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.
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.
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?
Star 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.