Breastfeeding: my hopes and fears

I have always loved breastfeeding – the concept, the idea, the bonding time and the feeling that you are the one making that baby grow and flourish. 

With baby number 4 due to arrive very soon, breastfeeding has been on my mind again – I plan to do it, I hope I can do it,  but of course I have concerns and fears. It’s not always a case of sticking a baby on your boob and getting on with it. There are so many other considerations, and I have never had a very successful start to breastfeeding. A combination of premature babies, SCBU stays and C sections has always made it tricky to say the least, and this time looks to be no different, although I am hoping to avoid a SCBU stay if at all possible. I am facing the prospect of a 4th C section, the very real possibility of this baby coming early which could mean a poor suck reflex and the juggling of a newborn as well as a toddler and school runs on top of it all. So I know it may well not be easy.

I am lucky enough to be working with Medela throughout this pregnancy and subsequent breastfeeding journey, and I am hoping that this will provide support and encouragement as the new addition and I learn how to feed together. As part of my Medela collaboration, I have had the chance to ask their Lactation Consultant Sioned some questions – and so I have stuck to the things that I know I will need support with most, and I know many others will too – so I hope this helps you as much as it has me!

1. What is the best way to establish breastfeeding after a C section?

It is exactly the same advice and support that you would if you had a vaginal delivery:

• Start in theatre with skin to skin immediately after birth for as long as you both want.
• Ideally baby will root and feed within the first hour after birth during magic hour when he is alert and rooting, licking the nipple, bobbing and stimulating you love hormone oxytocin.
• Your baby may then not feed for a few hours recovering from birth and sleep.
• Make sure that you are comfortable and your pain relief is topped up.
• Ask for assistance and support to find a position that is comfortable for you – you may need some help and extra hands to help with latching on – if it doesn’t feel right ask again.
• Remember it is normal to have lots of long feeds during the first day – some more frequently – every hour or so – this is nature’s way of getting lots of practice in to help with your milk coming in and getting to know your baby.
• Keep your hospital buzzer or phone near you so that you can ask for help.

2. How soon can I start expressing and letting Dad feed with a bottle?

Ideally wait 3-4 weeks so that your breastfeeding is off to a good start, your milk supply is established, you are a little more confident with latching on and little one has regained birth weight and had her 3 week growth spurt. If lo isn’t feeding well then on the advice of your midwife you may need to support establishing your milk supply with expressing. If baby is sleepy or you need to express, pump after every feed at least 6-8 times in 24 hrs (including night feeds) this is expressing for a medical need rather than for dad to be involved in feeding, but of course you can introduce that when you feel you want to.

3. Can you recommend some good feeding positions post C section?

• Immediately after birth you may still be under the influence of pain relief medication and anaesthetic. It is advisable to see if you can have your partner stay with you if they allow, to give you some extra help as you may be more sleepy and the ward busy.
• The midwives may put the bedsides up if you are sleepier but be cautious that you are still nursing and may need to fall asleep. If this is the case buzz and get help to place baby back in the cot.
• Ask your midwives on antenatal ward before baby is born to show you some feeding positions that are good for mums following a C/S such as the underarm rugby hold, or side lying in bed.
• Use a pillow to nurse in cross cradle – you will still have your baby bump but the pillow will help you a little if you are in bed or sitting in a chair so that it cushions your tummy a little – make sure that baby is not too high and you end up feeding uncomfortably.
• Find a position that you are comfortable in – ideally if you are in a chair make sure that you can touch the floor so that you have a comfortable base – or use a foot stool so that you are a little more reclined.
• Coughing and laughing is uncomfortable, holding and supporting your wound whilst you cough makes it a little easier.

Just because you have a caesarean, getting breastfeeding established is the same as any other mother and baby. You may be more tired and exhausted as you are also recovering from major abdominal surgery so look after yourself, rest a lot and let your body heal.

I am so pleased with these answers – it has made me feel much more confident that breastfeeding after a C section CAN be just as successful as after a vaginal delivery. I am planning to take this information forward into my next consultant appointment, to stress just how important skin to skin in theatre is to me, and how I am hoping for positioning support from the midwives. I hope this will set baby and I off on a long and happy breastfeeding journey – and I look forward to sharing it with you!