Dear Lactation Consultant,
I have to have a scheduled Cesarean section due to a pre-existing condition (I had a vein burst in my head two years ago and doctors feel they do not want me to push as in natural childbirth). Many manuals and articles I have read tell me that a baby can be put right on the breast after birth which will give it a good head start. Since I will be supine for a certain amount of time, I am wondering if it is still possible to attain a good 'head start' to breastfeeding as it seems I might be lagging a bit behind women who give birth naturally. Any thoughts?
Congratulations on your upcoming birth! It it a good thing to think ahead when you know you will be having a cesarean birth. In answer to your question, it is most definitely possible for you to get off to a good start with breastfeeding.
The key is to plan to breastfeed long and often during the first few days. It is frequent feedings that triggers the increase in milk production and the establishment of a good milk supply. A good target number is eight to twelve feedings per 24 hours. Research indicates that some mothers who have cesarean births get off to a slower start with breastfeeding is when the number of feedings drops below this range.
In order to achieve the most feedings per day, I often advise women in your situation to take maximum advantage of the time during which their pain medication is still in effect to get in as many nursings as possible. Those may be your most comfortable breastfeedings for a while. So talk to your partner and your doctor about helping you to breastfeed right after delivery and in the recovery room. The baby can be laid across your chest while you are supine. A helper can gently support the baby's forehead, if needed, so that his/her nose is free for breathing.Also, in preparation for the feedings after this, learn what you can (both at breastfeeding class and from the LCs in the hospital) about how to breastfeed lying down and in the football hold. These are positions that prevent the baby's weight from resting on your incision. By nursing lying down, you can doze while feeding, so that you don't have to make a choice between getting the rest you need and fitting in enough breastfeedings.
Plan to take full advantage of all the breastfeeding help your hospital has available during your longer stay. In some hospitals, you may not see the lactation consultant unless you ask. It would be worthwhile to put in a request to see her so that she can see what you're doing and offer any positioning and latch-on suggestions. That can often make a difference in your comfort.
Hope this helps,
-- Nancy, IBCLC
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.