Breastfeeding After C Section: Concerns, Positions And Tips

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Cesarean birth is recommended for mothers who, for some reason, are not able to undergo vaginal delivery. However, many mothers are apprehensive about breastfeeding after C-section. They are often concerned about whether they can breastfeed their baby after birth or whether the anesthesia and medications can harm the baby.

Regardless of the mode of delivery, breastfeeding is essential to provide the required nutrition to the infant and signal the mother’s body to continue producing more milk. Read this post to know if it is safe to breastfeed the baby after a C-section and related details.

When Does Breast Milk Come In After C-Section?

The American Academy of Pediatrics (AAP) states, “Your breast milk will come in almost as readily as it would have if you had delivered vaginally.” So you will not have to wait to feed the baby (1).

Can You Breastfeed Right After A C-Section?

Yes, you can breastfeed after a C-section. Medical experts recommend that you breastfeed as soon as possible after childbirth (2).

Benefits Of Breastfeeding After C-Section

The first hour after childbirth is called the “golden hour.” Breastfeeding in the golden hour has several benefits for the mother and the infant. The mother starts producing colostrum initially, which becomes breastmilk over three to four days.

Benefits of breastfeeding in the golden hour for babies (3) (4) (5)

• Ideal nutrition for the baby as it is packed with protein, salts, fats, and vitamins
• Regulates body temperature, respiration, and heart rate.
• Improves immunity
• Helps establish a healthy gut by coating the inner lining
• Helps the baby pass meconium and reduces their chances of developing jaundice
• Balances blood sugar levels and reduces the risk of developing diabetes
• Reduces the risk of asthma, ear infections, and Sudden Infant Death Syndrome (SIDS)
• Lowers the risk of childhood obesity and leukemia
• Provides the necessary nutrients to boost the growth and development of the brain, eyes, and heart

Benefits of breastfeeding in the golden hour for mother

(6)

• Satisfaction of providing your baby with the best nutrition
• Helps the uterus contract and stop bleeding
• Reduces the chances of postpartum hemorrhage
• Skin-to-skin contact and the baby suckling at the breast helps boosts milk production (7)
• Improves the bond between the mother and the baby

For preterm infants, breastfeeding has several positive effects on the infant’s overall health. Breastfeed your preemie immediately after C-section birth to ensure healthy growth (8). If your baby has to be admitted to NICU or needs to be away from you for medical reasons, start pumping immediately or as soon as possible.

What Are The Concerns Over Breastfeeding After C-Section?

You may have heard of some complications arising from a C-section operation. However, most have less severe effects on breastfeeding:

1. Influence of anesthesia

The first concern most mothers have while still in the operation room is the probable effect of anesthesia on the infant. Can the anesthesia pass into the baby through breastmilk? The answer is no.

Doctors know that breastfeeding right after birth is essential and thus only administer local/ epidural anesthesia. This numbs your lower body, whereas the torso has normal sensitivity. It ensures no effect on the upper body parts, including breasts.

Researchers state that epidural anesthesia has no adverse impact on the infant’s health or breastfeeding (9)

2. Use of pain medication

Since you are under anesthesia, you will not feel the pain. However, as its effect tapers off, you will feel pain around the site of operation. Pain impulses can interfere with the secretion of oxytocin, the hormone essential for the flow of breastmilk.

Doctors provide an intravenous (IV) drip of pain medicines during surgery to prevent the onset of pain. These drugs are morphine-based and can provide pain relief as long as 18 hours after surgery. The pain medication does not pass into breastmilk readily and whatever gets transferred has a negligible impact on the infant.

The baby may feel slightly tired, but there is no long-term influence on healthy growth. Colostrum absorbs the least amount of pain medicine. Therefore, it is undoubtedly safe to breastfeed the baby immediately after C-section, even if you are administered pain medication (1).

Opioid-based medicines

The mother could be later prescribed oral painkiller compounds such as oxycodone (sold as Percocet) and hydrocodone (sold as Vicodin), which are opioid-based medicines or narcotics. These compounds readily pass into the breastmilk, but doctors only administer a concentration safe for the infant.

