Organization of breastfeeding after caesarean section. Breastfeeding after caesarean section

Breastfeeding after a cesarean section has features that are associated with the fact that there was an operation.

Caesarean sections are usually performed using quite a few different medications, and therefore they usually refrain from the first application immediately after the baby is born. Yes, you will not be able to give breastfeeding, even if the caesarean was performed under spinal anesthesia and you were conscious. Severe weakness, when it is difficult to simply raise your hand, will not allow you to feel skin-to-skin contact, and your baby will be left without the first sip of colostrum immediately after birth. This is the price to pay for surgical delivery, and there is nothing you can do about it.

However, caesarean section and breastfeeding are quite compatible. After your caesarean section, you will be transferred to the intensive care unit. Your child will be brought to you depending on his and your condition. It takes time for all the drugs that were used during the operation to leave your body, and the child may also be under the influence of anesthesia and be depressed.

Perhaps you will meet in the first 2 hours after birth, then you will have a chance to latch on to the breast, but if more than 2 hours pass, the baby will no longer latch onto the breast, he will sleep. This does not mean that you have no chance of breastfeeding, it will just be more difficult.

On the 2nd day, if both you and the baby are fine, you will be transferred to the postpartum ward and the baby will be given to you.

You will most likely experience pain while feeding your baby. The pain is disturbing due to the fact that during feeding, oxytocin is released, which causes contractions of the uterus, and there is a wound there. This is why breastfeeding after a cesarean section is perceived as more painful than after a normal birth. Pain from contraction of the uterus, pain in the area of ​​the postoperative wound is normal, these pains will soon go away, you will have to be patient.

Try to minimize the pressure on the postoperative suture; you want there to be no pressure on it. You can feed lying down, or put a pillow on your lap under the baby if you feed sitting, it will be easier. Caesarean and breastfeeding mean that your baby will receive through breast milk the medications that you will be given to prevent complications and relieve pain. Therefore, it is often not worth asking for painkillers; of course, they will give you an injection, but in secret, the doses for the day are calculated taking into account the fact that you are breastfeeding and an extra injection may simply be a placebo (do not contain the actual painkiller), it is better to try to endure it.

How quickly does milk come in after a caesarean section? If your operation was performed during a full-term pregnancy, most likely there will be no problems with the first flow of milk; it will come in the usual time, on the 3-4th day. If you did not carry the pregnancy to term, the milk supply may be somewhat delayed. If your baby was born prematurely and you cannot put him to the breast, you should start pumping within 12 hours after birth. First it will be colostrum, then milk, your baby needs it and no formula can replace it.

For some reason, many young mothers are quite pessimistic about breastfeeding after a caesarean section, and believe that it is impossible to establish lactation if there has been an operation.

Undoubtedly, due to surgical intervention in the process of bringing the baby into the world, it may take longer for milk to “receive” than during natural delivery. But this does not mean at all that the newborn will have to grow up on artificial formula. Let's talk about how a young mother can “make” the body systems that are responsible for producing nutrition for the baby work. We will also consider in detail what problems associated with lactation can arise as a result of CS.

How to establish breastfeeding after cesarean section

It is noteworthy that women who have undergone “upper birth” began breastfeeding not so long ago. Some 40 years ago, only 2% of newborns born through CS grew up on mother's milk. In the 70s and 80s, manufacturers of artificial mixtures began to appear, like mushrooms after the rain, and HF depreciated in value. In those days, CS was quite a rare occurrence, and all operations were performed only under general anesthesia. All this contributed to the widespread opinion that breastfeeding is impossible after surgical delivery.

Are you planning to breastfeed or bottle-feed?

GV IV

Today the situation has changed dramatically, and almost all babies can enjoy their mother's milk. The process of establishing lactation, thanks to the enormous work done over the years by specialists in the field of medicine, has been significantly simplified.

