Cesarean Birth and Breastfeeding

Erica McClannahan, RN, BSN, IBCLC

Part of my job as a lactation consultant in the hospital is to help moms latch their babies for the first time right after they are born by cesarean section, and it’s always one of my favorite parts of the day!  Any stress from surgery melts away from moms’ faces as their baby is placed on the chest and ready to latch and feed.  It truly is one of the miracles of life that most babies are born eager to eat no matter how they are born! 

Whether it be a planned or emergency c-section, it’s normal that the anticipation of surgery can cause fear or worry.  I often have moms ask if their delivery method will affect the baby’s breastfeeding ability.  While there can be a few added hurdles to breastfeeding when a baby is born by c-section, these are usually short-lived, and most babies go on to breastfeed without any issue. 

No Squeeze?!

When babies are born vaginally, their entire body receives a tight squeeze that helps physically push out the amniotic fluid that fills their belly and lungs in the uterus.  C-Section babies don’t get that same kind of squeeze, and because of that, it may take a little longer for them to clear the fluid in their belly, which can postpone their readiness to feed at the breast. You may notice clear spit-ups in their first 24 hours of life, which is helpful as they are trying to get the amniotic fluid out of their system to be ready to eat. That said, most babies born by c-section are ready to feed right out of the gate and latch without difficulty.

Stress

A c-section is considered major abdominal surgery, so it takes a toll on the mother’s body.  The amount of blood you lose during the surgery and the shock of the surgery itself can place your body in a state of stress, so it is not as prepared to focus on making milk. There are some studies that suggest a slight delay in complete milk onset after cesarean. Don’t fret, though! The colostrum your body makes in the late stages of pregnancy and the first days after birth is packed with nutrients and antibodies and contains everything your baby needs until your mature milk comes in.  You can also support your milk coming in with frequent hand expression and skin-to-skin contact, as these aid the hormonal shifts required for milk onset. 

Pain

It’s also reasonable to expect a certain degree of pain after surgery, although there are a variety of safe medications that can be provided to help you through the healing process.  The medications offered to you in the hospital pass through the breast milk in minute quantities and are considered safe and compatible with breastfeeding. Keeping your pain under control and stress levels as low as possible will be beneficial for bringing your milk in faster!

Positioning

Certain feeding positions may feel more uncomfortable than others, as you may not be ready to sit up very far or place the baby's weight on your incision in the first few hours and days.  I often recommend the football hold for post-surgery moms as this takes the pressure away from the abdomen and works great with newborns.  Check out the football hold here. 

Conclusion

All moms are heroes no matter how they deliver their babies.  Different methods come with their own pros and cons, but they won’t necessarily have a major impact on your feeding goals.  In either case, the best thing you can do for yourself is to trust your body, offer yourself lots of rest and time to heal, and enjoy the precious miracle you worked so hard for.  If you or someone you know needs help with breastfeeding after a cesarean birth, please contact one of our professionals for specialized guidance!