After a cesarean delivery, following tips for a good start to breastfeeding is crucial. Breastfeeding after a c-section can be challenging, but with preparation, support, and perseverance, it is achievable.
One of my main worries as a mom who was having a scheduled c-section was whether or not I would be able to breastfeed. I am glad to report that I have had a fantastic breastfeeding journey and am still exclusively breastfeeding several months postpartum.
Along the way I have learned about a range of best practices that I have summarized as my top tips for a good start to breastfeeding below. With those tips, you’ll be on your way to a successful breastfeeding journey after a c-section.
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Why breastfeeding after a C-section can be challenging
Breastfeeding after a c-section can be challenging for several reasons. During a c-section, the anesthesia and surgery can cause a delay in the onset of milk production, making it harder to establish a good milk supply. Mothers may also experience discomfort or pain from the incision site, which can make it difficult to find a comfortable position for breastfeeding. That’s why it will be crucial to stick to your pain medication regimen, even as a crunchy mama that may want to avoid exposure to drugs via breast milk.
Overall, the recovery period after a c-section can be longer and more challenging than after a vaginal delivery, making it harder to devote the time and energy needed for breastfeeding. The stress and fatigue of a major surgery can make it harder for both mother and baby to establish a good breastfeeding routine. Despite these challenges, however, with the right preparation, support, and persistence, most moms can successfully breastfeed after a C-section.
Breastfeeding is incredibly beneficial for both mother and baby, as it provides essential nutrients, boosts the baby’s immune system, and helps establish a bond between mother and child.
What you can do before delivery
1. Inform yourself about breastfeeding
Experiencing pregnancy, birth and breastfeeding has shown me one thing: modern women have very little knowledge about any of those topics. We, therefore, outsource anything to do with those innate activities to external “experts”. What used to be knowledge passed down from one group of women to another, has now become relegated to “experts”.
Luckily, we live in a time where the whole world is connected as one and information is easier to access than ever. So the single most important thing you can do before giving birth is to inform yourself as much as possible about breastfeeding. What is it like to breastfeed? What’s good positioning? What does a good latch look and feel like? How should you feed your baby? How do you know your baby is getting milk? What’s considered a red flag that might need further investigation (and actual help by a medical professional)?
There are many ways of getting this information (as well as lots of misinformation!). Numerous lactation specialists have an online presence on YouTube or Instagram that can be informative. You can attend a La Leche League meeting or reach out to one of their leaders. You can read books, such as “The Womanly Art of Breastfeeding” to tap into some of the wisdom of other mothers who have done it before you.
A breastfeeding class was one of the most helpful things I have ever invested in. While it seemed almost ludicrous to me at the time, I was glad to have knowledge about what to expect and when I should seek support when the time came. A breastfeeding class is also an excellent opportunity to connect with an IBCLC (International Board-Certified Lactation Consultant) who might support you postpartum.
2. Purchase necessary breastfeeding supplies
Take this point with a grain of salt – you really don’t need much, if anything, to breastfeed. There are, however, a few things I have found helpful in the initial weeks of breastfeeding, especially after a c-section. Those things included a breastfeeding pillow (such as the Boppy Pillow); and a Joeyband for some hands-free skin-to-skin or laidback breastfeeding. While the Boppy is not recommended by most IBCLC’s, it did help to protect my c-section incision from the weight of baby in the early days.
Even though breastfeeding should not be painful, nipples can get a little sensitive or sore. This is especially true in the beginning while both mom and baby get used to breastfeeding. The one thing that helped me reduce friction and helped with nipple soreness were silverettes. These are little silver cups that you can put on your nipple to soothe and heal. Silver has antibacterial properties and the cups will last a lifetime! You may also need a few Comfortable Nursing Bras to hold the silverettes in place.
Lastly, a soothing nipple balm can feel great to apply in between nursing sessions. Lanolin is a good all-rounder option that is also safe for your baby. I especially liked this Arnica and Hemp Balm. It is not specifically marketed as nipple balm but has a nice cooling effect and contains pain-relieving arnica.
3. Communicate your breastfeeding goals to your healthcare team
Your healthcare team should be 100% supportive of your breastfeeding goals. Especially c-section mamas should make sure to tell their providers ahead of the surgery if they want to exclusively breastfeed. This way, the nurses know not to whisk your baby away post-op unless absolutely necessary. They can also plan to initiate skin-to-skin in the OR and continue in the recovery room. If you plan a gentle cesarean, all of these should be a given.