• Attaching a newborn to the breast. There is a common misconception that you should not feed your baby immediately after a CS. Yes, indeed, the sucking reflex does not immediately awaken in a child born through surgical intervention. But already within 4–6 hours after the baby is born, you can and even need to feed it. It will be quite difficult for a mother who has recently undergone surgery to organize this process on her own, so the help of medical staff or, even better, a loved one will not be superfluous.
• Stop, bottle. We are not talking about newfangled drinking vessels that prevent liquids from spilling. On the contrary, even if a newborn very strongly asks to eat, communicating this with loud crying, giving him a bottle with an artificial formula is extremely undesirable. It is optimal if the baby’s first “dish” is colostrum. In the meantime, while mom is recovering from anesthesia, dad or grandma will help establish contact with the baby (bring him to the breast).
• Stimulation. Even if it was not possible to establish lactation immediately after childbirth, there is no need to give up. While still in the maternity hospital, and after being discharged home, you need to regularly knead your breasts and try to express milk. At this time, the baby can be on artificial formulas and receive his “moral compensation” when the mother’s milk production improves.
• Meal upon request. Even if a newborn eats from a bottle due to lack of milk from the mother, it is necessary to offer the baby the breast as often as possible. It’s even better to organize free access for the child to it, for example, carry him in a sling, often practice skin-to-skin contact, etc.

Important! If you have to feed your baby formula during the breastfeeding recovery period, it is better not to use a bottle. The best option is to use a system for supplementary feeding at the breast, which will allow you to control the amount of food consumed and help the newborn learn how to properly latch onto the nipple.

Painkillers during breastfeeding

It is no secret that establishing lactation is associated with quite severe painful manifestations. In addition, after a CS, a young mother may be bothered by headaches, aching sensations in the suture area, pain in the abdomen, etc. Is the use of analgesics allowed in such cases?

Painkillers during breastfeeding should:

• Be non-toxic.
• Enter the blood in minimal quantities.
• Do not affect the composition of breast milk.
• Quickly eliminated from the body (maximum 4 hours).
• Be compatible with the lactation process.
• Act quickly.
• Contain a minimum of components (optimally 1 active ingredient).
• Do not cause side effects.

Paracetamol and ibuprofen-based drugs best meet all of the above requirements. You can safely take children's syrups - Efferalgan or Panadol.

But in any case, consultation with your doctor, including a pediatrician, is necessary. Only a specialist can accurately determine whether it is permissible to take certain tablets/syrups in a particular situation.

Some women mistakenly believe that analgesics in small doses will not harm the baby. It is worth considering that the drug gets into the milk in any case (even if it is only half a tablet) and can cause irreparable damage to the health of the baby.

Important! Painkillers should be taken only after the newborn is put to the breast. This minimizes the risk of harm to the baby - before the next feeding, most of the medicine will have time to be eliminated from the body.

How to develop breasts after cesarean

We found out above that caesarean section and breastfeeding are quite peacefully coexisting concepts, contrary to popular contrary opinion. Next, we’ll look at how to develop the breasts so that milk flows in sufficient volume and with minimal pain. The first thing a woman in labor should take care of literally the next day after the CS is her own proper nutrition.

It is optimal to adhere to the following menu for the first few weeks:

• Breakfast: porridge (oatmeal, buckwheat), boiled in water, tea (preferably green), bread with low-fat butter.
• Lunch: vegetable soups, steamed beef cutlets, mashed potatoes, dried fruit uzvar.
• Dinners: baked apples, low-fat cottage cheese with sour cream (fat content no higher than 15), kefir.

By eating this way, a young mother will not only ensure stable lactation, but will also be able to recover faster after undergoing abdominal surgery.

As for the development of mammary glands directly, the process consists of the following activities:

Washing your breasts with warm water (you can practice a non-hot shower) several times a day - this will help improve blood circulation in the mammary glands and ensure the expansion of their ducts.

A massage that begins with light stroking, smoothly turning into gentle kneading of the chest. Strong compression of the nipples should be avoided, movements should be careful.

Creating compression, which involves lifting the chest with one hand while simultaneously pressing on it with the palm of the other hand.

Expressing milk from the glands using light squeezing movements - at this time it is very important to control your own sensations.

Applying cool compresses to the chest - the procedure lasts up to 10 minutes.

All of the above activities should be performed in strict sequence 5–7 times throughout the day. If positive dynamics are not observed, you should consult with a specialist who will determine the causes of milk stagnation and prescribe therapy.

Possible problems after surgery

Of course, breastfeeding a newborn during a caesarean section has some peculiarities. But by preparing for possible difficulties in advance, mom will be able to overcome them with ease.

