding

Support for a c-section mom is key.  You just had surgery, and recovery can be hard.  Breastfeeding naturally has a learning curve, and those two things together can feel so overwhelming.  Make sure people are around to help you out the first week or so.  My mother, for instance, made us dinner every single night for a week with my second baby.  It was the greatest thing ever.  I was so not up to cooking yet; I was still trying to figure out how to recover from surgery and handle two kids.  Just make sure that you are getting supportive support, and not unsupportive support and be willing to protect your boundaries, it can make a difference in your breastfeeding journey. 

Finally, many of the moms I see that are up and moving around regularly after surgery do better at breastfeeding.  This is totally anecdotal, and it could just be that those moms didn’t have it as hard as others for whatever reason.  But I do encourage moms to do what they can to feel like a normal human being again.  Walk if you can.  Those fluids that I talked about earlier?  They are still in your body, too, and some can hang out in your breasts, making it harder for the baby to latch well.  Moving can help your body to eliminate those  fluids.  Although I tell you to try to return to some semblance of normal as soon as you can, I am not telling you to overdo it.  Go with your body and how it reacts.  With my second baby, I was ready right away to walk after my c-section.  I felt great.  The second they allowed me, I had a nurse in there helping me up.  Anddddddd then I projectile vomited and almost passed out.  When I thought about it later, I was so gung ho to move nownownow that I ignored a lot of signs that I wasn’t ready yet (sporadic dizziness, nausea, and just a general unwell feeling.)  Don’t force yourself to do things too early and don’t make yourself sick or hurt.  Also, remember to eat and drink to hunger and thirst.  This will help your body to heal and produce the milk that you need.  You don’t have to force yourself to eat extra, just eat what you need.

And if possible, relax.  Be gentle with yourself and your new baby.  Having a newborn is challenging.  Having a newborn and recovering from surgery is that geography between rock and hard place.  Postpartum recovery is important not only to your health but in reality to your entire family, read this on how important taking time to heal birth is for your whole family.  To take care of your baby well you must take care of you.  Your recovery matters and your healing is a key piece in the continuation of your breastfeeding journey.

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Did you have a c-section?  Did it impact breastfeeding?  If you had a c-section and breastfed, what helped you and how would you encourage other c-section moms?

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StarbabyStar Rodriguez, IBCLC, RLC is a provider in the Central Lakes, MN area.  She provides services online at Lactastic Services and in person.  She also blogs for The Leaky B@@b and volunteers her services to loss mothers at Stillbirthday.

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Comments

  1. Wonderful post. As a mom of two boys, also both c sections, this was hugely uplifting and made my situation seem more “normal”, if there is such a thing.

  2. I had a C-section after a long labor and being pumped full of fluids. My milk came in fully on day 4, and boy did it come in with a vengeance. I was so engorged that my baby couldn’t latch at all. I struggled to pump enough to allow him to nurse, but it was slow going. It was scary and overwhelming for someone with no previous breastfeeding experience. Also, side-lying was ABSOLUTELY not an option for me during the first few weeks. If I even tried to roll slightly it felt like my insides would fall out. It was terrible. Thankfully, my baby was a pro at nursing and we didn’t have any other issues. With my next one, though, I’m hoping to avoid a cesarean and the complications it can bring.

  3. I had an unexpected c-section and I had no problems breastfeeding thank goodness. It took my milk about 3 days to come in and he latched beautifully about 1 hour after I had him. Next time I will ask that they postpone the bath and nail trimming so I can get the baby even sooner! Even though he will be three this week I still miss it!

  4. I breast fed with 2nd daughter – c section (26 years ago)….never thought once about it impacting my breast feeding – and it didn’t at all – ignorance is bliss?

  5. I was lucky enough to give birth via c-section in a hospital that was very supportive of our breastfeeding relationship. During my second c-section, I had requested skin to skin contact in the OR and was able to do so. The only wrinkle was that my beautiful, 22 inch long, plump 8 lb 14 oz baby barely fit on my chest between my chin and the screen. He latched perfectly (cradle hold) in recovery and nursed until he was ready to nap. With my first c-section, I felt too crummy afterwards to attempt breastfeeding until about four hours later. The anesthesia gave me such bad shakes that I needed to wait until I could use my hands again. However, after a brief nap for both of us, I was able to snuggle and nurse. It took my body a while to heal enough to make milk for my babies, but once supported by the LC’s, we had a plan and continued nursing for seven months with my first and 6 months and counting with this baby. Thank you for highlighting this potential booby trap with kindness. As another reader said, rolling over in bed to nurse was pretty unpleasant. I used a cradle hold and a few pillows to avoid rolling for a two weeks or so.

