Caesarian birth and breastfeeding

How does a Caesarean birth affect breastfeeding?

Mothers who have had a Caesarean birth are less likely to start breastfeeding than other mothers. If they do breastfeed, they are more likely to breastfeed for a shorter time. This may be due to many reasons, including illness, pain medication, separation from the baby, and difficulty finding a comfortable position to breastfeed. Mothers who are facing a Caesarean birth should consider delaying delivery until at least 39 weeks, using skin-to-skin contact as much as possible, and breastfeeding as soon as possible after delivery. The under-arm and the laid-back breastfeeding hold can be used to keep the baby away from the tender tummy. Mothers who have had a Caesarian birth may benefit from extra help.

A) The impact of Caesarean birth on breastfeeding

Babies born by Caesarian birth are at higher risk of developing a less healthy gut bacteria (microbiome). Breastfeeding, and in particular exclusive breastfeeding, helps the microbiome to improve (Hoang 2021).

Unfortunately, compared with mothers who have had a vaginal birth, mothers who have had a Caesarean birth are (Chen 2018; Hoang 2019; Hobbs 2016; Wu 2018; Yisma 2019; Zhao 2017):

B) Reasons for a Caesarean birth affecting breastfeeding

Many factors play a role in lower breastfeeding rates in mothers who have had a Caesarean birth including:

Mothers who have general anesthesia during childbirth instead of epidural analgesia for pain control, have been found to have less success breastfeeding over the long term (Kutlucan 2014; Lie 1988).

C) Support for mothers facing a Caesarean birth

While the reasons for a Caesarean birth vary, all mothers and babies in this situation benefit from extra support. If you are facing a Caesarean birth, consider the following:

  • Delay delivery until at least 39 weeks to prevent breastfeeding and health problems common in early-term and premature babies (Wilmink 2018).
  • Keep the baby in skin-to-skin contact and avoid unnecessary separation between you and your baby.
  • Breastfeed after delivery as soon as you can and the baby shows signs of hunger.
  • If the baby cannot breastfeed effectively, express colostrum or breast milk whenever the baby needs to feed in order to establish a good milk supply and use this to supplement the baby.
  • The laid-back and under-arm breastfeeding holds allow you to keep the baby away from your tender tummy.
  • Make sure you are well supported and in a relaxed position while breastfeeding. This may mean extra pillows and being a little creative.
  • Ask for help for yourself and in caring for the baby.
  • Use appropriate pain medication as needed (Martin 2018).
  • Make sure the baby is getting enough milk and is not getting too sleepy or irritable.
  • Ensure you have support from others.
  • If you have concerns or are struggling, ask for help from your health-care providers or from a breastfeeding specialist.

Breastfeeding babies born by Caesarean birth tend to lose slightly more weight than those who have a vaginal birth. It is important to monitor the other signs that the baby is taking in enough milk.


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