Yes, You Can Breastfeed After a C-Section!

PART 1: My Story

My beautiful baby girl entered this world after 36-hours of labor and an emergency c-section. There were complications from the surgery that led to my being sedated towards the end of the procedure. I vaguely remember the relief I felt hearing my daughter’s first cry before she was quickly taken to a nearby table where a team of respiratory therapists worked to get her breathing. Then the lights went out. (Note: this is not standard protocol for a c-section! Most c-sections are done with either a spinal block or epidural, during both of which you remain awake the entire time). My husband's instincts drove him to follow our daughter wherever she went that morning so that she would not be alone. He watched her get her first bath and have different tests done while I was still heavily sedated. I really wanted to breastfeed. So it was also important that he stay with her to ensure that she was not given any unnecessary supplements.

I awoke in a daze several hours later in a recovery room before being wheeled into the nursery to meet my daughter for the first time. My first impression was not quite love at first sight. I remember thinking: “That’s my baby? But she’s blonde!” I assumed she would have inherited my own dark hair and eyes. I felt disconnected, as many women do after delivering via c-section, and I felt disappointed that I had missed out on bonding with my daughter the moment after she was born. She wasn’t put on my chest to nuzzle and nurse and I was not the first person to hold her. Not to mention the fact that she didn’t look anything like me!

After I had settled into a postpartum room, my daughter was brought to me from the nursery. She was ravenous and a little fussy by the time she got to me. I had planned to breastfeed from the start, but I hadn’t planned on having a c-section and having to wait several hours after her birth to feed her for the first time. Luckily, I had filled out pre-registration papers at the hospital stating that I was planning to breastfeed and that I didn’t want her given any supplements or pacifiers unless medically necessary. I was so excited to breastfeed, hoping that, even though everything else about my labor and delivery had not gone according to plan, I would get a second chance to bond with my daughter by providing her with the milk that my body had made especially for her.

As my daughter attempted to latch onto my breast for the first time, she seemed almost in a panic to find the nipple. She was bobbing her head (rooting) and making little whimpering sounds. Her whole little body was tense. When my hungry child finally latched onto my breast, she sucked for a minute or two and then fell asleep. I became worried immediately. She needed to eat, and I felt it was solely my responsibility to nourish this helpless human being! No pressure at all. I now know that my expectation for this "perfect" first feeding was unrealistic. Newborns don't follow any rules! My daughter and I had to learn to breastfeed together, and that took a lot of practice.

I had taken a breastfeeding class prenatally where I learned several techniques to help wake a sleepy baby to feed. I undressed her, flicked her feet, rubbed her cheek, talked to her, etc. Luckily I was able to arouse her enough to ensure that she fed frequently. From our research with moms and babies, we've found that the BEST way to wake a sleepy baby is to use a variety of positions, touch, and words. Later, as the effects of the medications from the c-section wore off in her little body, as well as in mine, she became more effective with sucking and fed for longer periods of time.

While it was great that my daughter was more awake and alert to feed, my own pain level peaked as the medications from the delivery wore off. I remember feeling a searing, sharp pain in my abdomen (from the incision) every time I tried to sit up in bed to breastfeed my daughter. I was lucky to have great nurses who kept my pain under control with medication so that I could be comfortable enough to nurse. Still, I needed help getting her out of her bassinet and positioning her for every feeding for the first few days.

There is no doubt that breastfeeding after a c-section is challenging, but with a little help, you can have a positive breastfeeding experience!

Next time: Part 2: Tips for Successfully Breastfeeding After a C-Section

Breastfeeding comes naturally, right? One story of a not-so-perfect start to breastfeeding

The first feeding: Getting to know you
I thought latching came naturally to newborns. I had this vision of my brand new baby, this little creature I had just birthed, nuzzling up to my breast, latching on and feeding for the first time, with ease. Well, that’s not always how it works! First of all, I wound up having a C-section, and thus, a medicated baby, who, after I got out of the recovery room, was still drowsy from all of the medication. This was not part of my plan! I felt that I needed to get her on the breast quickly because I had been in recovery for awhile and thought she must be starving. The first time I put her to the breast she did latch on, but like a ravaged little animal! She was so drowsy, she would stay on the breast only for a minute or two at a time before falling asleep. I felt a little panicked: would she get enough milk? Was there any milk there? Now I know that the first feeding is more of a “getting to know you” experience between breast and baby, and not a complete meal. She may start by simply licking or mouthing your nipple. She is getting to know you.

Colostrum: The first milk
At first, your body makes a very special type of milk, called colostrum. It is yellowish, thick and sticky. It might seem like colostrum is not enough for your baby because it is produced in very small amounts, but your body is making the perfect amount for your baby, a little goes a very long way. Colostrum is packed with important nutrients and easy to digest. Keep in mind, a newborn baby’s tummy is tiny! My daughter fed every hour or two in the first few days.

