By Kendra Atkins-Boyce, Portland, Oregon

“Alert and active participation by the mother in childbirth is a help in getting breastfeeding off to a good start.”

This statement from La Leche League philosophy encompasses all births, whether medicated or unmedicated, vaginal or cesarean section. Due to the surgical procedure, mothers who have a cesarean birth may face challenges unlike those who have a vaginal birth.

The Womanly Art of Breastfeeding (8^th edition) states on page 57:

“The effects of medications and IV fluids, and the difficulty in finding comfortable positions for breastfeeding when your abdomen is tender from surgery, can make breastfeeding more difficult. And it’s challenging to recover from major surgery and look after a new baby at the same time. This doesn’t mean that you can’t breastfeed after a C-section—many, many women do…”

Here are a few tips for getting breastfeeding off to a good start after having a cesarean birth:

• Breastfeed as soon as possible after delivery. Because of the nature of Cesarean delivery, it may not be possible to breastfeed immediately following delivery, but as soon as you feel comfortable doing so, try to nurse. Nursing soon after delivery stimulates the release of hormones, which will help your body first produce colostrum followed by your breast milk. Whether a mother went through labor or had a cesarean birth, her milk supply may take longer to come in and vary if she received medications or other circumstances at the time of delivery. Your milk will come in anywhere from two to six days (usually two to three days) after delivery, and colostrum will provide exactly what your baby needs until then.
• Take advantage of an extended hospital stay. Room in with your baby if possible so that you can bond and offer the breast as frequently as every two hours. Concentrate on nursing and bonding with your new baby. Encourage your partner to snuggle and bond with the baby when visiting. This gives you time to rest.
• Try different breastfeeding positions to avoid discomfort at the incision site. If holding your baby across your belly is uncomfortable, try the football hold, where baby is tucked under your arm on the feeding side. Another position to try is side-lying. With the baby parallel to your body, lie on your side with pillows to support your back and incision.
• Stay well rested. Eat nutritious, protein-rich meals and stay hydrated by drinking plenty of water. When you were pregnant, you likely heard, “If I can do anything for you, just let me know,” from friends, family, and neighbors. Take them up on their offers. Allow people to bring over food, walk the dog, do the laundry, or help clean the house.
• Ask for help. Don’t assume that just because the act of breastfeeding is a natural function of your body that it comes naturally. If you are having an issue, reach out to a La Leche League Leader, lactation consultant, or your health care provider. They may be able to answer questions and provide insights to help you overcome many breastfeeding struggles.
• Create a nursing station. Gather the things you will need while feeding your baby in one place or put them all in a basket that you can carry with you. Having your supplies together will minimize the number of times you have to get up and allow you to focus on nursing. Have a water bottle, some reading material (or the television remote), your phone or tablet, baby wipes, snacks, and burp cloths handy at your nursing station.
• Try to relax. Establishing your breastfeeding relationship while learning how to be a mother and recover from surgery may be stressful for you. Take a few minutes here and there for a hot shower (or a bath once your doctor gives the go-ahead), go for a walk, or have someone rub your back and shoulders. Snuggle time and skin-to-skin time with your baby can relax you.
• Rule out other issues. If you are having problems getting started, don’t be too quick to associate them with the surgery. Contact a La Leche League Leader, lactation consultant, or your health care provider to discuss concerns that may be related to latch, inverted nipples, or other issues.

For more information about getting breastfeeding off to a good start and breastfeeding after a cesarean birth, please click on the following links:

Frequency of Feeding https://www.llli.org/breastfeeding-info/frequency-feeding-frequently-asked-questions-faqs/.

Breastfeeding After Cesarean Birth: https://www.llli.org/breastfeeding-info/breastfeeding-cesarean-birth/