Breastfeeding After C-Section - Tips with Katie James, IBCLC

When you give birth to your baby there are many changing hormones that help with bonding and building your milk supply immediately after birth. So how does having a Caesarean section impact this process and what can we do to help mitigate the impact?

Katie James, IBCLC and I chat about Breastfeeding after a caesarean section. This is great for anyone to read before birth in preparation, or after birth too. Scroll down to see the transcript below.

Hi there I'm Corryn from Milk and Love and today I'm speaking to Katie James, IBCLC about Breastfeeding after a Caesarean Section.

Corryn - What type of things should mums be aware of and what can they do to help with Breastfeeding after a C-Section?

Katie - This is a really good question as 1 in 3 mothers will have a planned or unplanned C-Section. There are risk factors in terms of how we birth.

Some of the impacts of a Planned Caesarean Section on Breastfeeding

Katie - If you have a Caesaren, our babies can be affected by the medications that we use during labour. Their liver is smaller so they talk longer to process the medications from an epidural or opiate drugs so they can be quite sleepy sometimes.

Also with a planned Caesarean, women are not having contractions, which are there to help baby come out and also to release oxytocin hormones, which go through the baby too and helps babies know that they have to come up to mums chest and bob around looking for the breast.

When we have a Caesaren, our babies are more sleepy so they're not quite ready to do this. The baby may be sleepy for 12-48 hours. What's really important is the breast is designed to get that early stimulation and vacuum sucking from the baby within the first 1-3 hours. They have a feed and then they have a sleep and then they feed ferociously and frequently for the next few days.

When you have a caesarean, it's the opposite in most cases as the baby is very sleepy and it takes the baby a couple of days to get going to feed enough and regularly and this puts mums at risk from the very first few days of bringing the milk in on time and if your milk is delayed past 72 hours, you are at much higher risk of never making enough milk. We know this now from more recent studies on breastfeeding.

What to do to help establish Breastfeeding Milk Supply if you have a sleepy baby after birth

So if you have a sleepy baby for any reason, especially a caesarean section, then it's really important to start expressing early in that first 1-3 hours. The second magic number is 8. Which means expressing 8 or more times in 24 hours.

Should You Hand Express Milk or Use a Breast Pump After Birth?

There is a great debate also about hand expressing or using a pump. In the first few days you want to be using both. The reason is that the baby uses vacuum suction with their mouth and the pump will do this too, whereas the hand will use compression, which we also want.

What we want is that suction that stimulates and raises the prolactin hormone, which switches on all these milk cells. Once they are switched on and working, they know to automatically keep making milk.

If you don't switch on the milk cells in the first 72 hours, they may never work and never produce milk. This is why the first 3 hours and the first few days are really key to successful milk supply.

If your baby is not feeding well, or at all, express by pump and by hand, 8 or more times in 24 hours to help establish your milk supply.

How do I Hand Express and use a Pump?

Corryn - Is that taking turns between hand and pump or doing both at the same time?

Katie - I would recommend both at every time. Double pump (i.e. use a hospital grade electric double pump) first for about 15 minutes and then hand express and get whatever colostrum you can get out from both sides for about another 10-15 minutes. So all up about 30 minutes, which is about what a newborn feed would last for, 20-40 minutes.

You want to make sure that whatever colostrum you are getting is given to your baby approximately every 3 hours as well. 8 times in 24 hours.

The frequency of pumping is more important than the regularity.

Katie - The reason we say 8 in 24 and not every 3 hours is about the frequency and not the regularity. This allows you some flexibility to express a bit more frequently and then have a 4 hour sleep for example. We know it's exhausting looking after a newborn so get sleep when you can.

Don't sleep longer than 5 hours though, because if you start sleeping all the way through the night and then start pumping out 8 expressions, it doesn't work. Your body needs to be feeding at night.

Using the 8 in 24 rule means that you can have a bit of flexibility with your day and slightly longer sleeps, especially because it's exhausting and after having major surgery like a Caesarean section, it keeps us sane.

Corryn - Wow thank you Katie for all of your tips and insight. Thank you everyone for watching. Make sure you leave a comment down below and don't forget to join our Facebook group so that you can ask any questions or tell us about topics that you would like us to cover.

About the author

Katie James, IBCLC has helped thousands of women through their breastfeeding challenges during those early newborn days. Katie's extensive knowledge and experience, coupled with her down to earth, practical approach is reassuring and empowering for new mums.  Find out more about Katie here.