Let's highlight the 5 most common problems:

• No. 1 – the impossibility of early attachment of a newborn to the breast. The reason may be the poor health of the mother after anesthesia or the lack of sucking activity in the child. Nothing bad will happen if the baby has to eat artificial formula for the first 24 hours until the mother fully recovers. If the baby does not want to suckle, you should offer feeding for every concern - after a few hours the newborn will definitely show activity.
• No. 2 – prescription of medications. Often, women in labor are prescribed a course to exclude possible infectious complications after a CS. In such cases, it is necessary to postpone breastfeeding, giving preference to formula. But it is necessary to maintain lactation by systematically expressing milk.
• No. 3 – the newborn’s refusal to breastfeed after supplementary feeding. If a child, due to circumstances, is accustomed to a bottle nipple, it will be difficult for him to latch onto the breast correctly. At first, the baby will need to be helped in this process, paying attention so that it captures the entire areola, and not just the nipple.
• No. 4 – choosing a comfortable position for feeding. Of course, sitting for a long time to feed a child is very difficult for a woman who has undergone surgery. The way out of the situation is feeding, in a lying position or “from under the arm.”
• No. 5 – lack of milk. It is normal for lactation to fully improve only a week after the CS. Therefore, do not be alarmed if the baby does not have enough milk before this period; supplementary feeding will save you in such cases.

In general, the problems that may arise with lactation after surgical childbirth are no different from those that appear in mothers who gave birth to children naturally.

What do doctors think?

Member of the ILCA multilingual committee, lactation consultant with international certification IBCLC Irina Ryukhova: “If a woman has had a caesarean section, there may be some difficulty breastfeeding her newborn. In such cases, it is imperative to enlist the help of specialists. Problems, as a rule, lie in insufficient milk production and the reluctance of the baby to latch on to the breast. A young mother should not worry in such situations - this will only worsen the overall picture. There is nothing wrong with supplementing the baby with formula while breastfeeding until lactation improves and the baby’s reflexes return to normal.”

Conclusion

Based on the above information, supported by the opinion of an authoritative specialist, we can confidently say that breastfeeding after a cesarean section is quite possible and even necessary. Despite the fact that breastfeeding during surgical intervention during childbirth is a little more difficult to establish, the mother must make every effort to provide complete and, most importantly, healthy nutrition for the newborn.

In particular:

• Establish the process of milk production after cesarean section by massaging the breasts and systematic pumping.
• Do not take painkillers or other medications unless necessary and with your doctor’s permission.
• Follow the regime.
• Supplement the baby with formula if milk is not produced in sufficient quantities.

Some women believe that it is difficult to establish lactation after a caesarean section, so they are prepared in advance for artificial feeding. This reasoning is erroneous, and a baby born in this way will also actively suckle at the breast if the mother makes every effort to do so.

Timing of milk appearance

The birth of a baby is a programmed course of events that leads to the mother's production of breast milk. Caesarean section makes its own adjustments to the program, but does not exclude the appearance of natural nutritional fluid, but only slightly delays lactation.

How long does it take for milk to start coming in after a cesarean section depends on the period at which the operation was performed. During natural childbirth, full-fledged breast milk begins to be produced within a day or two. The signal for this is contractions, which transfer the body of mother and child to a new system of relationships (and nutrition too). With a caesarean section the situation changes slightly.

If the cesarean section was planned, the doctor will wait until contractions begin and begin the operation. This will help the woman quickly establish breastfeeding. But if the artificial delivery procedure was forced, and the body has not yet had time to rebuild, then the establishment of lactation will occur a little later - during the first week.

A mother should not worry about the lack of milk after a cesarean section, because colostrum is already oozing from the breast. It is nutritious enough for a baby, and his newborn stomach is more adapted to this whitish liquid. Until breast milk appears, it is colostrum that will help the baby get enough.

Speeding up the process

If a mother is committed to breastfeeding her baby naturally, she can speed up the appearance of milk after a cesarean section. To do this, the woman takes the same actions as those who gave birth in the usual way.

What to do to get breast milk after cesarean

• put the newborn to the breast immediately;
• observe the frequency of applications;
• express colostrum;
• stimulate nipples.

Milk production in the breast begins from the moment the baby takes the first sip of colostrum. If this does not happen within a few hours after birth, the body may perceive the situation as a refusal to breastfeed and stop lactation. This is why it is so important to put your baby to the breast after surgery.

Even if the newborn is not yet active and does not understand what is wanted from him, attachments should be repeated periodically. One or two sips are enough to cause a flow of milk to the glands.

If it is not possible to immediately put the baby to the breast because the mother is in the rehabilitation therapy room (or the baby is on IVs), pumping is the best option. This is done manually, using mechanical or electric breast pumps.

