Breastfeeding after a cesarean section

It is believed that breastfeeding after a caesarean section is a daunting task and invariably associated with difficulties and problems. In fact, the impact of operative childbirth on subsequent lactation is somewhat exaggerated, although a lot will depend on how much the young mother will be able to properly establish the process of breastfeeding the baby. In this article, we will look at the specifics of milk production after a cesarean section and show you how to establish feeding.

Features:

During pregnancy, the mammary glands almost double in weight. Under the influence of certain hormones (progesterone, estrogen), the milk ducts grow, the lobules become heavy, and only a couple of days before the onset of labor, the maturation of the glands is complete. The drop in progesterone levels, which is common in all women before childbirth, triggers the mechanism for the production of immature milk in the mammary glands.

But a cesarean section is not always done on the expected day of childbirth, and they do not always expect the body to be fully prepared for labor. It is for this reason that after surgical delivery, lactation may occur with a slight delay, because hormonal changes take a certain time. The rate of milk production is also affected by the drugs used during the surgery for anesthesia. They somewhat slow down the natural processes in the female breast.

It is clear that the closer to the due date a cesarean section was performed, the less problems the mother will have with lactation. If there was a premature caesarean section for health reasons and the readiness of the mammary glands is far from optimal, there are more problems with milk production.

For a successful start of feeding, the level of a special hormonal substance prolactin in the female body is important. To stimulate its production, it is important to attach the baby to the mother's breast as early as possible. Today, when up to 90% of operations are performed under epidural or spinal anesthesia, when a woman remains fully conscious at the time of removing the baby, latching to the breast in most maternity hospitals is practiced right in the delivery room.

Problems are likely if it was not possible to immediately attach the baby to the breast, if on the first day the woman is in intensive care in a serious condition, or the baby is in serious condition in children's intensive care. In this case, there is no question of the joint stay of the mother and the baby, or of the delivery of the baby for feeding.

But even if all of the above negative factors took place, this is not a sentence. It is quite possible to contribute to the establishment of normal lactation. Opportunity to feed the baby is not available only in puerperas who do not have milk and colostrum at all due to hormonal imbalance, and such disorders (prolactin type) are extremely rare.

What to look for?

The first hour and a half of his life in this world are considered the best time to latch on to the breast. It's okay that milk is not yet fully understood, even a drop of colostrum will be enough for the baby to receive a large supply of proteins, vitamins, fats and carbohydrates. The nutritional value of colostrum is incredibly high. But even if there is no colostrum, it still makes sense for the crumb to be applied to the breast for an hour and a half.

This will help the development of his sucking reflex, will have a beneficial effect on the contraction of the uterus after surgery, and will also be an excellent stimulus for the production of prolactin. Not in every maternity hospital they try to apply the application in the first hour and a half, and therefore this issue needs to be resolved with the doctors in advance, to agree on the time of application, if unforeseen circumstances do not occur.

Formula supplementation is not the best way to start a meal. After the baby sucks on the nipple, from which food flows out relatively easily, without resistance, he may then refuse to take the breast, because the baby will need to make some efforts to absorb it. This issue should also be discussed with your doctor in advance. A woman has the right to demand the absence of complementary foods on the first day. It will be administered only if even colostrum does not appear within 24 hours.

Today, long-term separation of mother and baby after surgical delivery is not accepted. If there are no contraindications on the part of the well-being of the mother and baby, after 8 hours, when the woman starts to get up, they can bring her a child for a joint stay. From this time on, the main measures for the development of lactation will begin. Breastfeeding will benefit both the woman and her baby.

How to improve milk production?

Do not worry if there is no milk on the first day or two after the operation. This is completely normal; in many women, after a cesarean section, even colostrum begins to be released with a delay. Multiparous women start breastfeeding earlier, because their nipples are more adapted to this and there is a corresponding experience. If the birth was the first, then the breast has yet to be developed. This is what the woman will have to do in the hospital ward after the child is transferred to a joint stay.

Increases milk production by expressing. It should be done every 3-4 hours to stimulate the production of high-grade breast milk. Even if all the efforts of the parturient woman rest only on the extraction of a couple of drops of colostrum, you should not give up this activity. You can stretch your breasts with your hands in between feedings (by applying to the breast), you can use a breast pump.

There are several types of such devices - manual, pump, electric. Which one to choose is a personal matter for each mother and a question of the family budget. The principle of action is the same for everyone - the nipple is irritated, the production of prolactin is stimulated, the volume of breast milk increases. It is quite possible to straighten the breasts to a state suitable for feeding a newborn within 2-3 days.

