Success rate of breastfeeding after c-section
A caesarean birth can affect breastfeeding at first so here are some helpful tips on how to get breastfeeding off to the best start. Some evidence suggests that mums who give birth by caesarean can find it more difficult to establish breastfeeding and are more likely to stop breastfeeding earlier. But other research has found that the type of birth has very little effect on the numbers of mums still breastfeeding when their babies are six months
old (Prior et al, 2012; Hobbs et al, 2016). We discuss why a caesarean birth might make breastfeeding more difficult. And here are some helpful suggestions for breastfeeding your baby after a caesarean birth, including how some positions can make it easier. Skin-to-skin contact between mum and baby are recommended immediately after birth (NICE, 2021; UNICEF, no date). This means your baby is placed naked onto your bare chest. This helps babies adjust to the world, begin bonding and start breastfeeding. Babies in skin-to-skin contact with their mums soon after birth are more likely to have a
successful first feed and are more likely to be breastfeeding at four months (Moore et al, 2016). Mums who give birth by caesarean are more likely to stop breastfeeding earlier than those who give birth vaginally (Hobbs et al, 2016). Yet there is no difference in breastfeeding rates with different types of birth in babies who have early skin-to-skin contact (Lau et al, 2018). Skin-to-skin contact within the first hour after a caesarean birth is more
challenging, but mums who request this – and who are supported by health professionals to achieve this – are more likely to have a positive outcome (Stevens et al, 2018). Guidelines on caesarean birth recommend that women who want to breastfeed should be supported to have skin-to-skin contact with their babies as soon as possible after birth (NICE, 2021). The many benefits for you and your baby of holding them skin-to-skin include: (Stevens et al, 2019) If a baby can’t have skin-to-skin contact with their mum, skin-to-skin with the other parent is also beneficial (UNICEF, 2019b). After a
caesarean birth, early skin-to-skin contact should be encouraged and extra support offered (Beake et al, 2017; NICE, 2021). Extra support could include the following… You can ask your midwife to help you to find positions that are comfortable for breastfeeding (NICE, 2021). Your midwife or someone on the infant feeding team should support you
with keeping your baby as close to you as possible. They should also support you to help your baby to have as much skin-to-skin contact and access to your breasts as possible (NICE, 2021). They can check whether your baby is latching effectively, especially if they’re drowsy from medication. They’ll also help to make sure your baby feeds frequently and
will continue to support you with breastfeeding your newborn. If your baby is unable to breastfeed directly, they should show you how to express your milk. This is so that your baby can have your milk and your milk supply will be maintained (UNICEF, 2014). Women do experience pain after a caesarean birth, which can have a negative effect on establishing breastfeeding. It is usually necessary to take pain relief.
It's fine to take paracetamol and ibuprofen to help with the pain but aspirin and codeine are not recommended when breastfeeding (Karlström et al, 2007; NICE, 2021).
Babies born by caesarean absorb some of the IV fluids given to the mum during surgery, increasing the baby's weight at birth. These babies urinate more in the first 24 hours, which restores their weight to normal. That means it’s more accurate for babies born by caesarean to have their birth weight recorded at 24 hours and for this to be used as a baseline to compare their progress with (UNICEF, 2019).
Do give yourself and your baby time to adjust, you’ve just been through an amazing but huge change in your life and your baby needs time to get used to life outside the womb. Plus, it takes time for you and your baby to recover physically from the caesarean birth and from any medications you had (NICE, 2019).
Do accept all offers of help and certainly don’t be afraid to ask for it – you’ve just had an operation and a baby after all. Help isn’t just good for you, it’s good for your baby too. Research says that mums who ‘look after themselves’ by asking for more help are more likely to breastfeed for longer (Tully and Ball, 2014). Breastfeeding positionsIt’s important to find a breastfeeding position that’s comfortable for both you and your baby. This helps your baby to latch well and helps you to maintain the position for as long as your baby is feeding. Some mums like to cover their caesarean scar to protect it, others prefer positions that keep their baby away from it. Some mums find the position of the cannula in their hand or arm from the caesarean can affect how easy it is to find a comfortable breastfeeding position. So it might be worth discussing this with midwives or breastfeeding supporters. When your baby is breastfeeding, they should come to your breast chin first, nipple pointing up the nose, body in a straight line, nipple aimed towards the roof of their mouth and their body very close to you. Read our article How to help your baby attach and breastfeed for more information. Here are some positions you could try… Lying down on your sideThis position can be quite restful as well as keeping pressure away from your scar. If you’re using a pillow for your head or a duvet, they need to be kept away from your baby.
Laid-back breastfeedingThis position helps to trigger a baby’s instincts to position themselves and latch on to breastfeed. It can also be a very restful breastfeeding position because you don’t have to sit upright and your body supports your baby’s weight. With baby’s cheek resting on your chest, you can put your baby face down onto your body wherever it feels comfortable. This might be diagonally across your body so your baby is away from your scar. Then you can relax and enjoy the cuddle with your baby. For more details about what laid-back breastfeeding is and the ideas behind it, see our article here. Rugby-ball or underarm positionThis position might help to keep your baby away from your scar. For more on how to breastfeed in this position, see our article about breastfeeding positions. If using this position after a caesarean, you might find it helpful to have pillows behind you to help support your back. You might also want to place a pillow under your arm to help to support your baby’s weight; this is best done after baby has latched on. Try to bring the baby to your breast rather than leaning forward to post your breast into their mouth as this achieves a deeper latch, which is more sustainable during a feed. It will stop you getting an aching back. Why a caesarean birth might make breastfeeding more difficultFrequent, effective removal of milk from a mum’s breasts ensures she produces the amount of milk her baby needs. That’s because the more milk your baby takes, the higher your levels of breastfeeding hormones (prolactin and oxytocin) will be and the more milk you’ll make. We also know that the earlier breastfeeding starts, the more likely it is to continue. A caesarean birth could affect this in a variety of ways…
Take a look at our articles for more about the practicalities of recovering from a caesarean birth and for tips to help you recover more quickly. This page was last reviewed in December 2021. Further informationOur support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700. You might find attending one of our Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area. Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.
