How to establish lactation after cesarean section: tips and secrets. Feeding an infant born by caesarean section Lactation after a planned caesarean section

Establishing breastfeeding after a caesarean section seems like a daunting task. But only for that mother who does not know anything about the physiology of lactation and is not in the mood for breastfeeding.

In this article, we analyze in detail why milk after cesarean comes with a delay. How to stimulate lactation after surgical delivery.

After natural childbirth, milk comes in 3-4 days. With caesarean section - 7-9 days after the operation. Generic activity and lactation are closely interconnected. Hormones that are produced during natural childbirth trigger the mechanism of lactation. During uterine contractions, oxytocin is released into the blood in pulsating rhythms. It continues to stand out during feeding. In operative labor, there are no contractions and the release of oxytocin slows down. It takes more time and effort for the body to start the process of lactation after a cesarean section.

Oxytocin is released during contractions and stimulates lactation.

Milk most often comes with a delay after a planned caesarean section. The baby's body is ready for birth at 38-39 weeks of gestation. Doctors see no reason to wait for the onset of labor and perform a caesarean section at this time. In this case, the woman's hormonal system does not yet have time to tune in to lactation. From this point of view, the operation to extract the child, which is carried out with the onset of labor, is the most successful scenario.

Of those breastfeeding after a cesarean, 71% had an epidural and 39% were operated on under general anesthesia. The type of anesthesia used also affects the timing of the arrival of milk. And there is some logic in this. With epidural anesthesia, the woman is conscious, recovers faster, she is allowed to attach the baby to the breast immediately after childbirth. After general anesthesia, the newborn is brought to the mother only a day or later. The earlier the baby was put to the breast, preferably immediately after extraction, the faster the lactation hormones will begin to be produced.

Reasons for delayed lactation:

• The baby was not put to the breast immediately after birth.
• Conducting antibiotic therapy after cesarean, and a ban on feeding.
• Planned caesarean without waiting for the onset of labor.

In general, it is not so important what kind of anesthesia was used during the operation. Much more important is the planned caesarean or emergency was carried out, and how soon the baby was put to the chest.

First breastfeeding immediately after childbirth is important

Attaching a newborn to the breast immediately after delivery is essential for successful breastfeeding. When a baby suckles, the mother's brain receives a signal that milk is needed, and lactation hormones trigger the lactation mechanism. In addition, the child gets acquainted with the microflora of the mother, and this is a strong incentive for the development of strong immunity.

If the operation was performed under general anesthesia, then the mother gets to know the child when she regains consciousness. It is good if the baby is attached to the breast in the first 6 hours after birth, when the baby has a strong sucking activity. The mother can ask the medical staff to bring the baby to intensive care and help attach to the breast.

If there is not enough milk

In the first days after childbirth, both natural and operational, colostrum is released. It is the precursor of mature milk, which contains a lot of protein and immunoglobulins. A very small amount of this nutrient fluid is enough for the crumbs in the first days after birth. But it is not always possible after a cesarean from the first days to be close to the baby and breastfeed him.

In this case, the main task of the mother is to support lactation. While in intensive care, you need to gently pump every 2 hours for 5 minutes on each breast. Stimulation of the nipple will trigger the release of hormones and milk production. How to express breast milk with your hands. You should not pay attention to the fact that little or no milk is secreted. It doesn't matter now. The key is stimulation.

Antibiotics given routinely after surgery are compatible with breastfeeding. In case of complications after childbirth and special antibiotic therapy, breastfeeding is not allowed. But at the same time, we continue to express the breast to maintain lactation.

How to improve lactation after cesarean

After the child is finally with his mother, you need to teach him how to take the breast correctly. Read how to properly attach a baby to the breast. Perhaps there will be problems, because he most likely received supplementary feeding and may refuse to suckle. But here the mother's mood for feeding, her patience and perseverance play a decisive role.

Children after caesarean section are usually lethargic, suck little, sleep a lot. But the rule is still the same: we apply it on the first search movement and gently wake it up every hour and a half so that we suck at least in a dream.

After a caesarean section, it is especially important to choose a comfortable and correct position for feeding. Such that there is no pressure on the abdomen. The best position is from under the arm.

Under arm feeding position

Breastfeeding after CS is possible, and even more preferable for the baby and mother than artificial. For mom, this is a way to get out of a stressful state after the lack of natural childbirth. For a child, there is nothing more important than contact with her mother's breast milk.

