Breastfeeding after a c-section (caesarean)
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Breastfeeding after a c-section
Tips to help with breastfeeding after a c-section
What are the best breastfeeding positions after a c-section?
What should I do if my baby coughs up mucus?
Does breastfeeding stop me from getting pregnant?
Emotional support after a c-section
Breastfeeding after a c-section
Your midwife will help you start breastfeeding or chestfeeding after your c-section, if this is how you choose to feed your baby.
They will help you with the first few feeds in hospital. Everyone in your maternity team can give you support if you need it.
Once you are home, you can get support from your community midwife, health visitor and local breastfeeding support groups. They can you make breastfeeding more comfortable and show you different breastfeeding positions.
You may find it harder to get started with breastfeeding after a c-section, for example, if:
- you have pain
- you have a drip in your arm
- you can’t move around easily.
If your c-section is planned, you may be able to express or ‘harvest’ your colostrum which is the fluid your breasts produce in the first few days after birth. This is a very concentrated food, so your baby will only need a small amount, about a teaspoonful, at each feed.
You can usually do this from 37 weeks of pregnancy. You can use this colostrum if your baby needs extra feeds, until your milk comes in.
You may not be able to harvest your colostrum if you have complications during pregnancy so speak to your midwife first. They can tell you whether this is something that may benefit you and your baby. If it is, they will show you how to express colostrum safely.
Each time you see your midwife or health visitor, they will ask you how you’re getting on with breastfeeding, if that’s how you’re choosing to feed. They can help you with any problems or worries you may be having. For example, if you’re having pain, they can help you find a more comfortable position or change your pain relief.
Ask for help straight away if you have breast redness and swelling for more than 24 hours and it’s getting worse.
If you have given birth within the last 28 days, call your maternity or postnatal ward. They are open 24 hours a day, 7 days a week and can tell you how to get help quickly if you need it. If it has been longer than 28 days you should contact your GP or NHS 111.
Breast swelling and redness could mean that you have mastitis, which is when your breast becomes swollen, hot and painful. It is common in breastfeeding women and does not usually need medical treatment.
However, a GP will usually prescribe antibiotics if you have mastitis and your symptoms are not getting better.
Tips to help with breastfeeding after a c-section
- Skin-to-skin contact with your baby after birth helps you bond with your baby and can help you start to breastfeed. If you weren’t able to have this contact, for example, if you or your baby were ill, you can still breastfeed. But it may take a bit longer for your baby to latch on and for your milk supply to come in. Your midwife will help you to get started.
- Feed your baby as often and for as long as they want. This will mean your baby is getting the right amount of milk at the right time and it will help your body produce enough milk.
- Ask for help from your midwife or breastfeeding specialist if your baby has problems with feeding or if you need help when you’re in hospital. They can also teach you how to hand express or pump breast milk. Don’t be afraid to ask if this is possible.
- Ask your midwife for advice on expressing breast milk. This may help to stimulate your breastmilk supply. This is also helpful as it means that your partner (if you have one), a relative or friend can feed your baby expressed breastmilk if you need to rest.
- Ask someone to pass your baby to you so you don’t have to twist or bend in bed to pick up your baby.
- If you live with someone else, ask them to help you with household tasks once you’re home so you can focus on feeding your baby and resting.
- Try different feeding positions to find one that is most comfortable for you. You may find it more comfortable to feed lying down or using a feeding pillow.
- If your wound is painful, try putting a pillow over it to protect it.
- If your wound is very sore or painful, speak to your midwife or GP about whether you can have different pain relief.
- Community support groups, such as breastfeeding cafes, can be a good source of support and information once you’re home from hospital. Your midwife or health visitor can tell you what’s available in your area.
What are the best breastfeeding positions after a c-section?
Your midwife or health visitor can help you find a comfortable position to feed your baby. Two positions that avoid putting pressure on your wound are the under-arm (rugby) hold and the side-lying hold.
For the under-arm hold:
- Position you baby at your side, under your arm.
- Use cushions to support your back.
- Put a cushion at your side to help support your baby.
In the side-lying hold:
- Lie on one side.
- Support your head and back with pillows.
- Lie your baby so they are facing you, tucked up close to your body.
Does breastfeeding stop me from getting pregnant?
You're unlikely to have periods if you breastfeed exclusively (give your baby breast milk only) and your baby is under 6 months old.
Because of this, some women use breastfeeding as a form of natural contraception.
It’s not a reliable form of contraception, especially if your baby is sleeping through the night or you’re topping them up with expressed or formula milk. It’s best to organise contraception before you start having sex again, even if you’re breastfeeding, if you don’t want to get pregnant.
Read more about breastfeeding.
What should I do if my baby coughs up mucus?