You can also stimulate milk production by massaging your breasts and nipples. Mom kneads the mammary glands slightly, pinches, but does not have a strong effect on the mammary glands. This has an exciting effect and increases the production of oxytocin, a hormone involved in labor and lactation.

Introducing your baby to the breast

A baby born in the wrong way is most often in a state of intrauterine rest in the first hours. His body has not yet had time to adapt to familiarity with the outside world. In this regard, children born naturally are more adapted, since the natural program was completed in full.

How to put a baby to the breast after a caesarean section:

first, prohibit giving your baby a pacifier;

first application - no later than 6 hours after birth;

help the baby latch onto the breast;

constantly be near him.

Until now, not all Russian maternity hospitals practice keeping mother and newborn together in the same room. This will prevent a woman after surgery from familiarizing her baby with the breast in time. Especially if the woman is in a difficult situation and has not yet recovered from the effects of anesthesia.

Preparing in advance for surgical intervention in the natural process, the pregnant woman agrees with the hospital medical staff that the newborn will not be given a pacifier until he touches the mother's breast. If this condition is not met, the baby, weakened by the operation, may take the path of least resistance and choose artificial nutrition.

A baby who has had a cesarean section may develop a sucking reflex within a few days, but you should not wait that long. As soon as the woman recovers from anesthesia, she tries to feed the newborn. If a child does not latch on to the breast after a caesarean section because he does not latch onto the nipple, the mother helps him.

In this case, you need to squeeze out a little colostrum from the breast so that it gets on the baby’s tongue. Having felt the nutritious liquid in the mouth, the baby will inevitably have to take a sip, and soon it will be followed by a sucking movement.

On the first visit, the baby may not get enough, so it is important that he is close to his mother. Even in the first hours after birth, children smack their lips in their sleep - you should take advantage of this and give the newborn the breast. As soon as the baby understands what they want from him, the establishment of breastfeeding after a cesarean section will be more active.

Milk preservation

It is not always possible for a woman to breastfeed after a cesarean section. This is due to a number of reasons, including rehabilitation therapy after a major operation. Some antibiotics are not compatible with breastfeeding, as they have a long elimination period from the body and can cause poisoning of the baby.

But this is not yet a reason to refuse natural feeding, because it is much more valuable for the child’s immune system than formula milk. Therefore, the mother will have to try to maintain lactation until she can feed the baby fully.

• regular pumping;
• putting the baby to the breast;
• drinking large amounts of liquid;
• teas for lactation;
• compliance with the regime.

All these points will help increase lactation, because the baby will need more and more breast milk every week. The mother must take every opportunity to put the baby to the breast. If this is not always possible, pumping will be required - the baby can also be fed from a spoon.

In the first days, pumping is carried out every 2 hours, devoting 5-10 minutes to each breast. In the future, if the baby is constantly near the mother, she first feeds him on demand, and then expresses the remaining milk. If breastfeeding follows a routine, then it is advisable to empty the breasts as much as possible 1-2 times a day.

A large fluid intake (at least 2 liters per day) will help improve blood pressure. This will maintain hydrobalance throughout the body and maintain the elasticity of the mammary glands. Be sure to drink hot drinks (especially lactation teas) - they stimulate the flow of milk to the breasts.

All processes in the body are subject to certain regimes, this also applies to milk production. If a woman adjusts her rhythm of life and introduces a balanced menu into her diet, this will help avoid stressful situations that negatively affect lactation.

Having psychologically adjusted to breastfeeding, even a previous operation will not prevent the female body from establishing full lactation. A pregnant woman should know that a caesarean section is not a death sentence, but just a small correction of the natural process. Preparation of the mammary glands begins from the moment a new life is born, and with the birth of a baby in any way, natural processes continue to follow the planned algorithm.

Sometimes, sometimes against our wishes, childbirth ends with a caesarean section. It happens that the expectant mother undergoes this operation for medical reasons. Contrary to popular myth, breastfeeding after a caesarean section is entirely possible.

Yes, of course, certain physical factors make it difficult to put a baby to the breast after surgical birth (it’s difficult for a mother to get up, it’s not easy). Even fear - of pain, fear of being alone with the baby - can cause the first unsuccessful feedings. In addition, due to many aspects that accompany a cesarean section - the use of general anesthesia and the limitation of the use of drugs that contract the uterus, the lack of necessary hormones released during natural childbirth - milk may come later (on the 5-9th day).

