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Breastfeeding After A Caesarean
Many babies today are born by caesarean section. There’s no reason why you shouldn't breastfeed afterwards, but you'll need to be determined early on.
You’ll face two main challenges. First, your tummy will be tender. Second, you'll find it uncomfortable to feed in the normal sitting position with your baby on your lap, so you’ll need to choose a position in which baby's weight isn’t on your tummy and your abdominal muscles aren’t strained by holding him to your breast. Enlist the help of a nurse to position him next to you as you lie on one side in bed. When the time comes to change breasts, ring for the nurse to help you turn over and change the baby to your other side.Horizontal Caesarean Section ScarIf you have a horizontal scar, try sitting up, with your baby propped up on a pillow at your side, his head facing your breast, and his legs tucked under your arm on that side - so he isn’t on your tummy. Alternatively, sit up straight (to avoid training your abdomen), lie him on a pillow at your side with his legs across your thighs, and support his head either with another pillow or with your arm (itself supported by a pillow). Or try feeding while you lie on one side.
Unrestricted breastfeeds are just as important for you as for any other mother, in order to produce a good milk supply, so feed your baby frequently by day and night. It's just as easy to breastfeed as to express or pump your milk, and you’re less likely to become engorged or get sore nipples if you feed like this from the beginning. A study in South Australia in 2003 found that by the sixth day after birth, only one in five breastfed babies born by caesarean had regained their birthweight, compared with two in five breastfeds born vaginally. However, by then all were getting similar amount of milk. So the slow start was unlikely to last long.
If you’ve had a general anaesthetic you may not be able to breastfeed immediately after delivery but as soon as you are awake or well enough, ask for your baby to be brought to you, even if he’s asleep. More caesareans are now performed under epidural anaesthesia, which means breastfeeding can get started sooner.
If your baby is in an incubator after delivery and the nurses can’t bring him to you for feeds, express or pump your colostrum and your milk when it comes in. The nurses can then give the breast milk feeds by tube or cup until you can go to him. Don't be alarmed by the small amounts of colostrum you produce - remember there isn't much in the first day or so.
A caesarean, especially if unplanned, can undermine a mother's opinion of herself as a woman, but breastfeeding may help her think well of herself. Breastfeeding also helps postoperative recovery, because it produces oxytocin which assists the womb to return to its former size. A caesarean leaves some mothers feeling very tired for some time, so it's important to get enough rest. This doesn't mean that nights must be unbroken, with your baby given a bottle by the nursing staff, but that between feeds the day shouldn't be crammed full of activity on the ward or at home. Allow ample time to sleep or catnap.
Painkillers may be necessary, especially in the first day or two, because the scar can be painful while healing, especially when coughing.
By the end of the first week you should feel very much better, though it will take many months before you’re back to normal.
Dr. Penny Stanway
June 2009
YOU CAN BUY DR.STANWAY'S BOOK 'BREAST IS BEST' HERE |
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What Is Colostrum?
