Difficulty levels of breastfeeding after a caesarean section (C-section) can vary from mother to mother. Breastfeeding is considerably more difficult for mothers who had a C-section as opposed to a vaginal birth.1 This is due to factors spanning from intense pain to a lack of bonding time with the baby.1
Breastfeeding for the first six months of the baby’s life is crucial for the best nourishment of your newborn.2 Despite difficulties, there are several ways you can encourage your newborn baby to latch onto your breast, and this article aims to explain the impact of C-sections on breastfeeding and provide ample advice on helping mothers breastfeed after a C-section successfully.2
There are several ways you can encourage your newborn baby to latch onto your breast, and this article aims to share explanations as to why breastfeeding can be trickier and breastfeeding advice for mothers who had a C-section.2
Read on to learn more about how to get your newborn breastfeeding after a C-section, the best position for breastfeeding after a C-section, and why you may be experiencing difficulty.2
C-sections and their impact on breastfeeding
C-sections are surgical procedures, planned ahead of birth or as an emergency, that help get the baby safely out of the womb when vaginal delivery is not a viable option.1,2,3 The procedure involves incisions across the abdomen and womb and can carry more risks than vaginal delivery, e.g., risk of infection.3 This procedure has been around for over 400 years and in present-day obstetrics, C-sections have become increasingly common with approximately 1 in 4 women in the UK having a C-section each year.3
So, how does this procedure impact breastfeeding? Research indicates that C-sections can lead to reduced breastfeeding initiation and a higher chance of using supplementation.4 What is more, babies born via C-section may experience less immediate skin-to-skin contact with the mother, and skin-to-skin contact has been identified as essential for fostering successful breastfeeding.4
C-section babies are more likely to delay breastfeeding attempts within the first 24 hours post-delivery.4 These delays can be associated with maternal-infant separation, reduced suckling ability, and insufficient milk supply, all of which could potentially lead to shortened breastfeeding duration.3,4
Early breastfeeding within the first-hour post-delivery has been recognised as a critical predictor of sustained breastfeeding.1 Therefore, overcoming delays in breastfeeding initiation after C-sections is crucial for more successful and prolonged breastfeeding experiences.1
Issues you may encounter when breastfeeding after a C-section
Every individual is different; while one mother might not experience any issues breastfeeding after a C-section, another mother might find it very difficult.1 There are several factors that could contribute to difficulty breastfeeding, such as:
- Medication effects
Medications administered during a C-section, including anaesthesia, can influence the baby's alertness and sucking reflex in the initial hours after birth.5 This may impact the baby's ability to latch effectively during breastfeeding.5
- Hormonal impact
C-sections can disrupt the natural hormonal processes that support milk production, leading to a delay in the onset of mature milk production.4
- Postoperative pain and discomfort
Recovering from major abdominal surgery can be physically challenging for the mother. The pain and discomfort may affect her ability to find comfortable breastfeeding positions and could potentially lead to a decrease in breastfeeding frequency.5
- Emotional factors
C-sections can sometimes lead to feelings of disappointment or stress in mothers who had hoped for a vaginal birth. These emotional factors and associated mental health issues, including postpartum depression, can influence the mother's confidence and ability to breastfeed successfully.5
- Latch difficulties
The incisions from a C-section can cause discomfort or pain for the mother during breastfeeding. As a result, finding a comfortable breastfeeding position and achieving a proper latch can be challenging for both the mother and the baby.1,2,3,4,5
Other issues that could be responsible for making breastfeeding after a C-section difficult include limited mobility during recovery, delayed milk supply, and the need for additional support.5 If you are encountering issues when breastfeeding after a C-section, it is best to speak to a lactation consultant or your doctor to get to the root cause.
Tips for successful breastfeeding after a C-section
To encourage successful breastfeeding in your newborn after a C-section, there are a few measures you can take to ensure success and one of the key ways of doing this is starting as soon as possible, otherwise known as early initiation.5 Early breastfeeding stimulates milk production and strengthens the bond between the mother and baby.5
Aside from early initiation, here are some additional ways to ensure successful breastfeeding in your newborn:
- Find comfortable breastfeeding positions
- Breastfeed your baby frequently and on demand
- Encourage skin-to-skin contact
All of these methods will help strengthen the bond between you, the mother, and the baby.3 Fostering a loving connection, providing skin-to-skin contact, and making yourself available to breastfeed on demand will be key to your success.1,2,3,4,5
Why do C-section babies struggle to breastfeed?