Even if the newborn was supplemented with formula in the early days, he can still be taught to extract milk from the breast. The main thing is the perseverance and determination of the mother.

The first weeks after childbirth are filled with worries and problems for a woman, and with a caesarean section, they are aggravated by postoperative pain and movement restrictions. In this case, it is important to strike a balance between the needs of the child and the desire of the mother to quickly regain their former beauty and good physical shape.

Can I breastfeed after a caesarean?

There are no restrictions on breastfeeding after a caesarean section. If the operation took place without complications and with standard medicines, then the child can be applied immediately after the woman recovers from anesthesia. International standards recommend doing this as early as one hour after surgery.

If the birth was preceded by natural labor pains, then milk should begin to appear within a few hours after the birth. In this case, next to the woman in labor should be a close person who will help in the process of feeding. Attachment to the chest must be carried out at least 8-10 times a day until its stable production by the mammary glands.

If the cesarean was planned, and it was not preceded by prenatal contractions, then milk begins to be produced 3-7 days after the operation. In such cases, feeding with artificial mixtures cannot be avoided. But even with a temporary lack of milk, the baby must be constantly applied to the breast. This will stimulate lactation and develop the correct reflexes in the baby.

Hello! I'm going to be caesarean with an epidural. How long after a caesarean can you breastfeed your baby? Will it be affected by the drugs that I have in my blood? Larisa, 24 years old.

Good afternoon Larisa! You can feed your baby one hour after birth, if your condition and baby allow it. Children often fall asleep after a caesarean, so the first time you can put the baby to the breast after sleep. If you drink painkillers, then ask your doctor about the feeding regimen.

Postures for feeding newborns with breast milk after cesarean

The soreness of the postoperative suture and the need to provide it with conditions for fusion limits the list of convenient positions for feeding the baby. Although a woman is allowed to sit down immediately after the operation.

The main acceptable postures are:

1. Lying on my side. Suitable for the first hours after surgery. The woman lies on her side, her legs are pulled up, a small roller is placed under her back, and a pillow is placed under her head. The child lies along the woman's head on the lower elbow or on the bed. Mom's belly with a seam can be additionally protected with something soft. It is possible to place the child with their feet to the female head.
2. "From under the hand." The woman sits in a comfortable, relaxed position, fully leaning on her back. 1-2 pillows are placed on the side, on which the child is laid horizontally. His body should be on the side of his mother, his head peeking out from under his arm, and his legs slightly behind the woman's back.
3. Cradle. This is the classic sitting position with the baby horizontally along the female breast. To reduce the load on the seam, the baby is placed on pillows in front of the mother, and his head is placed on the elbow near the nipple. The woman's hand should be as relaxed as possible.
4. "Over shoulder". This position requires external assistance and is indicated from the first hours after the operation. First, the woman lies down and puts her head on a low pillow. The assistant then positions the baby so that his stomach rests on his mother's shoulder, and his head is located above her chest.

The choice of a particular position is influenced by the woman's complexion, the shape of her breasts, the placement of the nipple and the availability of the necessary furniture and pillows. Therefore, it is advisable to try all the options and choose the position that will be most comfortable for both the baby and the mother.

Good day! Tell me, doctor, how to feed a child after a cesarean section in the first hours of life? An operation is coming soon, I want to prepare for it in order to know by the hour and by day how to behave. Natalia, 20 years old.

Good day, Natalia! If you have someone to help, then you can use the “Over the shoulder” position for feeding. In other positions, you will simply be in a lot of pain or there may be unnecessary stress on the seam. Although it all depends on the desire of others to help the child find the breast in your supine position).

Nutrition after caesarean section for a nursing mother

The nutrition of a woman after a caesarean section has significant features only for the first three days. After that, nutrition should become complete in order to ensure sufficient milk production and normal tissue repair after surgery.

On the first day after a caesarean section, you can not eat. It is allowed to drink non-carbonated water, mineral water or fruit juices diluted 3-4 times. Due to the abuse of drinking, the chest may become very engorged and the swelling of the postoperative suture may increase.

Be sure to stimulate the intestines so that the woman does not have to push when going to the toilet. To do this, injections of Prozerin are given, and after half an hour - an enema. Also, stimulating the intestines prevents the formation of adhesions.

