Embarking on your breastfeeding journey immediately after a caesarean section (C-section) can be daunting, but with the right information and support, you can help set yourself up for success.

For this blog, our Friend of Qiara, Lactamo, has picked the brains of Melissa Hays, from Cocoon and Cradle. Mel is a mama to three, Internationally Board Certified Lactation Consultant, Holistic sleep coach, Paediatric nurse, and Midwife. She shares a wealth of knowledge through her Instagram page and free Instagram lives.

Impact of C-section on milk production
The onset of milk production is primarily triggered by the significant hormonal shifts that happens when your placenta separates from the uterus. It’s this process that tells your body that it’s time to start producing milk, says Mel. Some mums might find that having a C-section may slightly delay this process, although mothers can expect milk to come in between two to six days post-birth. Your body will continue to make colostrum even if your milk is slower to come in. “If you feel like your milk is slow to come in, make sure you reach out for support. Remember, an IBCLC is your breast bestie!”

Supporting milk supply post C-section
Mel advises that initiating breastfeeding and maintaining skin-to-skin contact as soon as possible post-birth is the best way to breastfeed. This can normally be facilitated in theatre after your baby is born, however, if for some reason this is unable to happen, it is important it is facilitated as soon as possible. Try not to worry as you can stimulate your breasts through gentle massage with Lactamo and hand expression until you are able to feed your baby.

Risk of engorgement or fluid retention
Breastfeeding after a C-section presents unique challenges, one of which is the increased risk of breast engorgement and fluid retention. This is a common experience for mothers who have undergone a C-section, often exacerbated by the medications and intravenous fluids received during and after the surgery. These medical interventions, while necessary for the procedure and recovery, can lead to an accumulation of fluids in the body, including the breasts. This fluid buildup can cause the breasts to become overly full, firm, and painful, a condition known as engorgement.

The extra fluids within the body can make it harder for milk to flow as there is additional pressure on the ducts which means they can become narrowed. Additionally, these extra fluids can cause the nipple and areola area to become hard making it more difficult for your baby to latch. If this happens, it is important to address the engorgement proactively and reactively through the use of breast massage as early as possible to limit its impact to your breastfeeding journey.

Breast massage benefits
“According to the Academy of Breastfeeding Medicine (ABM), one of the treatments that can help reduce engorgement is breast massage. Two large studies found that breast massage results in a reduction in pain, engorgement, and discomfort,” informs Mel. Gentle breast massage with Lactamo, directed towards the armpit, can significantly alleviate swelling and engorgement and encourage lymphatic drainage. Whilst gentle massage with Lactamo toward the nipple before and during feeding can stimulate the let down reflex and encourage milk flow.

In addition, prioritising self-care is essential, not only for your milk supply but also for your overall postpartum recovery. Ensuring adequate nutrition and staying hydrated are fundamental to this process.

Comfortable breastfeeding positions
Mel advises that finding a comfortable breastfeeding position is important. “I personally find that for mums who have C-sections, one of the most comfortable positions to breastfeed in is the side-lying position.” This position not only offers comfort but also alleviates pressure on the C-section wound. Side lying allows you to feed your baby with minimal support from others to get yourself and your baby into the right position.

Mel's top tips for successful breastfeeding post C-section:

1. Engage in immediate skin-to-skin contact after birth.
2. Initiate breastfeeding within the first hour post-birth.
3. Breastfeed frequently, observing your baby’s feeding cues.
4. Unless medically necessary, avoid formula feeding to ensure frequent breastfeeding and adequate milk supply.
5. Seek professional lactation support early.

Preparation for breastfeeding with planned C-section

Mel suggests that antenatal expressing, or hand expressing colostrum during pregnancy, is a proactive approach to help you prepare for breastfeeding.

Early consultation with healthcare providers and lactation professionals is also highly recommended for personalised support and guidance to help make the experience as manageable and rewarding as possible.

_{Reference:
https://lactamo.com/blogs/the-circle/breastfeeding-after-a-caesarean-setting-yourself-up-for-success
By Kate Brown
Dec 10, 2023}