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Breastfeeding after a Cesarean Birth

Sara Walters
Carmarthen Wales UK
From NEW BEGINNINGS, Vol. 25, No. 3, 2008, pp. 36-37

Breastfeeding completes the normal, natural cycle of pregnancy, labor, and birth. One of the first changes we may notice when we become pregnant is our breasts becoming bigger, and they may feel sore or tingly. This is because they are already getting ready to feed the baby after it is born.

Whether a woman gives birth vaginally, or by cesarean, her body still needs time to recover, and it can take time to adjust to having a new baby. Still, a birth by cesarean means a longer hospital stay, and major abdominal surgery to recover from. This may make breastfeeding more of a challenge, particularly if the cesarean was unplanned.

The Unplanned Cesarean

If you were planning on a vaginal birth, an unexpected cesarean may leave you feeling disappointed or upset. It is normal to have negative feelings about what happened and to mourn the loss of the birth experience you were hoping for. These feelings may impact the way you feel about your baby, and also your feelings about breastfeeding. Again it is quite understandable to feel this way.

Your birth experience may not be what you planned, but you have the whole of your mothering journey ahead of you. Breastfeeding can make you feel in control and motherly. It also brings you in close physical contact with your baby, which may help you to feel better emotionally. Also, breastfeeding helps the womb to contract back to size, which will help you heal more quickly.

The Planned Cesarean

If you know you will be having your baby by cesarean, then you have the advantage of being able to plan for breastfeeding. The policies of the hospital will have a major impact on whether you get breastfeeding off to a good start as you will be spending more time there. It is important that you make your intentions to breastfeed known to the staff beforehand, and make the following points clear:

  • You would like your baby to sleep next to you, and not be separated from you if you are both healthy.
  • No routine supplementary bottles or dummies (pacifiers) to be given to your baby.

Getting Breastfeeding Off To a Good Start

It's important to breastfeed your baby as soon as possible after birth. If you have a general anesthetic, try to breastfeed as soon as you are alert enough to hold your baby. If you have had a regional anesthetic and were awake during the birth, try to breastfeed in the recovery room, or even on the operating table if possible. At this stage you will be free from pain, as the anesthetic will not have worn off, so this is a very good time to start. Although it is likely you will be flat on your back and may need some help positioning the baby, there is lots of new information that suggests simply lying there, skin to skin, is enough to prompt the baby to nuzzle down onto your breast. It is not necessary to be sitting up to breastfeed. If you can get your baby on the breast as soon as possible, it will boost your confidence in being able to feed him later on when you are perhaps feeling more uncomfortable.

Common Concerns

Although there may be anesthetic in your system, it is generally not harmful to the baby. Talk to your doctor if you have concerns, and find out the name of the medication. An excellent resource, Medications and Mothers' Milk by Thomas Hale, PhD, lists info about different medications and how they affect breastfeeding mothers and babies. Ask a local La Leche League Leader if she has this book to provide you with resources that will be helpful as you work with your health care provider.

It is possible that your baby may be very sleepy during the first few days, and may have to be woken up and encouraged to nurse. Keeping him close will make this easier, as you will be aware of when he is stirring and more alert.

Often, a mother who has had a cesarean will develop a fever. There is no need to separate mother and baby if this is the case. Most medications are compatible with breastfeeding, but because every situation is unique, it is important to gather information about a medication and work closely with your health care provider, letting him or her know how important it is to you to breastfeed. A La Leche League Leader can provide resources with information about the safety of medications for breastfeeding mothers.

Tips for Making Life Easier

Request that your IV be inserted into your forearm, rather than in the back of your hand (and without the supporting board if one is used). This will allow you more freedom of movement when handling your baby.

Arrange for as much help as you can get. Even in hospital you will need either your partner, or a family member or friend to help you with the baby, for example, changing his nappy (diaper) or dressing him, and passing you the baby, or helping you get comfortable.

Once at home, extra help will be essential. You will have to rest for a long time, and most women cannot drive for about six weeks. Arrange as much help as you can with meals, laundry, and essential housework, as well as with any other children you may have. Plenty of fluids and lots of nutritious food are important keys to your recovery.

Lying down is probably the best way to breastfeed at the beginning. You may need to use extra pillows and cushions. Let comfort guide you as to the best way to position your baby. Some moms use a rolled up towel to cover the incision. Extra support is important for women who have cesareans. As obstetrician Michel Odent points out in his book, The Caesarean, breastfeeding after a cesarean is a relatively new thing, even though now it is more and more common. But because the birth process is different, moms who have given birth this way have more challenges. Interestingly he notes that non-labor cesareans are associated with more breastfeeding difficulties than those that take place after labor. If you are planning a cesarean, it may be worth seeing if your doctor will let you go into labor first, rather than scheduling a date. However, if this is not possible, gather information and establish a support network beforehand -- it will stand you in good stead for breastfeeding your baby.

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