If your provider seems to be unwilling to support your goals, run! This is a major red flag that would make me question my choice of provider. You do not need to accommodate their preferences – it’s the other way around.
Immediately after the c-section
4. Feed on demand and learn your baby’s cues
As a first-time mother, I was under the impression that newborns slept. A lot. “Newborns sleep up to 18 hours a day!”. Wow, I thought. So much time! I will feed my baby every 2-3 hours, like the internet says, and the rest of the time she will sleep soundly and I get to relax.
Little did I know that newborns sleep very short stretches of time and breastfeed frequently. Forget every 2-3 hours. When it’s cluster-feeding time (and that is most of the time in the early postpartum days), your baby may feed every 20-40 minutes. And that is perfectly normal! Sometimes the baby will end a feed, just to cry or root for more milk 5 minutes later. This is a normal and important behavior that will establish your breast milk supply and give baby the nutrition they need.
The seemingly constant feeding can be particularly exhausting after a c-section. Every movement hurts and you are already tired and need rest. But listening to your baby and feeding on demand in the first few days after birth can really set you up for success in the long term. Try offering the breast any time your baby gives you any cue, even if it feels awkward to do so. You will soon learn to distinguish hunger from other cues as your baby grows.
Be wary of anything trying to sabotage your breastfeeding relationship. In the hospital setting, this can show as long stretches of separation from your baby (e.g. leaving the baby in the nursery overnight) or pediatricians trying to convince you to top off with formula to avoid baby losing weight.
5. Have lots of skin-to-skin contact with your baby
The benefits of skin-to-skin contact are known by most hospital staff now. Also known as kangaroo care, it is an important aspect of breastfeeding that has numerous benefits for both the mother and baby, starting with the “golden hour”.
The golden hour, also known as the first hour of life, refers to the first 60 minutes after a baby is born. Many hospitals and birthing centers now encourage this practice to promote a healthy start to life for the newborn. During this time, it is recommended that the baby is placed skin-to-skin on the mother’s chest and that any medical assessments and procedures are delayed until after this hour has passed.
Skin-to-skin contact during the golden hour and beyond can help the mother and baby bond. This can help to establish a strong emotional connection and promote breastfeeding.
Apart from that, skin-to-skin contact can help to regulate the baby’s body temperature and creates a sense of security and comfort for the baby. This can help to reduce stress and promote relaxation in both the mother and baby. Something that’s especially useful after a stressful surgical delivery!
Skin-to-skin contact is a valuable practice for promoting successful breastfeeding and the health and well-being of both the mother and baby, so try to take advantage of it as much as you can. So, undress or unswaddle that baby and put them on your chest!
6. Begin breastfeeding after a C-section as soon as possible
In addition, WHO reports that “early initiation of breastfeeding, within one hour of birth, protects the newborn from acquiring infection and reduces newborn mortality. It facilitates emotional bonding of the mother and the baby and has a positive impact on duration of exclusive breastfeeding.”
This point goes hand-in-hand with the golden hour and skin-to-skin. The sooner your little one can root to the breast and start their first suckles, the better. The nipple stimulation will help both of you relax by releasing Oxytocin. Early and frequent suckling will stimulate your breasts to produce milk and can fight engorgement while giving baby the colostrum they need to thrive until your milk comes in.[1]
Colostrum really is the only food your baby needs in the first few days. You do not need to wait for your milk to “come in” to start breastfeeding. This is outdated advice and may sabotage your breastfeeding journey by getting you dependent on formula when you actually wouldn’t need it.
7. Take advantage of breastfeeding-friendly hospital staff
Even with proper preparation ahead of time, it can be very overwhelming to be a first-time breastfeeding mama post-c-section. You may not know what frequency of breastfeeding is “normal” (there is a wide range of normal) or what a good latch is supposed to feel like.
Some hospital staff such as nurses and lactation consultants can help you use proper positioning and latch techniques. Not all of them are great and they are often overworked and have very little time to dedicate to each patient. But if you find someone knowledgeable and helpful, hold onto them and get all the help you can get!
You can ask them, for example, which positions are comfortable to use after a c-section. You can also ask lactation consultants to assess your latch and how you can increase your milk supply or relief engorgement.