If the baby does not breastfeed, you need to find out the reason. It is imperative to consult a doctor from the children's department. It is possible that the mother's nipple is small, anatomically uncomfortable. In this case, a special silicone nipple cover may be required.

If there is already enough milk and the baby is eating well, you still need to continue expressing the excess. The baby will grow and his nutritional needs will increase every day.

If you remove the remnants of breast milk from the breast, then the inhibitor that slows down the production of a new portion of breast milk will be eliminated in a timely manner.

In addition to expressing, there is a whole range of measures that will help a woman to establish breastfeeding after surgery.

Massage

Specialized lactation-stimulating massage is not difficult. They are within the power of any woman. A properly done massage will not only stimulate milk production, but will also help prevent milk stagnation in the mammary glands.

Take the breast in the area of the upper part of the gland and with an open palm make circular movements from top to bottom, towards the nipple. After massaging one breast for five minutes, proceed to massage the second.

Massaging the nipples with light pressure with your fingertips also helps. Massage each nipple clockwise and counterclockwise for 1 minute.

The massage should be done 4-5 times a day after each feeding of the baby.

Medication

There is a separate group of drugs that can help establish lactation after surgery. Before use, you should definitely consult a doctor, because in addition to the benefits, they can also show side effects. The most popular among nursing mothers are such products.

"Lactogon" - 1 tablet 3-4 times a day one hour before feeding the baby. The general course is 30 days.
"Mlekoin" - dissolve five granules half an hour before meals in the morning and evening. The duration of the course of treatment is unlimited, the drug is homeopathic.

Also special mixtures for nursing can help - "Milky Way", "Femilak". Taking folic acid is also recommended. If a woman has hormonal problems that interfere with the establishment of normal lactation, she will be prescribed hormonal drugs.

Nutrition

Nutrition should be balanced, but not meager. On the first day or two, a woman after the operation is recommended to have a strict diet, on the 4th day she can eat everything that is provided for by the general table for lactating women. The main thing is to prevent constipation. If you have difficulties with defecation (it is scary to push, the stitches hurt), you need to take a laxative in the form of rectal suppositories or microclysters to gently cleanse the intestines from feces.

Porridge, milk, dairy and sour milk products, stewed and boiled vegetables will be useful, it is recommended to drink more liquid. After the operation, women need the liquid doubly, because it is necessary to replenish the reserves of the lost fluid, but you should be very careful about your well-being, because stagnation and swelling of the mammary glands are not excluded against the background of a large amount of drinking.

You can add special teas for nursing mothers with fennel to the diet, they will help to increase the production of breast milk.

The influence of medications

Often women after surgery wonder how the drugs that are given in the postoperative period to a postoperative woman can affect the baby. It should be noted that a woman is obliged to inject painkillers in the first 2-3 days, since contractions of the uterus with sutures imposed on it can be quite painful, and the anterior abdominal wall is quite noticeable. Contraction drugs are administered separately, since the contractility of the uterus after surgical delivery leaves much to be desired. These drugs will not harm the baby.

Antibiotics are prescribed today only if there is reason to suspect an infection. Just like that, for prophylaxis, as was done before, antibacterial drugs after a cesarean section are not prescribed. Most modern drugs are not dangerous for a child, but if a woman is prescribed a rather toxic antibiotic according to indications, she will be warned about this.

During therapy, breastfeeding will have to be abandoned. So that the milk does not disappear and the baby can be fed later, the woman will need to continue pumping and massage her breasts.

"Contractubex", which many women use on the area of the scar after its healing, does not affect breastfeeding if the drug is used in the form of a patch. The effect of the gel on the composition of breast milk has not been sufficiently studied, and therefore manufacturers do not recommend using the product in this form for nursing mothers.

Useful Tips

Develop a feeding schedule that is comfortable for both mom and baby. Advice to apply the baby to the breast more often after the operation may result in other problems - in a couple of months the baby will “hang” on the breast around the clock, which will cause a lot of inconvenience to both him and his mother.

If the baby is used to bottle feeding at the hospital, then the mother will have to try to retrain the baby. In this case, the rational approach will be to feed by the hour, in which both the child will get used to food at certain hours, and the female lactation will “adjust” as well as possible to the needs of the child.

Caesarean section is not a cause for concern about lactation and breastfeeding success. There is nothing insurmountable on this path. Women who gave birth naturally sometimes experience no less problems with lactation than those who gave birth by caesarean section. It all depends on the woman's focus on breastfeeding, on her understanding of all its importance for a growing child. As a last resort, every antenatal clinic has GW specialists, you can seek advice completely free of charge at any time.