Studies show that women whose babies are born by cesarean surgery are just as successful at breastfeeding as mothers who deliver vaginally, as long as their commitment to breastfeeding remains high. It may, however, take a bit longer for mothers and babies to begin breastfeeding after cesarean surgery, and mothers’ milk tends to come in a bit later following a surgical birth. This may be a direct result of the surgery, or it may be because mothers who have cesareans have fewer opportunities for early and frequent breastfeeding.
If you know before you go into labor that you will be having a cesarean, talk to your doctor ahead of time about holding and nursing your baby immediately after the birth. Even if your cesarean was not the birth you anticipated, you can still make the most of the your baby’s first feedings. You will need extra help, since you’re doing double duty: healing yourself and feeding your baby. Try these time-tested helpers for successfully breastfeeding following a surgical birth:
• Ask to see and hold your baby as soon as possible after birth. With help from nurses and your partner, you can enjoy skin-to-skin contact and give your baby an opportunity to nuzzle at your breast.
• Plan to breastfeed your baby in the recovery room before the anesthesia wears off. With help from nurses, or your partner, you can put baby to the breast even if you must lie flat in bed.
• Your doctor can prescribe pain medication for you that will not affect your baby. Pain suppresses milk production and makes it harder for you to enjoy your newborn. To decrease postoperative pain, talk to your anesthesiologist about using medications that will help you feel the most comfortable, yet alert, after the surgery. Long-acting analgesics (for example, Duramorph) injected into the spinal tubing immediately after birth can considerably ease postoperative pain.
• Discuss with your doctor the use of “patient-controlled analgesia” (PCA) in which you administer your own pain-relieving medication as you need relief. Don’t hesitate to use pain medication–you and your baby will enjoy each other more if you are comfortable.
• Plan to breastfeed early and often. When baby is hungry or fussing, have one of your attendants (either the nurse or your spouse), bring baby to you and help you position his body and mouth for efficient latch-on.
• Ask your lactation consultant or attending nurse to show you how to breastfeed in the side-lying and clutch-hold positions. These positions keep baby’s weight off your incision. Lying down while nursing helps you rest and relax.
• When nursing in the side-lying position, comfortably surround yourself with pillows. Place one or two pillows between your back and the side-rail, another pillow between your knees, a pillow under your head, and one under baby. To support your incision while lying on your side, wedge a tummy pillow (a small, foam cushion or even a folded bath towel) between the bed and your abdomen.
• If you sit up in bed to nurse your baby, use lots of pillows to support your body. Put pillows under your knees to take the strain off your abdomen and back. Pillows on your lap under baby will protect your incision. You may find nursing sessions more comfortable if you get out of bed and sit in a chair.
• Be sure your partner watches how the professionals help you breastfeed. Have them show him how to help you in the hospital and later on at home. It’s especially important for dads to learn how to help you with the lower-lip flip (see Latch-on Basics).
• As much as possible, keep your baby with you in your room after a cesarean. Rooming- in is possible, even after a surgical birth. Get help from dad, grandma, or a friend – someone who can be with you most of the time in the hospital and lend a hand with the baby.
• The decisions and details surrounding a cesarean birth may seem overwhelming at times. Don’t let this distract you from your precious time with your new baby. Do whatever you can to enjoy these first few days together.