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Breastfeeding After a Cesarean

There is no reason why a Cesarean birth should keep you from breastfeeding your baby. If your baby is early or having health problems, providing breastmilk for your baby is the best thing you can do for your baby. If you are having health problems, breastfeeding or pumping can be delayed briefly until you are ready and able.

If you have a regional anesthesia (a spinal or epidural) during surgery, you should be able to view your baby shortly after your baby emerges. Feel free to ask to have baby placed on your chest skin-to-skin.

Many women are ready to nurse - or have important skin-to-skin contact - while still in the recovery room. Do not worry if you need help to hold your baby at this time. Your baby will love being close to you.

Lay your baby skin-to-skin and tummy-to-tummy or tummy-to-chest near your breasts. Place one hand on your baby’s bottom and the other on baby’s shoulders. Let your baby nuzzle and lick. Given enough time, your baby may latch and suckle

Research has shown that skin-to-skin contact keeps a baby just as warm as being in an incubator or warming bed, and helps to calm both of you.

Once in your postpartum room, you may want to have someone help you position your baby at your breast in the clutch (football) hold under one of your arms. This will keep baby’s weight off of your incision. Don’t worry if you need assistance positioning and holding your baby. You have just had a baby and you are recovering from major abdominal surgery.

This early contact at the breast will stimulate the release of oxytocin, which helps the uterus to contract back to non-pregnant size and stop bleeding. It is also the hormone that causes milk to let down. Suckling will also release prolactin, which supports milk production. These hormones are also beneficial in creating a calm and relaxing feeling for you and baby.

During the first 24 hours you will probably have an intravenous line (IV) for pain control. This means that one hand will have tubing attached to it. Just take your time getting baby situated so that the tubing is not in the way.

Whenever baby appears interested, or at least every 2-3 hours, have someone (your nurse or partner) help you position your baby to nurse. Many women find the clutch (football) position easiest in the first couple days before you are mobile and moving around easily. It is possible to nurse while semi-reclining in bed to minimize pressure on your abdominal stitches. (See our information on Helping Your Baby Latch.)

Do not be afraid to take pain medication. You must be comfortable to feel like nursing and to promote the let down of your milk. You can taper your medications as your pain level decreases, and baby will get very little in the small amounts of colostrum.

If your baby is unable to nurse, seek assistance to start pumping ASAP. Again, your nurse or a lactation consultant can help you the first time if you are tired and weak. Use a Medela Symphony to double pump every 2-3 hours for 10 minutes – working towards at least 8 x a day as soon as physically possible. Early pumping may produce just a few drops of colostrum. Hand expression is often more effective. You can feed the colostrum to your baby in a syringe or a spoon. (See our information on Finger Feeding.)

Stimulation of your breasts is important for long-term milk supply. If your baby is premature, ask for the “premie” programmed Symphony to optimize milk production. Visit http://newborns.stanford.edu/Breastfeeding/MaxProduction.html to watch a video with the latest research in this area, and instruction for “hands-on” pumping. It is important to bring in a FULL milk supply now, even if your baby is small and not eating very large amounts. Your goal should be at least 800ml in 24 hours by the end of the first week.

When your baby goes to breast, please ask for help to obtain a good latch. A deep latch will result in a good milk supply and good weight gain for your baby. It is important to be patient with both yourself and your baby as you learn to breastfeed.

As you recover from surgery, it is important that you rest frequently, eat a balanced diet, and drink plenty of fluids to aid in healing. Seek assistance from anyone in your support system to do laundry, cook meals, run errands, and help with other children. Your only jobs should be healing and feeding your new baby.