The medication is usually prescribed for three days (72 hours), in which the quantity of milk consumed by the infant is not sufficient to cause excessive oxycodone exposure (10)

Researchers note that the benefits of such painkillers outweigh the risks as less pain equals more oxytocin, which aids better suckling for the infant ( 11)

But, discuss with the doctor about non-opioid-based painkillers. You can always use acetaminophen (paracetamol) for pain within prescribed limits since the drug is compatible with breastfeeding (12)

3. Effect of antibiotics

You are administered intravenous antibiotics right after delivery to prevent infection in the surgical wound. However, as antibiotics pass into the breastmilk, only safe antibiotics are given to you. Antibiotics may cause mild side effects, which are temporary, and usually, the effects are assessed by the doctor in the post-delivery routine checkups.

The doctor might tell you to take the antibiotic after breastfeeding the baby, so there is a long gap between two breastfeeding sessions. This gives ample time for the body to process the medicine, resulting in minimal exposure to the newborn (13)

Antibiotics may seem unnecessary, but experts suggest that these medicines reduce the chances of infection in postpartum mothers. Overweight and obese mothers have a higher risk of infection after delivery. Antibiotics significantly mitigate the chances of infection in such cases (14)

4. Post-delivery medical needs

Some babies, especially those born preterm, may have to be admitted to the neonatal intensive care unit (NICU). In some other cases, mothers may be experiencing post-delivery health complications making it difficult for the babies to be breastfed.

However, if the mother can pump breastmilk for the baby, it should be the first choice. It will help signal your body to prepare enough breastmilk for your baby. Once you and your baby are reunited, you can work on latching and direct breastfeeding.

5. Delayed milk production

Studies have shown that it might lead to delayed milk production in some cases, especially for women who go for elective cesarean section (15). Your lactation consultant or gynecologist can help you initiate and boost your milk supply.

6. Emotions

Transition to parenthood can be an amalgamation of excitement, changing marital relations, pain from childbirth and labor, and a rollercoaster of hormonal changes. It is characterized by increased irritability, difficulty focusing, extreme mood swings, fatigue, difficulty sleeping, or insomnia. The fatigue and stress may result in “baby blues.”

Mothers dealing with baby blues may experience difficulties understanding their baby’s cues, and the stress may also impact their breastmilk supply. Latching problems, baby positioning, tongue ties, or other health issues with the baby or the mother may add to the frustration. Some mothers who find it difficult to cope with these emotions may decide to stop breastfeeding (16).

7. A sleepy baby

The painkillers can make the baby sleepy and cause them to lose the enthusiasm to wake up and breastfeed. You can try things such as touching them, talking to them, removing their blanket, changing their diapers, wiping their face with a wet washcloth, or stroking their cheek or bottom of their feet to wake them up.

What Are The Best Breastfeeding Positions After A C-Section?

You can choose from the following breastfeeding positions, which will not affect the postpartum recovery:

1. Pillow-supported lap hold

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Sit on a bed and place a soft pillow on your lap. Place the infant on the pillow, stomach to the stomach to you, so that his mouth can reach the nipple. Support the baby with your hands and use the pillow for support. You can consider buying a specialized C-section breastfeeding pillow that gives you better hold on the baby while breastfeeding.

2. Lying on the side

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Lie on the side and nurse the newborn by placing them beside you. You can place the baby on a soft pillow if you feel they cannot reach the breast. Wrap an arm around the baby over their head to provide support. You can use pillows under your head, behind your back, and between your knees to provide more support and comfort.

3. Reclined feeding

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You can feed in a reclined position on a chair if your back feels sore. Place small pillows to support your lower back. Alternatively, you can purchase a cushioned chair. Recline in the chair with the baby and breastfeed the usual way.