You may have to put in more effort than women who gave birth naturally. However, it is your baby who needs mother’s milk even more and the contact with his mother that natural feeding allows you to achieve!

What needs to be agreed upon in the maternity hospital

If you are having planned surgery, ask your doctor to let your baby go through contractions - this is more physiological for you and is very important for the hormonal preparation of the baby for birth.

While waiting for a planned operation, as well as during preparations for an emergency cesarean, ask to put your baby to the breast immediately after birth or after you recover from anesthesia. (It is useful to express such a desire at the beginning of any labor, and this can also be done by your husband or other loved one accompanying you.) Remember that there is the possibility of the first feeding in the operating room - provided that the operation was performed under local anesthesia, and hospital rules allow this feeding. It is also clear that you will have to wait a little longer with feeding if the operation was performed under general anesthesia or your child requires medical care.

Ask to bring the child from the children's ward as soon as you come to your senses. You may need the support of your doctor or the persistence of your loved ones if you encounter a ban from doctors or hospital nurses on feeding your baby in the postpartum ward. Unfortunately, this still happens in domestic maternity hospitals. Remember: if the birth proceeded normally, nothing threatens you and the baby - the baby should be brought to you for feeding.

Most often, in maternity hospitals after cesarean section, drugs that are compatible with breastfeeding are used, but nurses still sometimes scare mothers with harmful drugs. Ask your doctor what medications are prescribed for you and whether they are compatible with feeding. Write down the names of these medications. You can check the contraindications in the drug labels (including using the Internet), and also use the help of lactation consultants who have a database of drugs compatible with breastfeeding.

First feedings

From the first breastfeeding you should not expect real feeding - it took place immediately after birth or some time later. This point is important primarily for stimulating your body to produce milk - and for populating the baby’s intestines with beneficial microflora. Besides, you both still have a lot to learn.

Try to feed your baby at least 8-12 times a day. It may happen that your baby will be asleep during feeding times. Wake him up, even though it may seem unethical. When he wakes up, start feeding immediately. The main thing is your desire to start and continue feeding. Milk production is very dependent on: your confidence in your ability to feed your baby and your baby's sucking activity. Whenever your baby is brought in for feeding, be sure to put him to the breast, even if he is sleeping: babies can nurse while half asleep. It happens that the baby is tightly swaddled, and this prevents him from being active at the breast. Release a little of the diaper so that he can freely latch on to the breast.

Feed your baby only when he is calm, otherwise he will not be able to find and latch on to the nipple. If your baby is screaming a lot, hold him close, rock him and calm him down. Then give the breast.

Try to start feeding as calm and relaxed as possible. Learn not to think about anything that can upset or upset you. In addition, mental stress can reduce milk production.

Be patient. After a difficult birth, the baby may slowly return to normal. The sedatives and pain medications you take may cause your baby to be sleepy and lethargic at the breast for the first few days. If you are worried that the baby is hungry, monitor weight loss (children are weighed every morning). Weight loss over 3 days should not exceed 7-10% of birth weight. Also, if possible, monitor the number of urinations - this is another sign: before one week of age, there should be at least as many urinations per day as the child is days old.

Ask the maternity hospital staff not to give your child additional drinks (glucose water, weak tea) - this is often done in some hospitals when babies cry. As a result of supplementation, the child’s still weak appetite calms down for a long time. If your baby does not suckle your milk, your milk supply will decrease. In addition, the baby runs the risk of becoming accustomed to the method of feeding from a nipple, as a result of which he may suck at the breast sluggishly or latch on to the nipple incorrectly. This often leads to cracks in the mother’s nipple or.

If your baby's pediatrician has prescribed supplementary feeding due to significant weight loss, be sure to put your baby to the breast before formula feeding. If this is not possible, express your breasts.

To reduce post-operative discomfort, place a pillow under your baby when feeding. Mothers note that it is most convenient for the first time to feed while sitting with a pillow, especially one special for feeding. If you don’t want to roll over to give your baby the second breast, you should master feeding “from the upper breast” - place a pillow or a folded blanket under the baby and thus raise him to the level of the other, upper breast. Over time, the pain of the stitch will go away and you will experience only joy when feeding the baby.