Good day! And what can you eat after a cesarean section for a nursing mother in the first days and in the first week? And then you need to tell relatives what to bring to the hospital) Alina, 21 years old.

Good afternoon, Alina! On the first day, you can only drink still water or diluted juices. You can read about the set of products on the second and third days in the above article. From the fourth day, a woman can begin to eat the usual food recommended for nursing mothers. However, in the first month, nutrition should still be gentle on the gastrointestinal tract.

From the second day, the use of unleavened broths, yogurts, vegetable and chicken purees is allowed. You can drink tea, various compotes, juices, fruit drinks. Appropriate baby food is allowed. Food should be divided into 7-8 meals so as not to burden the stomach.

From the third day, a woman can eat steam cutlets on dietary meat, light soups, yogurts, cereals, baked fruits and boiled vegetables. You can drink almost everything that is allowed for any nursing mother.

What can a nursing mother eat in the first month after a cesarean?

When, after a caesarean operation, the mother and child safely return home, the main thing is not to be tempted by the usual homemade food. In the first month, a nursing woman should monitor her diet and eat only recommended food. These include:

1. Milk, low-fat cheese, kefir, cottage cheese, butter.
2. Vegetables, except strongly aromatic and legumes.
3. Lean meats.
4. Soft fruits, excluding citrus fruits.
5. Vegetable oil.
6. Eggs.
7. Porridge, soup.

These products will not lead to a deterioration in the taste of milk and will ensure the content of all necessary substances in it. The following foods should be avoided:

1. Natural honey.
2. Canned food.
3. Mayonnaise and other store-bought sauces.
4. Marinades and salinity.
5. Sausages and sausages.
6. Fried, smoked, spicy.
7. Chocolate.

The above lists only those products that are undesirable for use by a nursing mother in the first month after a cesarean section. After this period, you can introduce such food into the diet in reasonable quantities. In addition to these products, there is a general list of foods that are not recommended for consumption during lactation.

Hello! My name is Taisiya, 28 years old, two months after cesarean. I want to clean my stomach and improve digestion a little, because after giving birth I sometimes have constipation, I have to drink a laxative. Can I find out when it is possible to download the press after a cesarean section for a nursing mother?

Good afternoon, Tatiana! You can actively download the press no earlier than 4-6 months after childbirth. You should start with gymnastics with minimal amplitudes and efforts. Preliminarily, it is desirable to go to the surgeon and for an ultrasound scan to confirm the good condition of the sutures.

Not enough milk in a nursing mother after cesarean - what to do?

Lucky moms who have no problems with lactation after cesarean. But what to do if the breast does not fill either on the 1st or 3rd day after the operation? Doctors recommend not to wait for problems and start stimulating milk production in the very first hours after childbirth.

For this, the following methods are used:

1. Every hour, and also after waking up the baby, apply it to the nipple for 1-2 minutes. Even the negative reaction of the child to the lack of milk will be a good incentive to increase its production.
2. Try to pump several times a day. This will irritate the peripapillary receptors and create an imitation of sucking. You can also use a breast pump for this purpose.
3. Spend as much time as possible with your child. It is desirable that his lips touch the mammary gland more often.
4. Drink more fluids, including milk, but only 3-4 days after giving birth.
5. Massage the nipples several times a day. This should be done gently, without strong pressure.

If a week after the birth there are no signs of active lactation, then this is a reason to contact the antenatal clinic or to specialist volunteers for breastfeeding.

Good day! A month has passed since the operation, everything is fine, but the doctors forbid bathing in the bathroom. Can you tell me when it is possible to take a bath after a caesarean section for a nursing mother? Polina, 18 years old.

Good afternoon Polina! After a caesarean section, it is recommended to take a full bath no earlier than 8 weeks after the operation. Before that, it is quite possible to manage with an ordinary shower.

When can I play sports after a cesarean section for a nursing mother?

Women after caesarean just can not play sports. Most physical exercises are accompanied by tension in the abdominal muscles, which in the postoperative period leads to severe pain and the likelihood of suture divergence. Therefore, sports exercises after cesarean should not be practiced for at least 2 months.

