After A Cesarean Birth

Research has found that regardless of how her baby was born, a woman’s commitment to breastfeeding is the most important factor in her success. However, the mother who has a cesarean has a longer hospital stay, her discomfort is greater, she may not have easy access to her baby while she is in the hospital, and she may be mor edependent upon hospital personnel for assitance. Breastfeeding early and often offers some advantages that may be particularly important to the mother who has had a cesarean:

  • The baby’s sucking stimulates the mother’s uterus to contract more quickly and speeds her healing.
  • Breastfeeding can bring mother and baby emotionally closer, which may be especially important if they are separated after birth or the birth was traumatic.
  • Breastfeeding can help the mother feel competent and whole.

Choice of Anesthetic

The type of anesthetic that is used during a cesarean affects how soon the mother can begin breastfeeding.

If regional (spinal or epidural) is used, a mother can be awake for her baby’s birth and can breastfeed immediately after birth. She may need help in putting her baby to the breast. If she has had an epidural anesthetic, she may need to remain flat on her back also, one of both arms may be restrained if an IV or monitors are still in place. She may be able and turn to one side and breastfeed in a side-lying position once her incision has been closed. The baby’s father or a nurse can help the mother get the baby into position and arrange pillows for the mother’s comfort. Or, if pillows are not available, the baby’s father could physically support her while she nurses.

If a mother is given a general anesthetic, she may be unconscious for a while after her baby’s birth and may be groggy for some time after that, delaying the beginning of breastfeeding. As soon as the mother feels able to breastfeed, she should be encouraged to. Little anesthetic will remain in her system at that point and will not be harmful to her baby.

Finding a Comfortable Nursing Position

After a cesarean, many mothers find it difficult at first to find a comfortable nursing position, because they have to work around a painful incision and an IV, either in the hand or arm. Each mother needs to experiment to find the positions that feel best to her. There are several alternatives that will not put pressure on the mother’s incision:

  • Side-lying – with the mother and baby lying on their sides facing each other.
  • The football or clutch hold – with the mother sitting upright in the bed or on a chair and the baby resting on a pillow held along the mother’s side with his legs bent at the hips and his bottom against the back of the chair or bed.
  • The cradle or cross-cradle hold – with the mother sitting up in the bed or on a chair and the baby facing mother chest-to-chest horizontally while resting on a pillow covering the mother’s abdomen.

Many mothers find nursing while lying on their side the most comfortable during the first day or so. It’s also an easy way to nurse and rest at the same time. Here is a step-by-step guide fo rgetting into the side-lying position:

  • Begin with the bed in a flat position and side rails up.
  • Use extra pillows behind the mother’s back for extra support.
  • Then carefully roll to one side while grasping the side rail and relaxing the abdominal muscles. Move slowly to avoid strain.
  • To protect the incision from the baby’s kicking, cover the abdomen with a small pillow, a towel, or a rolled-up blanket.
  • To minimize the strain on stomach muscles, flex the legs and place a pillow between them for more support.
  • Lean back into the pillows behind the back.

To shift from side to side, the mother can either hold her baby to her chest with one arm and use the other arm to grasp the side rails or ask her helper or a nurse to move the baby to her other side before she begins. Then she should:

  • Turn her hips a little at a time with her feet positioned flat on the bed.
  • Move slowly, being careful not to pull suddenly, as it could pull on the incision.
  • Hold on to the side rails for support.
  • Reposition the pillows.

When using the side-lying position, the baby should be placed on his side facing the mother’s body – chest to chest – so he doesn’t have to turn his head to nurse. The baby’s knees should be drawn in close to the mother’s body with his head either lying on the bed or on the mother’s arm, whichever feels more comfortable. The mother can either roll her body toward her baby to latch him on or she can pull her baby toward her. Always ask for help when lifting or changing baby and in moving from side to side while lying down.

Resources: LLL International, The Breastfeeding Answer Book, 3rd Revised Edition

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