Latching Problems after a C-section

QUESTION

Dear Lactation Consultant,
Hi! I was hoping you could help me. I had a baby one week ago via emergency C-Section. I tried breastfeeding him right after and he attempted to latch, but I had no milk in yet really, so he got nothing. The nurses told me I could formula feed and he would be ok to latch when my milk came in. I tried a few more times and started using the hospital electric pump on Friday. Finally on Sunday I woke up and my milk had come in.

I have tried several more times to get him to latch. He just pushes away from me. My nipples are not inverted or totally flat, but I have ordered nipple shields. I have heard this should help. Now I am pumping 8-12 ounces a day with a manual pump and supplementing with formula the rest of the time.

What do you suggest? I really hope the nipple shields help as I want to breastfeed. But more importantly I want my son to eat, which is why I am pumping/formula supplementing.

Also, if I do get him to latch successfully, how soon can I do both that and bottle feed so my husband can help?

Thanks!
Elisabeth

ANSWER

Hi Elisabeth,
It sounds like you've had a tough time so far. I'm glad to hear that your milk has come in. It's not unusual for your milk to be delayed following a stressful birth (which it sounds like you've had).

At this point, I would suggest that you keep pumping to keep your supply up and let's gradually get your baby back on the breast. You will want to probably rent an electric pump for the next few weeks as a manual pump won't help keep your supply up. And after everything you've been through, I'd hate for you to have a low milk supply. How many times a day are you pumping? You'll want to be pumping 8-12 times a day. So if you're not doing that, graduallly start ramping yourself up (adding a pumping session every day).

As for your baby latching, nipple shields won't really help at this point. What's probably happened is that your baby has starting associating the breast with frustration (perhaps because your milk was delayed). So what we want to do is reverse that. The good news is that's entirely possible! What you'll want to do is place your baby skin-to-skin between your breasts and just hang out. Don't do this when your baby is frantically hungry. Just try it several times a day when everyone's calm. Your baby may try to latch, just to experiment. Let him do it. The more practice you get, the better for you both. Also, try to catch him when he is showing early signs of hunger (smacking, sucking his fists). He may be more receptive then. In the meantime, keep up your pumping. As you get more milk, you'll be able to wean off of formula -- but do this gradually.

As for using a bottle, at this point, I'd say wait until at least 6 weeks. Let's get your milk supply and breastfeeding back on track. Then you can try to have your husband offer some pumped milk.

How does that sound to you? Feel free to write back and let me know how things are going. It sometimes takes a bit to transition babies back to the breast. But it definitely can be done.

Let me know how it is going.
-- Kathy Kendall-Tackett, PhD, IBCLC

Kathleen Tackett

Dr. Kendall-Tackett is a health psychologist, International Board Certified Lactation Consultant, and Research Associate Professor of Psychology specializing in women's health at the Family Research Lab, University of New Hampshire. She is a Fellow of the American Psychological Association in both the Divisions of Health Psychology and Trauma Psychology. Dr. Kendall-Tackett is a La Leche League leader, chair of the New Hampshire Breastfeeding Taskforce, and the Area Coordinator of Leaders for La Leche League of Maine and New Hampshire.

Dr. Kendall-Tackett is author of more than 140 journal articles, book chapters and other publications, and author or editor of 15 books including The Hidden Feelings of Motherhood (2005, Hale Publications), Depression in New Mothers (2005, Haworth), and Breastfeeding Made Simple, co-authored with Nancy Mohrbacher (2005, New Harbinger). She is on the editorial boards of the journals Child Abuse and Neglect, Journal of Child Sexual Abuse and the Journal of Human Lactation, and regularly reviews for 27 other journals in the fields of trauma, women's health, interpersonal violence, depression, and child development. Dr. Kendall-Tackett is the "Ask a Lactation Consultant" columnist on Pregnancy.org and serves on the Board of Directors of Attachment Parenting International.

Dr. Kendall-Tackett received a Bachelor's and Master's degree in psychology from California State University, Chico, and a Ph.D. from Brandeis University in social and developmental psychology. She has won several awards including the Outstanding Research Study Award from the American Professional Society on the Abuse of Children, and was named 2003 Distinguished Alumna, College of Behavioral and Social Sciences, California State University, Chico.