During Breastfeeding Awareness Month, it is important to remember those who will be breastfeeding after having difficult births. One type of difficult birth is a Cesarean section, also known as a C-section. A C-section requires a vertical or horizontal cut through the abdominal muscle to reach the uterus (womb) and is a major abdominal surgery. While recovering from surgery, mothers should follow hospital discharge guidelines when caring for their infant. Breastfeeding is still possible, so the following are a few reminders for mothers and their families.

Medications

Medications, food, and any substance (including nicotine) the mother consumes are passed through breast milk to the baby. As the mother recovers, they will be offered medications to manage the pain. Their physician will need to check that the pain medications are compatible with breastfeeding, so be sure to tell the physician that the plan is to breastfeed. Although there may be worries, research has found that only small amounts of medications pass into breast milk. If mothers are concerned, talk with the doctor or midwife about alternative medications and ways to manage pain that avoid medication.

Breastfeeding Position

Breastfeeding requires holding the baby up to the breast and positioning them so that the baby can be successful. This may be painful for the mother. To prevent this, mothers should use positions that keep the baby’s weight off of the healing incision. Traditional breastfeeding positions–like the cradle or cross-cradle hold–might not be comfortable. The two positions usually best for post-C-section breastfeeding are the side-lying position and the football hold. In these positions, the baby does not rub the incision.

• Side-lying. When lying on their side, mothers should make sure that the mattress is firm and the bedding is not piled around the infant, so that they do not get tangled in the bedding. Little infants cannot lift their heads well. When worried about using this position, mothers should have someone help them.
• Football hold. The football hold involves having the baby lie lengthwise on the mother’s arm, with her palm under the baby’s head. It is helpful to have someone hand the baby to her so she does not have to use her abdominal muscles.

Mothers can also purchase a C-section-friendly breastfeeding pillow. These pillows are designed to protect the incision.

Pumping and Storing Milk

Mothers should plan to pump and store their breast milk. Although breastfeeding helps to create a human bond, breast milk also has many nutritional benefits. If the mother is in too much pain to hold their baby during the first two weeks, pumping may be the only way to provide breast milk. Breast pumps can be free with insurance and other pregnancy programs.

Pumping helps to ensure that breast-milk production does not shut down due to interruption. Pumping can also help reduce engorgement, which sometimes happens right after birth to mothers as the body swings into full milk production. Newborns have tiny mouths and struggle more when the breast is engorged.

More Information

Mothers must be mindful that recovery from surgery can be difficult while caring for a baby and learning to breastfeed. Some people have more pain than others, and there can be complications in the healing process. Be patient and get support from the free hospital lactation consultant and family. Mothers can also find support online or through in-person groups.