  6. What a fantastic post! Full of important information and tips! Thanks!

  7. After a 3 day labor and unexpected c-section my son was unable to latch due to a deep palate and my overfull breasts (from fluids) and short nipples. After he grew into his mouth we still had troubles. We met every other week with an IBCLC and attended every La Leche League meeting we could get to. After 11 weeks of triple feeding (pumping, feeding pumped milk through a finger feeder and cups, and trying to get a latch) my son finally latched on like a champ. We struggled with supply issues due to the exclusive pumping (and the STRESS!) in the beginning, but once he started to breastfeed I have no worries about my supply now. He’s almost 4 months old and we are now in a successful breastfeeding relationship; I have a bit of pride to say that even with our struggles he’s only had breastmilk from the beginning. We gave birth at a baby friendly hospital and were able to use precious donor milk while in the hospital. My advice was my mantra for those 11 weeks – never quit on your worst day. You may have a lot of them, but that day your little one finally gets it will be so sweet. Oh, another piece of advice, find an IBCLC you click with. We had 2 in the hospital who told me not to worry (I was just a new mom, what did I know?), but the third one realized we had a serious issue. Thanks for a great post!

  8. I’m a mom of two boys, both were csectiona, the first was an emergency csection nearly six weeks before my due date. I was told I wouldn’t be able to bf him because he was so early so they put him on formula and ignored my requests for help. I finally got him nursing, but I wish I had had the kind of support that is offered here then. We only made it about six months, but I’m glad we did any at all. With my second we are still nursing at 16 months and going strong because of the support and stories I get from this site. Thank you!

  9. Danielle Jones says:

    I had my first son, via emergency c-section in April. I was only given 30 minutes to hold and attempt to feed him before they wisked him away from me. There was no one there but my husband trying to help me. They didnt return him to me until almost 5 hours later! Latching was almost impossible. I was in so much pain, so hungry, and so badly wanted to feed him. I had MAYBE one nurse who tried to help me, and then there was my husband. I dont know what I would do without him by my side. He was my rock, and he is the reason we are still going strong with nursing. Honestly, the hospital could have done a lot more! Thank you for this blog, and now I know I am not the only one.

  10. I had a sort of planned c-section with my third baby. I was told to supplement with formula because he lost too much weight. I wish I’d known about the excess fluid thing then because I’m pretty sure the hospital staff didn’t take that into account. Thankfully I’m stubborn and ignored the doctor’s request to use formula. For the first few weeks I made it my mission to only focus on nursing my baby and keeping my body comfortable as I recovered from my c-section. I can definitely thank my amazing family (mostly my inlaws) for their support in the process.

  11. I had a planned c-section with my third baby. I was very vocal and somewhat demanding in refusing to be separated from my baby for an extended time. While I was being sewn up my husband was holding our baby in the recovery room. As soon as I was finished I joined them and immediately began nursing. I wish I would have known about fluid retention in my baby because I don’t think hospital staff took that into consideration. The doc wanted me to supplement with formula because baby lost more than 10%. I silently refused because I knew as soon as my milk came in we’d be fine. I also had trouble getting him to latch properly so I used a nipple shield (no one was available to help & I felt pressured to get him to eat more). When I finally got help from the LC she was very rude and pushy. I finally told her to leave and we’d figure it out ourselves, since she was just stressing us out. She made me feel ashamed because when she left she said this is your third baby after all. Except being my first c-section it put a whole new spin on things. Thankfully I had an amazingly supportive family, don’t know what I’d do without them.