Trust that colostrum is all your baby needs until your milk comes in and then continue breastfeeding on demand at all hours of the day to establish a good supply-demand relationship with your baby.
After leaving the hospital
8. Continue to prioritize breastfeeding
A successful breastfeeding story might depend on those early days and weeks. Breastfeeding should be the priority when making other decisions, such as whether to introduce and use a bottle or pacifier and how to sleep. Ideally, there will be no formula or bottle-feeding in the first 4-6 weeks, so as not to interfere with breastfeeding. It is also helpful to be as close to baby as possible. Avoid any long stretches of mother-baby separation, e.g. forcing them to sleep through the night on their own.
The best thing you can do to prioritize breastfeeding is to rest for those first weeks postpartum. Hand off any housework or other duties to other family members or hired help and create an environment and daily routine that is conducive to breastfeeding. This could mean staying at home more than usual, embracing frequent feeding and night wakings and allowing easy access to your breasts by wearing comfortable, breastfeeding-friendly clothing.
9. Stay hydrated and well-nourished
This one can be hard to do post-op! Your mobility will be limited and as mentioned above, it is best to focus on spending one-on-one time with your baby instead of hours in the kitchen. That being said, once you have healed enough, you can easily prepare healthy meals while wearing your baby close in a baby wrap or baby carrier.
As a breastfeeding mother, hydration is super important. You are producing liquid, so replenishing your body with plenty of water is crucial to keeping up your milk supply while staying hydrated. Keep several tumblers of water around the house and consider adding electrolytes to your daily routine.
Try cooking as many meals as possible at home using fresh, organic foods to nourish your body. Vegetables are just as important as a good quality source of protein. Foods high in collagen, such as red meats or bone broth, are excellent to help with healing post-op too.
10. Monitor your baby’s weight gain and diaper output
I am not a proponent of monitoring every single diaper change and feeding as it seems very tedious and anxiety-inducing to me. However, in order to know your baby is doing well it can make sense to keep a general eye on having plenty of wet diapers and regular poops. Lack of wet diapers can be your first sign that your baby may not be drinking enough milk. Slow or stagnant weight gain – or even weight loss beyond the first week or so – can be your next sign, and would warrant further investigation.
After a c-section, babies can be very sleepy because of the anesthesia and the continued pain medication administered to mom, of which small amounts transfer into breastmilk. This can sometimes cause babies to sleep more when they should normally be feeding. After 1-2 weeks, this sleepiness should pass and your baby should be getting into a regular feeding pattern.
If your baby is gaining weight at a steady rate and produces 8-12 wet diapers a day, you are probably doing everything right! Keep it up, mama!
11. Seek help if you encounter challenges or concerns
Despite the best intentions and preparation, any mama can encounter challenges during breastfeeding. Breastfeeding, even though absolutely natural, is not an instinctual behavior but a learned skill. This is why primates who grew up in isolation will not always know how to breastfeed their young. And it is why we may need help from more experienced mamas when we encounter problems.
In case of challenges, it is best to seek help early so you can intervene before things escalate. The website of La Leche League (LLL), an international breastfeeding organization, has a helpful glossary for initial troubleshooting called “Breastfeeding Info A to Z”.
If you don’t get far by trying to troubleshoot yourself, you can reach out to your local LLL chapter to find in-person support. Lastly, it can be worthwhile getting in touch with a trusty IBCLC who can help with a myriad of things and, above all, can also assess more “severe” challenges to breastfeeding such as a tongue tie.
Successful Breastfeeding After a C-Section
Breastfeeding after a c-section can be challenging, but with preparation, support, and perseverance, it is achievable. Remember to prepare, prioritize skin-to-skin contact, proper positioning and latch, and staying hydrated and nourished. Seek help if you need it, and don’t be afraid to ask questions.
Most importantly, give yourself the grace to adjust to not only being a mother but also healing from major surgery and figuring out a new skill – breastfeeding – on possibly very little sleep. It may not always be easy, but it is always worth it in the end.
I hope some of these tips help put you on your way to a successful breastfeeding journey after a c-section.
[1] https://www.who.int/data/gho/indicator-metadata-registry/imr-details/early-initiation-of-breastfeeding-(-)#:~:text=Early%20initiation%20of%20breastfeeding%2C%20within,on%20duration%20of%20exclusive%20breastfeeding.
