A Guide to Breastfeeding After A C-Section

By Dr. Kenosha Gleaton, OBGYN

Research shows that those who deliver via C-section are more likely to have trouble initiating breastfeeding, difficulty breastfeeding, and early discontinuation of breastfeeding than those with vaginal births. [1] It’s important to know what steps you can take to potentially improve the nursing experience after having a C-section delivery. 

What is a C-Section?

A cesarean delivery, also known as a C-section, is the surgical delivery of a baby. During a C-section, a healthcare provider will make a surgical incision in the abdomen and uterus in order to remove the baby from the womb. [2] The placenta, a vital organ that produces hormones necessary for a healthy pregnancy, is also removed during a C-section. After the placenta and baby are removed, the uterus and abdomen are closed using stitches. 

C-sections are sometimes necessary if labor isn’t progressing, there are health concerns, there are multiple fetuses, in the case of some infections or medical conditions, and so on. [2] As with most surgeries, there are some risks associated with a C-section delivery, such as infection, blood loss, blood clots, and internal injury. [2] C-sections are thought to be the most commonly performed surgery in the United States, with over a million people undergoing cesarean deliveries every year. [3] 

Is it Possible to Breastfeed After a C-Section?

Yes, breastfeeding is possible after undergoing a C-section. The drop in pregnancy hormones and stimuli of suckling are what tell the body to begin producing the hormones vital for milk production— prolactin and oxytocin. [4] Even if someone doesn’t have a vaginal birth, the placenta will still be removed from the uterus during a C-Section, causing a decrease in the pregnancy hormones such as estrogen and progesterone. This drop in hormone levels, accompanied by your baby suckling on the breast, will cause milk production. [4] 

Should I Breastfeed After a C-Section?

There are many benefits to breastfeeding for both mother and baby. Breastfeeding promotes healing, bonding, and gives your baby the nutritional support they need to grow. [5] Breastfeeding is generally recommended for at least the first six months of life and is recommended to continue until a year postpartum. [5] That being said, breastfeeding is a personal decision that you may or may not want to discuss with your healthcare provider and partner. Not everyone wants to or is able to breastfeed, and that’s okay! An alternative to breastfeeding is formula feeding, which has its own pros and cons. Learn the Pros and Cons of Formula Feeding and Breastfeeding

How Early Does Breastfeeding Start After a C-Section?

The body begins to prepare for lactation as early as the second trimester of pregnancy. [4] Hormone levels communicate to your body that it should begin increasing the number of milk ducts in the breasts and begin producing colostrum (thick, nutrient dense breast milk). [4] Breastfeeding can sometimes be delayed, especially in those that had a C-section, but typically breastfeeding can start within a few hours after giving birth. In some cases, it may take a few days for milk to come in. [6] 

Tips for Delayed Milk Production

If you are having trouble breastfeeding or have a delay in your milk production, don’t feel discouraged! It’s normal to experience a few bumps when breastfeeding, and there are a few things you can do to support lactation. First, you may want to speak to a healthcare provider or lactation consultant to ensure your baby is latching on correctly. You may find that switching positions can help encourage an adequate latch. It’s also important to feed as frequently as your body and baby allow, as high demand is helpful for encouraging milk supply. You may want to increase the number or length of feedings. Continuing to express milk by hand or breast pump can also help stimulate the breasts and may result in more milk production. [7] In some cases, health conditions could be to blame for the delay in breastfeeding. Be sure to speak to a healthcare provider about your concerns, and supplement with infant formula to ensure your baby is getting enough nutrients. [6] It’s also important to note that not everyone can or chooses to breastfeed, and that’s okay! If it’s painful or difficult for you to breastfeed, speak to your healthcare provider about infant formula. 

Tips for Breastfeeding After a C-Section

While breastfeeding is possible after a C-section, research shows that breastfeeding initiation is more likely to be delayed in those who deliver by cesarean section. [1] Learning some of the best practices for breastfeeding may be helpful for improving milk production and the overall nursing experience. Learn more about postpartum life on the Natalist blog → 

Plan Early

We know that breastfeeding (much like pregnancy and parenting in general) doesn’t always go to plan. Being prepared can improve the birthing and breastfeeding experience, so it’s important to come up with a plan, and a few backup plans, before giving birth. Do your research on where you expect you’ll be delivering your child. While some C-sections are planned, many aren’t, and it’s important to find a healthcare provider or a hospital that you trust will attempt to stick to your wants and needs regardless of a vaginal or C-section delivery. Familiarize yourself with the hospital policies as far as breastfeeding in the operating room, if lactation consultants are available, and so on. 