  12. Love reading about women conquering challenges like this, its tough, but all of you are awesome.

  13. After being in the hospital for about three days trying to get my son out naturally, he was born via c-section. Nothing in my birthplan had come to pass, but I insisted on breastfeeding. I don’t know that I was very affected by all of the extra fluid, but he certainly was. He wet all the time and pooped all the time too when he came out, so much so that he lost more than the 10% the hospital allowed for us to be able to take him home. He did however feed like a champ from the beginning. He fed so well that one of the doctors that came in thought I had breastfeed another child before him (he’s our first)! He came out rooting and licking on my face (one of my fondest memories of delivery) and I was able to have him latch on in recovery. The one thing I can say is to go in firm with your mind made up about what you want to do, especially if breastfeeding. I found, surprisingly, that even most doctors are not supportive of the breastfeeding experience. When he was losing weight, I had to come up with the plan, because I refused to supplement with formula, which they were trying to make me do. Instead, I demanded a manual pump and I was able to prove to them that there was colostrum present and I fed it to him by syringe. Almost one year later, he was ebf for six months and still breastfed with solids thereafter. Even with a c-section, know that you can make it happen, just stick to your guns and do what you feel best for you and baby.

  14. What a great post! This is great advice! Thanks for sharing.

  15. I had 2 C-sections.. My daughter was my first c-section after a failed induction I was pumped full of iv fluids didn’t get to see her for at least 3 hours after I had her. I was in so much pain afterwards but I was determined to breastfeed. She wouldn’t latch even with the nurse trying to help me. I ended up pumping my colostrum and syringe feeding her it. Breastfeeding after her was very difficult b/c of my pain and PPD after my c-section. I kept on it for about a month but I felt horrible giving it up It put me in even more PPD.
    My Son was my Second c-section he was born just 10 days ago. Even thought I didn’t get the VBAC I wanted this c-section was night and day compared to the first one and had a big impact on my breastfeeding. Immediately after he was born I was able to have skin to skin with him he stayed in the room with me the whole time and I got to hold him until I got to recovery where the nurse helped him latch on to me right away before they did anything. My recovery with this C-section was so much better I was up and moving the very next day and I have been doing very good with this recovery. My son is feeding very well and gaining weight. Im very excited!
    This article was great to read makes me feel like I am not alone with the whole c-section breastfeeding issues. You gave great advice and it was very uplifting.

  16. Owens Momma says:

    My son was born via c a week late and after 3 miserable (and obviously unsuccessful) days of induction. I was horribly sick from the meds, so I didn’t get to see him for several hours after my surgery. They brought him in and I was able to nurse, he latched right away and I was so proud! I was also still out of it from the meds so for his safety they took him back to the nursery. In the morning they brought him back to nurse again, but it was a little more difficult. They took him to run some more tests on his heart. That afternoon he was transported to the NICU almost two hours away. Having had surgery 12 hours prior, I wasn’t able to go with. I attempted to pump, but colostrum is hard to pump, and I didn’t have any real success.
    In the NICU, he refused the bottle of formula they tried to give him so he was given a feeding tube. 24 hours after he was transported I was released and spent the next two weeks by his side. When he got his feedings, I put him to breast. I struggled to pump to supplement then replace the formula. A nurse told me I had to rent their pump, because my medela freestyle wouldn’t be enough. I proved her wrong. I used my little pump and got him off the formula within a few days, and he was gaining enough weight before the weeks end he was allowed to eat when and as much as he wanted.
    My son is 4 1/2 months old and exclusively breast fed. We had a lot of obstacles to overcome, but we did it and I am so proud to be where we are.
    I was stubborn, determined if I could do nothing else for my son I would give him breast milk! But I had a lot of nurses and a lactation consultant to turn to. If you want to breast feed, don’t give up. Ask for help. A lot of people will look at your nipples and feel your boobs, but it’s totally worth it!

  17. I had an elective c-section 3 weeks ago. I had gone into the delivery suite following 5 days of on/off contractions and was told baby was breech. I had the choice to wait it out and attempt natural delivery and all the complications that can come with that or go for an elective. It came down pretty much to more recovery for me or for baby. Baby has enough to contend with starting life I'll do what I can for him. 

    The rugby/football hold was fine for me in hospital but I found once I got home I didn't have enough support in my own bed to be able to get him at the right angle. Side by side worked fine in the first few days when I wasn't entirely mobile and still very sore. Now three weeks on I'm feeding across (so feet are next to non-feeding boob) and it's working for us. I am still a little sore across my incision but still able to take paracetamol and/or ibruprofen as needed.

    When we were taken to recovery following the surgery, the nurse who was doing my obs was also able to help me try breastfeeding and try to get him used to it. We had a 45 minute feed in recovery and it went from there. 

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