Breastfeeding after a c-section
Your midwife will help you with the first few feeds in hospital. Everyone in your maternity team can give you support if you need it.
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
- you and your baby feel tired after the birth, especially if you had an emergency c-section or needed a general anaesthetic.
It may also take longer for your milk to come in than after a vaginal birth. But you will produce a concentrated food called colostrum before your full milk comes in. Once you have started breastfeeding, you are just as likely to be able to continue breastfeeding as women who have had a vaginal birth.
If your c-section is planned, you may be able to express or ‘harvest’ your colostrum. 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. 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 6 weeks, 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 you are more than 6 weeks postnatal, your GP will be able to help.
Tips to help with breastfeeding after a c-section
- Skin-to-skin contact with your baby in the first 24 hours 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 someone to pass your baby to you so you don’t have to twist or bend in bed to pick up your baby.
- 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.
- If you live with someone else, ask them to help you with household tasks 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 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
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 your 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 in bed 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?
Breastfeeding causes your body to make a hormone called prolactin. High levels of prolactin stop you from ovulating and getting pregnant.
But 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. So it’s best to organise contraception before you start having sex again, even if you’re breastfeeding.
Read more about breastfeeding.
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 new 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 et al. (2017) Interventions for women who have a caesarean birth to increase uptake and duration of breastfeeding: a systematic review. Matern Child Nutr. 2017; 13(4): e12390.
- Moore ER et al. (2016) Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews Issue 11. Art. No.: CD003519.
- NHS. Breastfeeding: the first few days. www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/breastfeeding/the-first-few-days/ (Page last reviewed: 04/11/2019. Next review due: 04/11/2022)
- NICE (2021). Caesarean birth: NICE guideline 192. National Institute for health and care excellence https://www.nice.org.uk/guidance/ng192
- NICE (2021). Postnatal care: NICE guideline 194. National Institute for health and care excellence www.nice.org.uk/guidance/ng194
- The Mid Yorkshire Hospitals NHS Trust. (2020) Harvesting and storing your colostrum (first milk). www.midyorks.nhs.uk/download/doc/docm93jijm4n6984.pdf?amp;ver=8658
- Tully KP, Ball HL (2014). Maternal accounts of their breast-feeding intent and early challenges after caesarean childbirth. Midwifery. 2014; 30(6):712-9.
- WHO (2017) Guideline: Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services. Geneva: World Health Organization.
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