Skin-to-Skin Contact

There have been many studied benefits of skin-to-skin contact, including an increase in milk production, successful breastfeeding, and can even reduce the risk of postpartum depression. [8-9] Advocate for yourself while giving birth and let your providers know that you would like to have skin-to-skin contact as soon as possible after delivery. You may also want to attempt skin-to-skin contact regularly during or after breastfeeding. 

Find the Best Position for Breastfeeding

Breastfeeding doesn’t always come naturally and may take some trial and error to find what works well for you and your baby. It’s especially important to protect your abdomen when recovering from a C-section to allow your wound to heal properly. Speak to your healthcare provider about finding a position that is comfortable for you. Two common positions to try that may be helpful are the side-lying hold and under-arm or football hold. Whatever position feels the best for you and your baby and prevents any pain or pressure on the abdomen is likely to be a great option. 

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Nurse, Pump, or Hand Express Often

It’s important to breastfeed frequently, at least every few hours if you want to promote successful breastfeeding. Even if you are noticing a delay in your milk production, attempting to pump or hand express your breasts often will encourage your milk to come in. [7] Plus, if you’re unable to breastfeed your baby after delivery due to medical or other issues, you may still be able to pump milk for them. 

Ask for Help and Set Boundaries

You can still be a supermom without straining yourself or taking on more than you can handle. A C-section is a surgical procedure and you will need time to heal properly. While you are recovering from surgery, learning to breastfeed, and taking care of your newborn, you shouldn’t be afraid to ask for help or set boundaries with family and friends as needed. You may not be ready for visitors right away, and that’s okay! Lean on your loved ones when you need help bathing, feeding your baby, finding a comfortable position, etc.

Get Postpartum Support with Natalist Products

Postpartum life is a mixed bag of emotions and symptoms. We’ve been there, and we get it. Whether you’ve had a vaginal delivery or C-section, you’re breastfeeding or using infant formula, Natalist has products to make postpartum life just a little bit easier. Support your nutrition and encourage healthy breastmilk with the Postnatal Vitamin, encourage hair and skin health with Biotin Gummies, or soothe cracked, dry nipples with multipurpose Nip & Lip Balm. 

References:

1. Hobbs, A.J., Mannion, C.A., McDonald, S.W. et al. The impact of cesarean section on breastfeeding initiation, duration and difficulties in the first four months postpartum. BMC Pregnancy Childbirth 16, 90 (2016). https://doi.org/10.1186/s12884-016-0876-1
2. What is a C-section? NIH. Office of Communications. September 2017. URL. 
3. Sung S, Mahdy H. Cesarean Section. [Updated 2023 Apr 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546707/
4. Lactation. Cleveland Clinic. December 2021. URL. Accessed July 2023. 
5. Breastfeeding Your Baby.  American College of Obstetricians and Gynecologists. FAQ 029. May 2021. URL. 
6. Breastfeeding and Delayed Milk Production. Johns Hopkins Medicine. Accessed July 2023. URL. 
7. Flaherman VJ, Gay B, Scott C, Avins A, Lee KA, Newman TB. Randomised trial comparing hand expression with breast pumping for mothers of term newborns feeding poorly. Arch Dis Child Fetal Neonatal Ed. 2012;97(1):F18-F23. doi:10.1136/adc.2010.209213
8. Widström AM, Brimdyr K, Svensson K, Cadwell K, Nissen E. Skin-to-skin contact the first hour after birth, underlying implications and clinical practice. Acta Paediatr. 2019;108(7):1192-1204. doi:10.1111/apa.14754
9. Bigelow A, Power M, MacLellan-Peters J, Alex M, McDonald C. Effect of mother/infant skin-to-skin contact on postpartum depressive symptoms and maternal physiological stress [published correction appears in J Obstet Gynecol Neonatal Nurs. 2012 Jul-Aug;41(4):580]. J Obstet Gynecol Neonatal Nurs. 2012;41(3):369-382. doi:10.1111/j.1552-6909.2012.01350.x