References
Beake S, Bick D, Narracott C, Chang YS. (2017) Interventions for women who have a caesarean birth to increase uptake and duration of breastfeeding: A systematic review. Matern Child Nutr. 13:e12390. Available at: https://www.ncbi.nlm.nih.gov/pubmed/27882659 [Accessed 30th December 2021] Chantry C, Dewey K, Peerson J, Wagner E, Nommsen-Rivers L. (2014) In-hospital formula use increases early breastfeeding cessation among first-time mums intending to exclusively breastfeed. J Pediatr. 164:1339-1345. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4120190/ [Accessed 30th December 2021] Hobbs A, Mannion C, McDonald S, Brockway M, Tough S. (2016) The impact of caesarean section on breastfeeding initiation, duration and difficulties in the first four months postpartum. BMC Pregnancy and Childbirth. 16:90. Available at: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s1288… [Accessed 30th December 2021] Karlström A, Engström-Olofsson R, Norbergh K-G, Sjöling M, Hildingsson I. (2007) Postoperative pain after cesarean birth affects breastfeeding and infant care. JOGNN. 36: 430-440. Available at: https://www.ncbi.nlm.nih.gov/pubmed/17880313 [Accessed 30th December 2021] Lau Y, Tha PH, Ho-Lim SST, Wong LY, Peng IL, Nurfarah BZMC, et al. (2018) An analysis of the effects of intrapartum factors, neonatal characteristics, and skin-to-skin contact on early breastfeeding initiation. Matern Child Nutr. 14(1):e12492. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6866048/ [Accessed 30th December 2021] Moore E, Bergman N, Anderson G, Medley N. (2016) Early skin-to-skin contact for mums and their healthy newborn infants’. Cochrane Database of Systematic Reviews. (11):CD003519. Available at: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003519.pub4/full [Accessed 30th December 2021] NICE. (2021) NG192 Caesarean birth. Available at https://www.nice.org.uk/guidance/ng192/chapter/Recommendations#care-of-… [Accessed 30th December 2021] Noel-Weiss J, Woodend AK, Peterson WE, Gib W, Groll DL. (2011) An observational study of associations among maternal fluids during parturition, neonatal output, and breastfed newborn weight loss. Int Breastfeed J. 6:9. Available at: http://www.internationalbreastfeedingjournal.com/content/6/1/9 [Accessed 30th December 2021] O’Brien M, Buikstra E, Fallon T, Hegney D. (2009) Strategies for success: a toolbox of coping strategies used by breastfeeding women. J Clin Nurs. 18:1574-1582. Available at: https://www.ncbi.nlm.nih.gov/pubmed/19220615 [Accessed 30th December 2021] Prior E, Santhakumaran S, Gale C, Philipps L, Modi N, Hyde M. (2012) Breastfeeding after caesarean delivery: a systematic review and meta-analysis of world literature. Am J Clin Nutr. 95(5):1113-1135. Available at: https://www.ncbi.nlm.nih.gov/pubmed/22456657 [Accessed 30th December 2021] Stevens J, Schmied V, Burns E, Dahlen HG. (2018) Who owns the baby? A video ethnography of skin-to-skin contact after a caesarean section. Women Birth. 31(6):453-462. Available at: https://pubmed.ncbi.nlm.nih.gov/29496385/ [Accessed 30th December 2021] Stevens J, Schmied V, Burns E, Dahlen H. (2019) Skin-to-skin contact and what women want in the first hours after a caesarean section. Midwifery. 74:140-146. Available at: https://www.ncbi.nlm.nih.gov/pubmed/30954633 [Accessed 30th December 2021] Tully K, Ball H. (2014) Maternal accounts of their breast-feeding intent and early challenges after caesarean childbirth. Midwifery. 30:712-719. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4451198/ [Accessed 30th December 2021] UNICEF. (no date) Skin-to-skin contact. Available at: https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/implemen… [Accessed 30th December 2021] UNICEF (2014) The Baby Friendly Initiative – The ten steps to successful breastfeeding. Available at: https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2014/… [accessed 30th December 2021] UNICEF. (2019) Research on skin-to-skin contact. Available at: https://www.unicef.org.uk/babyfriendly/news-and-research/baby-friendly-research/research-supporting-breastfeeding/skin-to-skin-contact/ [Accessed 30th December 2021] Is it harder to breastfeed after cMany people deliver their babies by Cesarean section (C-section). Whether it's planned or unexpected, the surgical delivery of a child may make breastfeeding a bit more challenging at first, due to recovery from the operation.
How can I make my breast milk come in faster after cTo encourage an abundant milk supply:. Nurse as soon after birth as possible. If something prevents the baby from being put to breast within the 4-6 hours, you should begin pumping with a hospital-grade breastpump. ... . Nurse frequently. ... . Avoid unnecessary supplements. ... . Ensure that baby is nursing well.. How long does breast milk take to come in after cStart Breastfeeding Early After a Cesarean Section
Any mother who has a stressful birth, such as a cesarean section, may experience their milk coming in a little later than what is considered in the range of normal. For most, milk transitions from colostrum (early milk) to milk coming in by 72 hours of birth.
Does cSo does delivering via a cesarean negatively affect a women's breast milk supply? The short answer is no. Women who give birth naturally or via cesarean have the same hormonal shift that prompts a woman's breasts to start producing milk.
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