Let's take care of the milk

The first feeding took place no earlier than the 3rd day and the child is kept separately (is he premature, in intensive care, or just in the children's department)? While in the ward separately from the baby, from the beginning of the second day, it is better to make 8-10 short attempts of 5-15 minutes (per day), every 3 hours. Some maternity hospitals (for example, all in Irkutsk) have Medela electric clinical breast pumps. While your baby is away, you can use them or individual manual or electric breast pumps. Don’t be alarmed: initially, the amount expressed is small, since your baby has just been born and little colostrum is being produced. So expressed 5-10 grams is a lot.

If your maternity hospital allows you to feed expressed milk, collect colostrum or milk in a sterile bottle (it can be stored for 4-6 hours without refrigeration, at room temperature) or, according to hospital rules, give it to your nursing sisters. Give colostrum to your baby as soon as possible, best by placing the baby on your elbow so that he is semi-vertical on your elbow.

If the baby is brought to you to feed by the hour, breastfeeding is sometimes ineffective due to the fact that the baby is supplemented and he is accustomed to sucking from a bottle. If during feeding the baby actively sucked at the breast in the correct position, consider this a full feeding. If the baby was sucking sluggishly or was sleeping and you couldn’t wake him up, express your breasts after feeding. Whenever you breastfeed, you should focus on how your baby is doing.

Be sure to place the baby on both breasts at one feeding to better stimulate lactation. Do this until there is a significant flow of milk, which can begin on the 2-5th day after the baby begins to be brought in regularly for feeding.

After discharge

Now the mother’s task is to start feeding the baby, at least after 3 hours, controlling the number of urinations per day, especially if there was severe weight loss in the maternity hospital or supplemental feeding was prescribed.

If you are concerned about something - a small number of urinations in your baby, a question about the need to pump, or any other questions, do not hesitate to call or visit a lactation consultant at home.

It is advisable that during the first weeks someone helps you around the house, and you can devote time to establishing breastfeeding. Good luck!

Jenny | 11/13/2013

I nursed my daughter until she was almost 3 years old. Those. there was experience, motive, and desire. The second difficult birth ended in a CS. She demanded to be brought in for the first application as soon as she recovered from anesthesia. She spent the night in intensive care. From early morning I almost began to make a fuss so that they would discharge me from my place, because... I need to feed the baby))) The doctors looked at me as if I had fallen from the moon. They say that mothers here prefer to rest for 3 days. My boy suckled so actively that the milk came on the 2nd day, and we were discharged on the 4th with a slight advantage)))

Yulia Mazunina | 04/14/2013

And after a cesarean section we are given the antibiotic nacef, and therefore they bring it in for feeding on the 4th day. I'm shocked. What do they feed them? And how will this then affect the digestion and absorption of my milk?

Medvedev | 02/07/2013

Thanks for the advice. They helped a lot.

Natalia | 08/10/2012

I have 2 cesareans. I don’t understand what problems can arise with breastfeeding. I fed one and the other for a year and eight months, there was a lot of milk.

Oksana | 04/29/2010

I had an unplanned caesarean section, my son was delivered the next day, when I was transferred from intensive care to the ward. I put her to my breast right away, the first few days there wasn’t enough milk, so I supplemented with formula feeding. A week after returning home, the milk was full, the baby was full, I always fed on demand, although the pediatrician advised by the hour, I still feed, my son is now one year and 9 months old, a strong, healthy baby. So a positive attitude is 99.9% of success! Good luck to all mommies and be patient!

anna | 03/12/2010

The baby was born at 4.5 kg, always hungry, even when milk appeared (on the 2-3rd day) she happily ate both milk and formula. Only by the 5th day did the glutton begin to have enough milk (always milk first, and then formula, if she is still hungry). My neighbor had a small child who was always crying, and he immediately became addicted to the bottle... I had to retrain him. mommies, don't follow blindly, make a decision depending on the situation! and all our Caesarean babies lay with their mothers even in intensive care; only very premature and abandoned children are taken to a separate ward!

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It is believed that breastfeeding (BF) after a cesarean section is associated with enormous difficulties, and in some cases is completely impossible, but the experience of numerous mothers whose children were born thanks to the operation proves the opposite.

Problems with breastfeeding after cesarean section can be caused by several factors:

• inability to apply for the first time;
• getting used to the pacifier;
• late arrival of milk, too little or too much;
• anesthetic drugs and antibiotics prescribed for the mother.

First application after caesarean section

Everyone knows that the first time a baby is placed on the mother’s breast is of great importance for how breastfeeding will proceed in detail and how quickly the baby adapts to new conditions.