4. Football hold

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It is also called a clutch hold. Sit on a bed with your feet folded or extended. Place a pillow to your left or right side, whichever is comfortable. Gently place the baby on their back, on the pillow, with the feet pointing backward and head towards you. Adjust the baby so that their head goes under your arm and their mouth reaches straight to your breast. You will get to hold the newborn like a football or a clutch by your side. This hold can be particularly convenient when breastfeeding twins after a C-section as it removes the strain of holding the infant entirely in your arms.

5. Cradle hold

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This is the traditional breastfeeding position. You can support the baby on the arm on the same side of the breast. The baby’s head rests in the crook of your elbow, your forearm supports the baby’s back, and the palm is used to cup the baby’s buttocks or upper thighs. You can use the other hand to support your breast or hold your nipple.

6. Cross-cradle hold

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You can engage the baby’s bottom in the crook of your elbow on the opposite arm of the feeding breast. The forearm supports the baby’s back, and the head is supported by your thumb and forefinger, right behind the ears. You can use the other hand to hold or support the breast. The baby will be in a tummy-to-tummy position with the mother.

7. Reverse crawl

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You can lie down and relax as the baby lies across your shoulder. This position is especially useful for mothers who had C-sections. You would need somebody’s help to place your baby in the position. This position is valid even in the operation theatre, immediately after childbirth.

Baby’s Weight Loss After A C-Section And Supplementation

Extra fluids are administered intravenously to the mother undergoing a C-section. These fluids pass through the placenta and the baby is usually born with more water weight. They lose this weight as they pee.

The doctors will monitor the baby’s weight 24 hours after birth before suggesting the use of supplementing the baby’s nutrition with formula (17).

Tips For Breastfeeding After A Cesarean Section

The following tips can help you have a long and successful breastfeeding journey after a c-section. 

• Start breastfeeding as soon as possible after your c-section

Mothers who have received spinal or epidural anesthesia can go for breastfeeding immediately after birth. If you cannot breastfeed the baby directly, you can consider holding your baby skin-to-skin. Skin-to-skin and frequent attempts to breastfeed may promote breastmilk production (18).

• Get help positioning your baby

You will need help from a loved one or a nurse to position the baby, especially in the first 24 hours. It is because of the limited movement with an incision on the abdomen, an IV line, and a blood pressure cuff. 

• Breastfeed frequently

Frequent breastfeeding (every one to three hours) is recommended for the first few weeks of the newborn’s life. It will enable breastmilk production and give your baby practice sucking and swallowing (19). 

• Keep your baby with you as much as possible

Being around our baby or indulging in frequent skin-to-skin contact causes a release in oxytocin, also called the “love hormone.” In turn, it will enable breastmilk production (20).

• Use a breast pump

Pumping once every two to three hours will help boost and maintain your milk supply. 

• Take your pain medication

If your pain is under control, you will be relaxed and be able to breastfeed well. The doctor will prescribe the necessary dose of painkillers if the benefits outweigh the risks.

• Take advantage of the extra time in the hospital

You will have access to your lactation counselor and nurses during your hospital stay. Clear all your doubts so you can be comfortable and confident when you return home with your baby.

Breastfeeding is considered to be the best source of nutrition for a newborn. Unless it is stated explicitly by your doctor due to specific reasons, do not refrain from breastfeeding your baby. Breastfeeding after a C-section is entirely safe as the skin-to-skin contact helps calm the baby and improves milk production. You could also choose from the list of breastfeeding positions so that the process does not interfere with the postpartum recovery and the healing of the stitches.

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Reviewer Author

Briana ViolandIBCLC, CSC

Briana Violand, International Board Certified Lactation Consultant (IBCLC) and Certified Child Sleep Consultant (CSC), graduated from Tiffin University with a Bachelor’s Degree in Business Administration and is a Certified Child Sleep Consultant (CSC) through the Family Sleep Institute.

Read full bio of Briana Violand

Dr. Ritika ShahBDS, CLC

Dr. Ritika Shah is a certified lactation counsellor (CLC) from iNational Health Care Academy, Singapore and a dental surgeon with more than seven years of clinical experience across various cities in India. She did her graduation in Dentistry from KM Shah Dental College.

Read full bio of Dr. Ritika Shah