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It's no secret that moms feel a variety of emotions surrounding growing their families. Birth can be an overwhelming event, and the anticipation can be quite powerful. Moms have all kinds of concerns. Sometimes, having a cesarean makes the whole process even more stressful as it involves major surgery.
I had a cesarean with my first born and the whole experience was overwhelming, to put it gently.
One of my biggest concerns that many of you can probably relate to is breastfeeding after a belly birth. There are concerns about separation, pain, incisions, and more. There is a misconception that mothers who deliver via cesarean can not breastfeed.
While it is true that having a cesarean, especially an emergency cesarean, can increase risks of facing breastfeeding challenges. But with the right information and support, these challenges can be faced!
Here are some tips to help youreach your breastfeeding goals after a cesarean birth.
1. Skin To Skin Is Still Possible
Skin to skin contact is so important for newborns’ transition to the world. This is especially true for babies born via cesarean. Skin to skin contact is proven to help stabilize breathing, heart rate and temperature which is especially important after surgical delivery as it tends to be a more physically traumatic procedure. As more and more hospitals are striving to reach baby friendly status, more hospitals are implementing evidence based practices of encouraging skin to skin even in the OR. Make sure you talk to your provider before delivery to discuss options for Skin to Skin in the OR. If you can not have skin to skin for one reason or another, another family member may be able to provide skin to skin contact for the baby. You can ask for a towel that was used to clean baby, to snuggle until you are able to be with your baby. Smelling the amniotic fluid aids in hormonal chain reactions that help your body transition to postpartum.
A baby born via cesarean is more likely to medically require additional care. This may result in mom and baby being separated for a period of time. This can be extremely taxing on mom and baby. If you are separated from your baby for many hours, you may want to begin hand expression to collect colostrum and avoid supplementing with formula if at all possible. Hand expression is generally recommended in early postpartum period because it tends to be more effective for collecting colostrum. Also, studies show that women who learn to hand express as opposed to pump in the beginning have better breastfeeding outcomes. That being said, I encourage you to work with the lactation consultant on staff, because depending on your specific scenario, you may benefit from pumping for your baby. If you do need to exclusively pump for a short time, it is important to pump about 12 times in a 24 hour period.
3. Positioning with an incision
Nursing positions can be challenging for any new mom to master. Add in an abdominal incision, and it’s that much harder. Many C-Section moms will find the football hold to be more comfortable than many others because the baby can’t kick the incision. Sometimes, though, some breastfeeding challenges are easily fixed by using laid back, belly to belly nursing positions. How can we make this work with a surgical incision? The key to laid back positions isn’t he laying back as much as the relaxed, belly to belly position. This position can be adapted with baby lying horizontally across mom, diagonally, vertically, or however is necessary. Sometimes nursing positions take practice and a couple extra helping hands. But you can find what works for you, even if it’s a bit unconventional!
4. Effects of Fluids
Mothers who receive excess fluids during labor are at risk for more engorgement, and their baby is at risk for skewed birth weight indicating higher initial weight loss. Being prepared to manage engorgement would be a good idea.
5. Delayed Milk Onset
Once the placenta separates from the uterus, a hormonal chain reaction is initiated that signals the body to begin producing colostrum. Milk begins to transition to mature milk sometime between 3-8 days postpartum. Having a Cesarean can increase the risk for a mom’s milk coming in on the later end of this window. Babies can thrive on colostrum in the first few days, but if you are experiencing delayed milk onset, it is imperative to work with a lactation consultant to ensure that baby remains well nourished and healthy while your supply is established and supported.
6. You can Supplement with Your Own Milk
If you can not breastfeed for one reason or another, or supplementation is required, you can still provide your milk. Working with a support person can help you determine a plan to meet your and your baby’s needs.
7. Medication Concerns
Some moms or doctors are concerned about mothers breastfeeding post-op due to surgical medications and pain medication. Infant Risk and LactNet are two great resources for families and doctors to learn more about medication compatibility with breastfeeding. Both resources come with apps for your phone as well! Infant Risk even has a hotline that mothers or medical professionals can call to discuss medication options and the most recent relevant research. Most medication used during surgery and post op are considered safe to breastfeed with!
I successfully breastfed after a cesarean and initial separation from my son. Many mothers have successfully breastfed after cesareans, and you can too!
What concerns do you have about breastfeeding after a cesarean birth? What tips do you have if you breastfed after a cesarean?
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