After a few days, your milk will "come in" and satisfy your baby’s needs as she (and her tummy) grows. The milk will appear thinner and white (or opaque) in color. This transition is normal, and again, your milk is made to meet your growing baby’s needs perfectly.

Getting help in the hospital
In the hospital, I was lucky enough to have knowledgeable nurses to help me when I had breastfeeding questions. I also had a Lactation Consultant (LC) stop in to check on me a few times. This is not always the case. As part of a study of how women feed their babies in the hospital, we found that most women received help with breastfeeding from the hospital nurses. A smaller number received help from a LC. LC’s are healthcare professionals specially trained to help mothers breastfeed successfully. Before you leave the hospital, I encourage you to ask your nurse if you can see a LC. Their help is invaluable, as my experience below shows.

Welcome home!
When I got home from the hospital, I discovered that I no longer had 24-7 nursing care! That’s when the real fun began. When my daughter latched on at home, something changed. I started having pain when she would latch to my breast. The pain escalated and within a few hours, one of my nipples was bleeding. The pain was overwhelming to the point that I didn’t want to put her to the breast at all. Luckily, I had the phone number of an LC that I knew from a past job; I called her right away. She came over that day and helped me position my daughter so that we were both comfortable. With her help and a new breastfeeding pillow, I was off and nursing again, pain free.

Kerri’s Story
Kerri had a similar experience. She describes her first breastfeeding experience as feeling unnatural and scary. She had problems getting her daughter to latch, but when the nurse would come in to help, she would get her to latch on easily. Then the next feeding would come, and she would try to latch her on by herself and it wouldn’t work. She would get frustrated because it seemed so easy for the nurse. She felt like something had to be wrong with her - women had been breastfeeding for hundreds of years, so why couldn’t she do it?

By the second day, her nipples were cracked and bleeding. Breastfeeding was painful! She thought about giving up because it hurt so badly, but the doctors and nurses kept reassuring her that she and the baby were learning to breastfeed, together. She kept trying and was finally successful. Once she found the breastfeeding position that worked best for them both, breastfeeding became much more natural.

Tips to survive your baby’s first week of breastfeeding...successfully

Get real: latching can be hard work
It is a natural process, but it is a learned process! Both you and your baby will need time to practice breastfeeding. Your baby may not latch on comfortably the first time, especially if she is drowsy from medication during your delivery. To learn more about positioning your baby at the breast and latching her on comfortably, talk to your nurse or a lactation consultant while you are still in the hospital!

If it hurts, get help NOW
The pain might not subside without intervention from a lactation professional (LC, nurse, etc.) Do not wait to call because the pain from an uncomfortable latch could just get worse or you may even develop a breast infection.

Most babies get enough to eat if they just breastfeed frequently
As I said before, the milk your body makes is nutritionally perfect. If you feed your newborn frequently (every 1-2 hours), your body will make just the right amount of milk to satisfy her. The frequent feedings won't last forever! If you are really concerned that you are not making enough milk, talk to a lactation consultant as soon as possible.

Babies cry for many reasons, not just because they are hungry!
Your baby might cry at the end of a feeding; that does not mean she is still hungry or not getting enough milk from you. Babies cry for many reasons. They might cry because they are cold, hot, lonely, tired, over stimulated or having a bowel movement. Keep in mind that even a normal birth is a pretty traumatic experience for a baby. She was warm, safe and comfortable in your womb. Now she is in a bright, cold world with lots of loud sounds and strange new sensations in her body. You might cry too!

Know where to get help before your baby is born
In the hospital, don’t be afraid to ask your nurse for breastfeeding help. Their job is to help you learn to take care of your new baby. Lactation consultants (LCs) are employed by many hospitals to help mothers get breastfeeding off to a good start. USE THEM! They have a wealth of knowledge and experience! Ask your nurse to get you a referral to an LC before you leave the hospital, and be sure to take the LC’s contact information home with you in case you have a breastfeeding problem or question once you take your baby home.

Take a breastfeeding class, prenatally
Breastfeeding classes are helpful for learning the basics of breastfeeding. It is also helpful for your spouse or partner to attend so that they can learn ways to support you while you are breastfeeding. Breastfeeding classes are usually offered at hospitals or at your doctor’s office. Ask your doctor for more information about finding a class.

Fast forward two years My happy ending: the newborn described throughout this post just turned two years old. She is a happy, healthy toddler that still enjoys breastfeeding. The only difference is now she can ask for it!

Next time: One of our moms shares the challenges she experienced when her pregnancy & delivery didn't go according to plan