How Cesarean Birth Can Influence Breastfeeding Outcomes

Research tells us that women who deliver via cesarean section are at higher risk for breastfeeding difficulties. With nearly a third of all U.S. births occurring via cesarean section, it’s important for you to identify specific strategies to help you and your baby meet your breastfeeding goals.

Below are 6 tips for breastfeeding success despite the added challenges of a cesarean delivery.

  1. Learn as Much as You Can About Breastfeeding BEFORE Your Baby Is Born
    • Whether you are planning a cesarean or a vaginal delivery, breastfeeding education is key! 
    • Take a breastfeeding class or set up a one-on-one consultation with an IBCLC (International Board Certified Lactation Consultant) who can teach you the basics of breastfeeding. Learning how milk is made, how to position and latch baby, normal newborn feeding behaviors, and ways to build and maintain a healthy milk supply will help you be better prepared to handle any potential obstacles after birth. 
  1. Prioritize Skin-To-Skin Contact and Early Breastfeeding
    • Many hospitals are adopting gentle cesarean birth as their standard of care. A gentle cesarean allows you to feel more connected with your baby’s birth by creating a family-centered environment right in the operating room. 
    • The use of clear drapes allows you to see your baby emerge, and if you and your baby are both stable, your baby can be placed immediately on your chest. This immediate skin-to-skin contact helps get breastfeeding off to an early start even while surgery is wrapping up! 
    • While uninterrupted skin-to-skin is recommended for the first hour after birth, the benefits don’t stop there. Incorporating lots of skin-to-skin in the days and weeks after birth helps boost oxytocin (the hormone responsible for triggering letdown) and keeps your baby close so you can notice early hunger cues more easily.
  1. Encourage Frequent Feedings
    • Certain anesthesia and pain medications used during cesarean birth may cause your baby to be sleepy. 
    • If your baby isn’t cuing to feed at least 8-12 times in 24 hours, you’ll need to encourage your baby to eat more often. 
    • It’s generally recommended not to go longer than 3 hours without nursing during the day and no more than a single 4-hour stretch without nursing at night. 
    • If your baby is sleepy at the breast, consider skin-to-skin, using breast compressions, including a diaper change part way through, and even tickling their hands and feet to keep them awake and engaged.
  1. Manage Your Postpartum Pain
    • Try breastfeeding positions that keep baby’s weight off of your cesarean incision. These might include football hold, side-lying, and laid back positions. 
    • Many moms find that using an ice-pack across their incision helps reduce swelling and pain. 
    • ACOG (the American College of Obstetricians and Gynecologists) recommends using a step-wise approach to pain medications. This means using over-the-counter options like acetaminophen and ibuprofen and only moving on to more potent medications, such as opioid narcotics, if breakthrough pain occurs. This is because opioid narcotic medications pass into your breast milk and can make it difficult for your baby to breastfeed. 
  1. Learn Hand Expression
    • Hand expression is effective at removing colostrum if your baby is having any breastfeeding difficulties after birth. This colostrum can be offered to your baby via cup, syringe, spoon, or dropper. 
    • Your own milk is also the first choice should your baby have a medical need for a supplement. Removing colostrum frequently is essential for helping your milk supply “come in”. 
    • If your baby continues to have difficulty latching or effectively removing milk, you will also need to incorporate pumping along with hand expression. An IBCLC can help you create a pumping and nursing plan that helps you reach your breastfeeding goals. 
  1. Get Support Right Away
    • If your baby has any difficulty breastfeeding, if you are separated from your baby after birth, or if you have any concerns about your milk supply, reach out to an IBCLC as soon as possible. Early support results in better breastfeeding outcomes, especially after a cesarean birth. 

What If I Have Questions?

If you are interested in learning more, these Aeroflow classes expand on some of the topics discussed above:

  • Ultimate Breastfeeding Prep
  • Birth and Breastfeeding Part 1 & 2 (with optional cesarean birth breakout session)

To register for these classes, log into your portal or click here.

Want More Info?

For a directory of Aeroflow’s other Care Guides offering information on pregnancy, baby care, and more, browse our comprehensive list of titles:

https://www.hersourcehealth.com/aeroflow-care-guides/ ‎

References 

  1. FastStats – Births – Method of Delivery. (2017, January 20). Retrieved March 31, 2020, from https://www.cdc.gov/nchs/fastats/delivery.htm
  2. Hobbs, A. J., Mannion, C. A., McDonald, S. W., Brockway, M., & Tough, S. C. (2016). The impact of caesarean section on breastfeeding initiation, duration, and difficulties in the first four months postpartum. BMC Pregnancy and Childbirth, 16(90). Retrieved from    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4847344 
  3. Prior, E., Santhakumaran, S., Gale, C., Philipps, L. H., Modi, N., & Hyde, M. J. (2012). Breastfeeding after cesarean delivery: a systematic review and meta-analysis of world literature. The American Journal of Clinical Nutrition, 95(5), 1113–1135. doi: 10.3945/ajcn.111.030254
  4. Yan, Y., Gao, X., & Xiang, S. (2020). Effects of Cesarean Delivery on Breastfeeding Practices and Duration: A Prospective Cohort Study. Journal of Human Lactation, 34(11). doi: 10.1177/0890334417741434