Many expecting parents who consider a possible cesarean delivery — also known as a C-section — have concerns about how it might affect their ability to breastfeed. This is totally understandable.
Will my milk come in? Will I be able to find a comfortable position? How will the pain meds affect me and my baby? What if I’m separated from my baby? Will I have the energy to breastfeed? These are just some of the many questions you may have about breastfeeding after a C-section.
Despite what you may have heard, though, breastfeeding after a C-section is absolutely possible. While you may face challenges, most who wish to breastfeed can successfully do so after their C-section.
In most cases, you’ll be able to breastfeed soon after your C-section. Sometimes this can even happen while you’re still in the operating room.
You may have heard that breastfeeding in the first hour after birth is
But even if you aren’t able to initiate breastfeeding right away — for example, if you or your baby have a medical issue that requires you two to be separated — you can still protect your milk supply and establish a strong breastfeeding relationship with your baby.
Although many new parents sail through their C-section and breastfeeding experiences without issues, some encounter challenges related to their C-section. Still, there are many ways to address these challenges successfully. You can do this!
Here are some potential complications, as well as tips on how how to manage them:
Post-delivery medical needs
If your baby has a medical need and must spend some time in the neonatal intensive care unit (NICU), you can still breastfeed successfully. The same is true if you have a post-birth complication and need to be separated from your baby.
If at all possible, pump your breast milk as soon as possible after birth. This will get your milk supply started and ensure a robust supply for your baby. Once you’re reunited with your baby, you can work on latching and initiating breastfeeding.
As you recover from your C-section, you’ll be given medications to manage the pain. Most pain medications are compatible with breastfeeding, as only small amounts of them pass into your milk.
You can consult your OB-GYN about the medication you’re taking and its compatibility with breastfeeding. If they say it’s not compatible, there are usually alternative pain medications.
The type of anesthesia used, as well as how much you were given, may affect breastfeeding.
Anesthesia can make your baby more drowsy at first, which can affect their ability to breastfeed. Yet, all babies respond differently to anesthesia, and its potential effects depend on the type of anesthesia you were given, along with the duration of its administration.
For example, a regional anesthetic, which allows you to be awake for the surgery, will likely have less of an effect on your baby than general anesthesia.
Delayed milk production
During the first few days after birth, your body produces colostrum — your baby’s first milk. Colostrum is low in volume but full of antibodies and other protection for your baby. About 2 to 5 days after birth, your milk becomes more abundant.
When exactly your milk comes in may be delayed by a few days if you’ve had a C-section, but it will come in eventually. You can help quicken this process by breastfeeding or pumping regularly, breastfeeding on demand, and having lots of skin-to-skin time with your baby.
You’re recovering from major abdominal surgery. As such, you’ll experience some pain or discomfort. Plus, no matter how delivery happens, you’ll experience uterine contractions after birth as your uterus shrinks back to pre-pregnancy size.
Don’t hesitate to use medication to soothe your pain or discomfort. Pain will definitely interfere with your ability to comfortably breastfeed, so it’s important to do what you need to do to take the edge off.
Again, most medications don’t pass into breast milk at high enough levels to affect the baby, but you can talk to your doctor or lactation consultant about options.
Giving birth is an experience that generates intense emotions.
It’s not uncommon to feel overwhelmed or sad in the post-birth days. Known as the baby blues, this emotional rollercoaster is due to shifting hormone levels, as well as the shift in identity that you experience as you become a parent or expand your family.
If you experienced a traumatic birth or complications after your C-section, your baby blues may be even more intense. You may feel guilt or anxiety, and if breastfeeding is challenging, things just might feel really hard.
Share how you’re feeling with others. Don’t hesitate to reach out to your doctor or midwife if your feelings are too hard to manage alone.
Ensuring that you’re able to initiate breastfeeding as soon as possible after your baby’s birth might take some planning. If you know you’re going to have a C-section, you can do a few things before the birth to make sure you can initiate breastfeeding as soon as possible after your baby is born.
Choose a baby-friendly hospital
Hospitals that have earned the Baby-Friendly designation from the Baby-Friendly Hospital Initiative (BFHI) are more likely to have policies that promote early breastfeeding, such as skin-to-skin time and rooming-in, which is the practice of keeping a newborn’s crib at the side of their mother’s bed.
Even if your hospital isn’t a designated Baby-Friendly hospital, you can ask about what policies it has that will allow you early access to your baby for breastfeeding.
Make sure you understand hospital policies
Familiarizing yourself with your hospital’s policies beforehand can be very helpful. For example, does your hospital allow you to breastfeed in the operating room, assuming mom and baby are healthy? Will the hospital provide you a pump if your baby can’t be brought to your breast right away?
Find out whether a lactation consultant can be brought into the delivery room
Having a breastfeeding helper nearby can be very helpful during that first hour or two after your C-section.
As you’re recovering, you may need help bringing your baby to your breast and positioning them. A lactation consultant can also be an advocate for you in prioritizing early breastfeeding.
Advocate for yourself
Make sure your OB-GYN knows about your desire to breastfeed as soon as possible after birth. Ask them how that can be accomplished. Can someone — your partner, nurse, or lactation consultant — bring you the baby after surgery and help you initiate breastfeeding?
As you recover from your C-section, certain breastfeeding positions will be more comfortable than others.
You’ll want to be sure that you use positions that keep your baby’s weight off your healing incision, so more traditional breastfeeding positions like the cradle or cross-cradle hold might not be comfortable in the early weeks.
Two positions that are usually best for post-C-section breastfeeding are the side lying position and football hold. In these positions, your baby doesn’t make contact with your incision. Here’s how to do them:
Lie in bed on your side, belly to belly with your baby. Place your baby a few inches below the breast that’s making contact with the bed.
Next, position your baby’s nose to your nipple, and then latch them on. You might need to experiment with pillows for your own comfort. You can ask a helper to bring you the baby when you’re in bed and help you position them.
Sitting up in a chair or recliner, wrap your baby around the side of your body (under your arm), with their belly facing your body. Keeping them snug and close, have them latch onto your breast. Pillows can help prop your baby up against your body.
Your top goals should be to breastfeed frequently, keep your milk flowing, and reach out for help if needed. Here’s what to keep in mind:
- Practice skin-to-skin contact. This is a great way to keep your milk supply up, establish breastfeeding, and bond with your baby.
- Pump often. If your baby is separated from you, sleepy at the breast, or your milk is slow to come in, pump every 2 to 3 hours. Expressing by hand can be helpful in the early days before your milk is in.
- Breastfeed on demand. Respond to baby’s cues and initiate feedings whenever they’re requested, or at least every 2 to 3 hours. The more frequently you bring your baby to the breast, the more robust your milk supply will be.
- Get help! You’re recovering from surgery, caring for a baby, and learning to breastfeed. That’s a lot and you can’t possibly do it alone. Accept offers of help, don’t expect to entertain visitors right now, and make sure you get lots of rest as you recover and snuggle that baby close.
- Contact a breastfeeding consultant. If you can’t solve a breastfeeding problem on your own, it may be time to get an expert involved. Usually, the sooner you address a breastfeeding concern, the easier it will be to solve.
Breastfeeding after a C-section is possible, but that doesn’t mean it’s easy.
If you’re struggling, you might be overwhelmed by difficult feelings. One of the best things you can do is share how you’re feeling with others. Your feelings are normal and OK.
If you’re having trouble managing your emotions or functioning, reach out to your healthcare provider. They can evaluate whether you have a postpartum mood disorder and get you the help you need.
Most of all, remember that you’re an amazing parent. You can do this, and before you know it, breastfeeding your baby will be second nature.