C-section babies can face some challenges with breastfeeding, but it's not a guarantee that they will struggle. The ability to breastfeed is influenced by various factors, some reasons why C-section babies struggle to breastfeed include:
- C-sections can sometimes lead to a delayed start in breastfeeding, affecting the baby's ability to latch early.1
- Medications given during a C-section may temporarily affect the baby's alertness and sucking reflex.1
- If the baby spends time in the NICU (neonatal intensive care unit) or is separated from the mother, it can disrupt early bonding and breastfeeding.1
- Some babies might experience temporary respiratory distress, making it difficult to coordinate breathing and sucking during breastfeeding.1
- Postoperative pain can make it hard for mothers to find comfortable breastfeeding positions.1
What helps produce breast milk after a C-section?
Producing breast milk after a C-section can be supported by:
- Breastfeeding your baby as soon as possible after birth and nursing frequently to stimulate milk production
- Practising skin-to-skin contact with your baby encourages hormonal responses promoting milk production
- Ensuring a good latch and comfortable breastfeeding positions to enhance milk flow
- Drinking plenty of fluids and maintaining a balanced diet to support milk production
- Taking enough rest to aid your body's recovery and hormone regulation for milk production
- Consult with a lactation consultant or healthcare provider for guidance and encouragement during your breastfeeding journey
Can you bring back a low milk supply?
While it's not possible to "bring back" the milk supply, there are steps you can take to address and improve it. If you are experiencing low milk supply, seeking support from a lactation consultant or healthcare provider is vital. They can help identify the underlying reasons for the low supply and provide guidance on appropriate strategies to increase milk production.1,2,3,4,5
Common ways to support milk supply include:
- Frequent nursing
- Proper latch and positioning
- Staying hydrated and eating nutritiously
- Rest and relaxation
- Power pumping
- Nutrition supplements
It is important to remember everyone is different and your response to these methods may vary, therefore, it's essential to work with a qualified healthcare professional to ensure a safe and effective approach to improving milk supply.
What is the best position for breastfeeding after a C-section?
Individual preferences and comfort levels may vary, so it is essential for mothers to find the most suitable position that works best for them and their babies. However, a common position for breastfeeding that research has proven to be effective in mothers who have had a C-section is the ‘football hold’.6
This involves positioning the baby beside the mother's side, under her arm, with the baby's legs facing backwards, like a football. This position can provide better support and minimise pressure on the incision site for mothers who have had a C-section.6
The lateral positioning of the baby in the football hold allows for less interference from the surgical incision, making it a preferred position for post-C-section breastfeeding.6 This position is often recommended for mothers who need more support while breastfeeding after a C-section.6
Breastfeeding after a c-section can be difficult for many mothers for a variety of reasons, such as postoperative pain and lack of skin-to-skin contact, and from the baby’s perspective, they may encounter respiratory issues, making it difficult for them to suck and breathe at the same time.
Understanding what is going on and why you are having difficulty breastfeeding after your C-section can help you take the right steps towards improving your breastfeeding journey. Tips on managing your symptoms, choosing the best breastfeeding positions, and speaking with qualified professionals and lactation consultants will be key to getting the best results for you and the baby.
- Hobbs AJ, Mannion CA, McDonald SW, Brockway M, Tough SC. The impact of caesarean section on breastfeeding initiation, duration and difficulties in the first four months postpartum. BMC Pregnancy and Childbirth [Internet]. 2016 Apr 26 [cited 2024 Jan 19];16(1):90. Available from: https://doi.org/10.1186/s12884-016-0876-1
- Li L, Wan W, Zhu C. Breastfeeding after a cesarean section: A literature review. Midwifery [Internet]. 2021 Dec [cited 2024 Jan 19];103:103117. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0266613821001972
- Antoine C, Young BK. Cesarean section one hundred years 1920–2020: the Good, the Bad and the Ugly. Journal of Perinatal Medicine [Internet]. 2021 Jan 26 [cited 2024 Jan 19];49(1):5–16. Available from: https://www.degruyter.com/document/doi/10.1515/jpm-2020-0305/html
- Stevens J, Schmied V, Burns E, Dahlen H. Immediate or early skin‐to‐skin contact after a Caesarean section: a review of the literature. Maternal & Child Nutrition [Internet]. 2014 Oct [cited 2024 Jan 19];10(4):456–73. Available from: https://onlinelibrary.wiley.com/doi/10.1111/mcn.12128
- Chaplin J, Kelly J, Kildea S. Maternal perceptions of breastfeeding difficulty after caesarean section with regional anaesthesia: A qualitative study. Women and Birth [Internet]. 2016 Apr [cited 2024 Jan 19];29(2):144–52. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1871519215003182
- Pehlivan N, Demirel Bozkurt O. Comparison of cradle hold versus football hold breastfeeding positions after cesarean section in primiparous mothers. Breastfeeding Medicine [Internet]. 2021 Nov 1 [cited 2024 Jan 19];16(11):904–8. Available from: https://www.liebertpub.com/doi/10.1089/bfm.2021.0029