Is it possible to breastfeed after a cesarean birth?
Yes, it is certainly possible to breastfeed after a cesarean. Whether you know about the cesarean in advance or not, you would be prudent to begin planning for the possibility of unexpected interventions. A smooth birth contributes to a smooth breastfeeding experience, so when you take advance measures to prevent difficulties from birth complications, breastfeeding can succeed more easily.
You can put together a "birth plan" that outlines your desires and expectations regarding your baby's birth and the hospital stay. Perhaps someone at the hospital, such as a lactation consultant or midwife, may be able to help you with this. Sometimes such personnel have templates of birth plans that you can work from. If not, you can create one on your own. Books such as The Birth Book: Everything You Need to Know to Have a Safe and Satisfying Birth by William and Martha Sears, many of which are available from the LLL Online Store, can help you devise a birth plan for yourself. Discuss the birth plan with your physician and get his or her signature on it. Make copies for your physician, for the hospital, and to keep with you when you go to deliver your baby.
As you prepare for your baby's birth, a good question for your doctor would be "What kind of anesthetics are available and under what conditions do you prescribe them?" If you know you are having a cesarean, an epidural, rather than a general anesthetic, can leave you alert, so that you can breastfeed immediately after birth in the delivery room. However, you may need assistance, from your partner, a doula, or a nurse. Following a cesarean, the IV, your incision and hospital equipment may restrict your movements, so that you may need to breastfeed lying flat on your back. Having someone arrange pillows to support you and the baby, or actually holding the baby in place, can make it more comfortable for you to breastfeed right away.
In the first few hours after your baby's birth you may need extra assistance, especially if you had a cesarean. Find out if the baby's father or another person can stay with you and the baby in your room so that you can have help in lifting the baby, changing position, changing diapers, and so forth. You'll be surprised how quickly you can be up and around after the cesarean, but there is definitely a time period when your ability to move around is quite restricted. Having a person in your room to assist you can allow unrestricted breastfeeding of your baby. This can be a key to getting breastfeeding off to a good start and help you to avoid engorgement.
Typically, the medications you may be given following a cesarean birth (pain medications and antibiotics) are compatible with breastfeeding. By the time your milk comes in, you may no longer need pain medication. During the early days, you can ask to skip or postpone doses of pain medication if you feel you can do without. Ask your physician if you could try taking over the counter analgesics, such as you would take for a headache. Take enough medication so that you are comfortable. This will help to keep your baby alert and better able to nurse frequently and effectively.
Positioning can be another challenge right after a cesarean. Lots of pillows to support the baby and to support your body in various positions can be your most valuable breastfeeding "accessories." Rolled up towels or blankets can also be used. You may find that your body is tender at the site of the incision and that you cannot move and change positions as easily as usual. Hospital beds, IV lines, and monitors may interfere with your freedom of movement and with your ability to position yourself and your baby for comfortable breastfeeding. You may need to experiment with various positions to see what will work best for you. The FAQ How Do I Position My Baby to Breastfed? includes descriptions of the side-lying position as well as the "clutch" or football hold position which many mothers who have had a cesarean find helpful. See the "Resources" section at the end of this FAQ for additional references.
As you make your plans for your birth, attend a La Leche League Group in your area for additional information and support. To find a Leader of a local Group, check out the section of our Web site entitled Finding a Local LLL Group. You will meet mothers who have had many different birthing experiences.
Resources for Additional Information
Breastfeeding after a Cesarean Birth urges the pregnant woman to be aware of the effect a cesarean birth can have on breastfeeding. Explains how to breastfeed comfortably and describes how medications can affect the baby. This pamphlet may be ordered from the LLLI Online Store or a Leader may have a copy you can purchase.
Positioning Your Baby at the Breast is a step-by-step guide which discusses effective positioning to ensure that baby suckles well and gets plenty of milk and mother avoids nipple soreness and pain. This pamphlet may be ordered from the LLLI Online Store or a Leader may have a copy you can purchase.
THE WOMANLY ART OF BREASTFEEDING, published by La Leche League International, is the most complete resource available for the breastfeeding mother and can be ordered from the LLLI Online Store or through your local Leader.