Breastfeeding after a C-Section: 8 steps to stimulating milk production
Many moms aren’t prepared for the fact that breastfeeding after a C-section can take time, and then struggle to establish feeding or feel guilty for not continuing.
Even the best laid plans go to pot sometimes. I planned two home births and ended up with a Caesarean section. Having personal experience of breastfeeding two babies and recovering from sections, I hope I can make your experience the best one possible.
Firstly, don’t beat yourself up if this happens to you. There are so many positive thing you can do to make the experience beautiful and special. With both planned and emergency C-sections, there is a massive part you can play in increasing chances of successful breastfeeding.
I insisted that my baby was delivered straight to my belly, with the screen dropped down so I could see him coming out and then placed skin-to-skin. I had no separation during recovery, and if my arms were needed for something, I briefly passed him to my partner.￼
There were raised eyebrows and tales of when this would not be possible. I understood that if the baby needed medical attention, he was going to get it. I was told if there was someone in recovery that would be upset by the sound of my baby, that it may not be possible. I explained that my baby had a right to stay with me and, as long as we were both well, that would supersede anything else.
My advice to any woman having a C-section is to insist on this level of care – it really should be the norm as otherwise you are looking at hours of unnecessary separation. Your arms work perfectly whilst surgery is going on, which is normally performed with the aid of an epidural or spinal block.
Skin-to-skin contact plays such a massive role in establishing successful breastfeeding – but what happens if you and your baby are separated?
My daughter had to go to special care for a while. If this happens to you, try to do kangaroo care (baby inside your top for skin-to-skin contact) as soon as possible and for as long as you can. Pull up a chair alongside your baby’s incubator (ideally, we should have beds as they do in some other countries), and stay with your baby whenever you can.
Help your body get ready for breastfeeding
Whether planned or unplanned, another amazing thing you can do to boost your chances of breastfeeding success is to get your breasts working immediately after the section.
As labour plays an important role in the stimulation of breast milk, there can be an initial delay after a C-section. Follow these steps (known as Shake, Rattle and Roll!) and get your body ready for breastfeeding.
1. Apply hot towels/have a hot shower/breastfeed or have skin-to-skin for 20 minutes.
2. Massage your breasts in long, feather strokes towards the nipple. Touch your entire breast. Do this for 3 minutes. It should never hurt.
3. Then hand express (or, if it has been over 72 hours since having your baby, express using a pump) for 15-20 minutes on each side. Double pump if possible.
4. On the next occasion, repeat step 1, then massage for 5 mins, then pump again for 15-20 mins.
5. On the third occasion, repeat step 1, but instead of massage do the shake. The shake is leaning forward and shake your breasts like no one is watching. Then express for 15-20 mins.
6. On the fourth occasion, repeat step 1 and on step 2, massage for 7 mins followed by expressing for 15-20 mins
7. There should be eight episodes of expressing in 24 hours – these can be done at anytime but at least one needs to be done between 11pm and 1am to maximize stimulation.
8. This should be done for 48 hours to boost milk supply. It can be implemented any time milk supply is low or in order to store extra milk.
So you’ve feathered, shaked and pumped your boobs – now let’s get to baby. Both of you are rather out of it. You will be living it up in a morphine haze and your baby will be clearing opiates from their system.
It is very important to note that this may interfere with breastfeeding for the first 24-48 hours. Their suckling and rooting reflexes will most probably be suppressed. These are the ones that help them search, find, latch and drink.
Unless your baby is suffering from a medical condition, such as dehydration or hypoglycemia, there is no reason to give them a bottle. Hospitals can be very understaffed and staff often don’t have time or adequate lactation training in order to support you at this time. Often we find that unnecessary pressure is put on mothers to give their babies a bottle.
Here’s the thing. Every mother has only a wee drop of colostrum for the first days after birth. No one spouts out massive amounts of milk. If your baby does truly need supplementing, use a syringe, french feeding tube, cup or a spoon. A bottle is not the only delivery mechanism.
My top tips
- Help make it the norm in Ireland by insisting on keeping your baby with you after a section, unless either of you need medical attention.
- Shake, rattle and roll to get things moving!
- Teats can confuse a baby. Babies need to spend the first few days learning how to breastfeed. The best way for them to do this is to practice at your breast. If they do need supplementing, there are alternatives to bottles.
- Your baby will be sleepy. You will be a bit high. Keep them skin-to-skin. Baby’s nappy on, your top off, both wrapped in a blanket. Lie your baby across your belly to avoid any pressure on your section scar. Sleep with them in this position.
- Use your little finger to press very lightly in rhythmic motions against their top palate to help strengthen the suckling reflex.
- Feed them on early cues. That is when the baby just starts to stir, lick their lips, flick their eyes. It is much easier to feed them when they are sleepy, rather than cranky and crying.
- See a lactation specialist in the hospital
Remember, the first few days can be shaky and it takes about six weeks for everything to click. Take your time, give yourself a break and don’t beat yourself up if you and baby need time to figure things out together.