In addition, stimulation of the nipples, the mother’s emotions from the realization that she has put her baby to her breast for the first time - all this gives a powerful impetus to the body’s recovery mechanisms, uterine contractions and a signal to activate the production of breast milk.

If a woman had a caesarean section under, then there should be no problems with the first application. Sometimes the baby is handed over to the mother immediately after extraction, even before the surgeon finishes stitching. This, of course, is the best option, since it is important for the baby to be in the caring hands of his mother: he will be in comfortable conditions and will take over his mother’s microflora, which is also important.

However, if the operation was complex and was performed under general anesthesia, then the woman may wake up only after a few hours.

There is no need to be upset about this. Even if the attachment did not take place in the first hour after birth, this does not mean at all that you can forget about breastfeeding after a cesarean section. Yes, it will be a little more difficult for you, but if you want to feed your baby milk, then you will overcome all difficulties. Try to provide the first feeding within 6 hours after the baby is born, as during this time he has a high sucking activity.

Judging impartially, almost all mothers who give birth in Russian maternity hospitals both naturally and by caesarean section put their baby to the breast for the first time for a few minutes, and ideally this should be at least half an hour for each breast. So, if the first attachment were the decisive factor, then natural feeding would practically never occur in our country.

Breastfeeding and caesarean section: be careful with the nipple!

Another important point is to agree with the staff or ask relatives to make sure that the baby does not receive any other food until you can provide him with a full hour-long breastfeeding, and ask him to bring the baby to you as soon as you can feed him.

If the baby managed to try feeding from the nipple before he was attached to his mother's breast, he may have some difficulty latching on to the nipple. Don't be afraid to help him, take the breast with your hand closer to the areola and try to place the nipple in the baby's mouth as deeply as possible.

Even those babies who immediately receive their mother’s breast sometimes have difficulty latching, so at first they need to be helped and taught how to grasp the nipple correctly. But when the child gets a little stronger and understands how tasty his mother’s milk is, he will not need help. You will even be surprised at how deftly he will learn to cope with this task - to suck his mother’s breast anywhere and in the most unexpected positions.

In addition, the nipple does not require much effort from the child, unlike the mother's breast. If your baby, for one reason or another, has managed to get used to the “easy life,” you will need a supply of patience, perseverance and, most importantly, desire. Don’t panic, often the harm from early introduction to the bottle is greatly exaggerated: a few days are enough to correct the situation and establish breastfeeding after a cesarean section.

Firstly, you need to completely stop using a pacifier. If the child is in the same room with you, this is not difficult. But if you can't see him all the time, try to convince the staff not to give the baby a bottle and check this yourself periodically.

Secondly, let the baby stay at the breast for as long as he needs. At first, the baby may get tired of sucking and take several breaks before he is full.

Premature and weakened babies need supplemental feeding because it is difficult for them to breastfeed for a long time and they often fall asleep exhausted or begin to worry without receiving the required amount of nutrition.

Supplementary feeding will help the baby gain strength, stop being nervous and suckle at the breast for as long as possible, stimulating the mother's milk production. For supplementary feeding, use a spoon or pipette and expressed milk.

Healthy but crying babies in the first days after birth, as a rule, do not need additional feeding. They cry from stress. You can calm such a child either by rocking him in your arms, or in no way - you just have to wait and let the baby cry.

Many mothers believe that the baby is hungry and feed him additional formula, after which the baby calmly falls asleep. However, most pediatricians and lactation consultants say that the baby does not suffer from hunger, but falls asleep after the formula because it is difficult to digest. You can determine whether your baby has enough nutrition by the number of urinations.

The minimum number of urinations in a child who does not suffer from hunger, and therefore does not need additional feeding:

• the first three days – 2;
• from the third to the sixth day - 4;
• further – at least 6.

So, if you still haven’t managed to influence the situation in the maternity hospital, don’t despair! Do you really want to breastfeed after a caesarean section? If the answer is positive, you will succeed. Nature has perfectly honed the mechanisms of lactation; you only need a little patience and perseverance to change the situation and put lactation “in the right direction.”

Quite often, mothers are faced with the fact that the child gets used to feeding according to the schedule, cannot suckle at the breast in the correct position and simply cries.

The baby will literally have to be taught how to latch onto the breast correctly. At first he will most likely resist. Spit out the nipple and turn away from the breast. Don’t be upset, sooner or later the baby will want to eat and will reach out to you. You need to be patient a little for innate reflexes to take over the first experience of a child receiving a pacifier instead of his mother's breast.