Babies born by c-section may cough up mucus in the first few days as they clear their lungs after birth. In a vaginal birth, this usually happens as they squeeze through the birth canal. Because of this, your baby may not be interested in breastfeeding or may not feed for very long each time.
It is important to keep trying to breastfeed, or express breastmilk, every 1-3 hours, so that your body continues to produce milk. Once the mucus has cleared, your baby should start to feed more often and for longer.
“My premature twins struggled to breastfeed after my c-section, as they were so small and tired. So, I used a breast pump to stimulate my milk supply while I was in hospital and to keep up my supply once I was at home. I now feed them almost exclusively with expressed breast milk and I’m so pleased I stuck with it in the first few difficult days.”
Jane
Emotional support after a c-section
Whether or not you’ve had a c-section it can take a while to feel confident about breastfeeding. Remember, you're not alone. Your midwife and health visitor are there to help, guide and support you.
There's also lots of advice available online or via support groups, helplines and websites.
Everyone’s feeding journey is different. For some breastfeeding is best, but for others formula feeding or combining the two is right. Find out more about different options for feeding your baby.
Breast awareness
Your breasts change a lot during and after pregnancy, so it’s important to check them regularly and be aware of any unusual changes. This is called ‘breast awareness’. Breast awareness is important because some breast changes might be a sign of breast cancer.
In collaboration with Tommy's, CoppaFeel! has produced a resource especially for women and pregnant people about natural breast changes during and after pregnancy, tips on how to check your breasts and what to do if you notice any changes. Find out more about your breasts during and after pregnancy.
Beake, S., Bick, D., Narracott, C. and Chang, Y.-S. (2016). Interventions for women who have a caesarean birth to increase uptake and duration of breastfeeding: A systematic review. Maternal & Child Nutrition, 13(4), p.e12390. doi: https://doi.org/10.1111/mcn.12390.
Karimi, F.Z., Miri, H.H., Khadivzadeh, T. and Maleki-Saghooni, N. (2019). The Effect of Mother-Infant Skin to Skin Contact Immediately after Birth on Exclusive Breastfeeding: A Systematic Review and Meta-Analysis. Journal of the Turkish-German Gynecological Association, 21(1), pp.46–56. doi: https://doi.org/10.4274/jtgga.galenos.2019.2018.0138.
Moore, E.R., Anderson, G.C., Bergman, N. and Dowswell, T. (2012). Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews, [online] 16(5). doi: https://doi.org/10.1002/14651858.cd003519.pub3.
National Institute for Health and Care Excellence (2021). Recommendations | Postnatal care | Guidance | NICE. [online] www.nice.org.uk. Available at: https://www.nice.org.uk/guidance/ng194/chapter/Recommendations#postnatal-care-of-the-woman [Accessed 28 Nov. 2024].
NHS (2019). Mastitis. [online] NHS. Available at: https://www.nhs.uk/conditions/mastitis/ [Accessed 3 Jan. 2025]. (Page last reviewed: 17 March 2023 Next review due: 17 March 2026).
NHS (2020). Breastfeeding: the first few days. [online] nhs.uk. Available at: https://www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/breastfeeding/the-first-few-days/ [Accessed 28 Nov. 2024]. (Page last reviewed: 1 February 2023 Next review due: 1 February 2026).
NHS (2020b). Sex and contraception after birth. [online] nhs.uk. Available at: https://www.nhs.uk/conditions/baby/support-and-services/sex-and-contraception-after-birth/ [Accessed 6 Jan. 2025]. (Page last reviewed: 7 February 2024 Next review due: 7 February 2027).
NICE (2021). Recommendations | Caesarean birth | Guidance | NICE. [online] www.nice.org.uk. Available at: https://www.nice.org.uk/guidance/ng192/chapter/Recommendations#care-of-the-baby-born-by-caesarean-birth [Accessed 28 Nov. 2024].
Tully, K.P. and Ball, H.L. (2014). Maternal accounts of their breast-feeding intent and early challenges after caesarean childbirth. Midwifery, [online] 30(6), pp.712–719. doi: https://doi.org/10.1016/j.midw.2013.10.014.
World Health Organization (2009). The Physiological Basis of Breastfeeding. [online] Nih.gov. Available at: https://www.ncbi.nlm.nih.gov/books/NBK148970/ [Accessed 29 Nov. 2024].
Wszolek, K. (2015). British Journal Of Midwifery - Hand expressing in pregnancy and colostrum harvesting—preparation for successful breastfeeding? [online] British Journal Of Midwifery. Available at: https://www.britishjournalofmidwifery.com/content/clinical-practice/hand-expressing-in-pregnancy-and-colostrum-harvesting-preparation-for-successful-breastfeeding/ [Accessed 28 Nov. 2024].
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