At the end of the article you will find a video that very clearly demonstrates how to hold your baby correctly and ensure optimal latching.

But what to do with the regime when the baby eats only at certain hours and sleeps the rest of the time?

You need to pay close attention to your child, especially an hour and a half after he falls asleep. Usually, at this moment, children begin to smack their lips in search of their mother’s breasts. This is the ideal time to pick up your baby and offer him the breast, without having to wake him up for this.

Experienced lactation consultants say that during proper feeding, namely frequent and natural feeding, hereditary mechanisms are triggered and endorphins are released in the baby’s body. Therefore, even if the baby is capricious when trying to take the nipple unsuccessfully, he is not in a state of stress.

And here everything depends on the mother, whether she can overcome the desire not to “mock” the child and offer him formula from a bottle, thereby depriving him of the best that a mother can give to her baby. As practice shows, breastfeeding after cesarean section and bottle feeding can be established in 2-3 days.

Low milk supply after caesarean section

There is no need to be upset because there is little milk in the breast. Usually, in the first 5-9 days, colostrum is released in small quantities - a very nutritious yellowish liquid. It is small in volume, but quite nutritionally sufficient for a newborn.

In order for lactation not to fade at the very beginning, a woman needs to periodically express colostrum, especially while she is in the intensive care unit and is not able to breastfeed the baby after a cesarean section.

Thus, the body receives a signal that milk is in demand and begins to produce it in large quantities.

In this case, you do not need to pay attention to how much colostrum is released from the breast during pumping; your task is to stimulate the breast, and therefore ensure milk production in the future.

You don’t have to pump on the first day after surgery - rest while you have the opportunity. On the second day, start pumping at intervals of 2 hours, devoting 5 minutes to each breast.

You should be taught how to express your breasts in the maternity hospital. You should start with nipple stimulation; you don’t need to put too much pressure on the breast, and under no circumstances should you put too much pressure on the nipple. Using smooth movements, move your fingers from the base of the chest to the areola, evenly increasing the pressure. Focus on your feelings - it shouldn’t hurt.

You can also use a breast pump: manual or electric. The latter option is preferable, as it imitates the baby's sucking rhythm.

After a caesarean section, it is recommended to drink a lot to replenish lost fluids. However, drinking too much can cause congestion in the breast when milk begins to actively flow. You should consult your doctor in advance on this issue.

If stagnation does happen

In the case when the baby is with the mother in the ward, you need to feed him on demand, and it is not advisable to pump additionally. Thanks to constant feedings, the breasts will not “overflow”, but there will be enough milk in it for the processes of regulating its quantity to begin: and gradually the volume of production will normalize and will not cause concern.

If the baby is brought only for feeding, then breast fullness can turn into engorgement. In this situation, experts advise expressing milk 2 times a day until the breasts are completely empty (do not try to express every drop, milk is produced constantly).

When this method does not help, you can try once a day (at 9 o’clock in the morning or evening) to express as much as possible, and then every time, according to the baby’s feeding schedule, until you feel relief. Moreover, if the baby has sucked so much milk that you do not feel tension in the chest, there is no need to pump additionally.

Once the situation has stabilized, you can stop pumping completely and release your breasts enough to avoid discomfort.

Antibiotics and lactation after cesarean section

After a cesarean section, a woman is prescribed a course of antibiotics to prevent complications from developing.

In this regard, many mothers fear that drugs can penetrate through milk into the baby’s body and harm him. There is no clear opinion on this issue; it must be considered individually, in the context of the policy and equipment of the maternity hospital, as well as the condition of the mother. In any case, you need to consult your doctor and, if necessary, ask him to choose the safest medicine possible.

It would also be useful to consult with an anesthesiologist so that he can clarify whether anesthetics enter the bloodstream.

Don’t be embarrassed to ask questions or ask the maternity hospital staff for anything. You have every right to quality service and to have your opinion taken into account. However, do not rush to create scandals if you fail to achieve what you want, because this may turn against you. There are many peaceful ways to influence the nurse caring for your baby, from asking politely to stimulating her interest with a gift.

In return, you can get the opportunity to feed your baby on demand, and the guarantee that he will never be introduced to a pacifier. In any case, remember that only serious complications, which are extremely rare, and the mother’s disinterest in this issue can interfere with breastfeeding after a caesarean section. Don't worry, be consistent in your actions - and you will succeed!

Video: how to properly attach to the chest

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