It is necessary to start physical activity with light gymnastics, yoga, Pilates, carefully monitoring the sensations in the lower abdomen and regularly examining the surgical suture. The first lessons should not last more than 10 minutes. If there are no negative consequences from the loads, menstruation does not come, then you can increase their duration and intensity.

Going to the gym for full-fledged training is allowed only after examination by a surgeon. Usually, active loads on the abdominal muscles are allowed no earlier than six months after the operation.

Good evening! And when can you twist the hoop after a cesarean section for a nursing mother? I would like to take care of myself, but I'm afraid. The child is already three months old. Valentina, 32 years old.

Good afternoon, Valentina! I would not advise starting physical activity with a hoop. 8 weeks after giving birth, you can do gymnastics, making circular movements of the entire torso and hips. Only after a few days, in the absence of pain and discomfort, you can proceed to use the hoop. But the movements should be as smooth as possible.

Sports activities after caesarean section have a lot of positive aspects:

1. Reduced back pain from carrying a child.
2. The muscles of the uterus are strengthened, reducing the risk of problems in subsequent births.
3. The breast is tightened, reducing its sagging after the cessation of lactation.
4. The stomach is decreasing.
5. The fusion of the abdominal muscles is stimulated.
6. The effects of adhesions are reduced.

How to lose weight after cesarean for a nursing mother?

With HB, any diet that limits the intake of a sufficient amount of nutrients is contraindicated. But there are other ways to lose weight after childbirth.

These include:

1. Regular sports and gymnastics, starting from the third month after childbirth.
2. Feeding the baby on demand. With milk, the female body will give up all the extra calories that it contains.
3. Contrast showers, anti-cellulite massage and other slimming physiotherapy.
4. Eating fresh vegetables, which will delay the onset of hunger after the next meal.
5. Meals in small portions 5-6 times a day, so as not to fill up at night after daytime worries.

In addition to these methods, emotional unloading contributes to weight loss. To relax and gain strength, you can practice yoga, meditation or visit the nursing club.

When can I have an intimate life after a cesarean section for a nursing mother?

Intimate life is an excellent psychological release, so many couples seek to return to it as quickly as possible after the birth of a child. During childbirth by caesarean section, the vagina is not injured, so there are no contraindications to sex from this organ.

To start an intimate life after pregnancy, lochia must at least end, and this happens 4-8 weeks after childbirth. The end of this process means that the uterine mucosa has restored its structure, and its internal suture has grown together normally. Before the first sex, it is advisable to do an ultrasound, especially if sexual intercourse is planned for 4-5 weeks after the birth of the baby.

Sex should bring joy to both partners, so the second important factor in the beginning of an intimate life is the absence of pain in women during intimacy. In addition, the posture should be as safe as possible in terms of injury to the postoperative suture.

Thus, breastfeeding after caesarean is associated with certain difficulties. However, the help of relatives, self-education and a loving attitude towards the child can smooth them out and help to survive this difficult period without any problems.

Hello! Two weeks after giving birth, I do not go to the toilet normally, regular constipation. Can you tell me how to fix a chair after a cesarean section for a nursing mother? Before pregnancy, there were no problems with this. Diana, 30 years old.

Good afternoon Diana! An important factor for the normalization of stool after cesarean is proper nutrition with a lot of fiber and the use of the amount of water required by the body. Problems with the stool can be observed up to 4-6 weeks. Symptomatic treatment in the form of laxatives for nursing mothers can only be prescribed by a doctor, so be sure to consult a doctor.

You can ask your question to our author:

The operation of caesarean section causes expectant mothers a lot of anxiety for their own health and the health of the baby. The main concerns are related to breastfeeding, because it is widely believed that it is extremely difficult to establish lactation after surgery. The first attachment to the breast and the arrival of milk in such a situation have their own characteristics. The task of a young mother is to take them into account, follow the recommendations of doctors, and then the result will be successful.

The nuances of breastfeeding after caesarean section

The amount of milk a woman has directly depends on how often the baby is applied to the breast and how early the first feeding took place. According to the World Health Organization, sufficient sucking activity in a newborn should develop within 6 hours after birth. It is important to consider this time interval for successful feeding. With a caesarean section, the first application is optimal an hour after the operation: a baby who has not passed through the natural birth canal takes more time to adapt and activate the sucking urge. To produce milk, regardless of how actively the child sucks, it is applied at each request until the reflex reaches the desired intensity.

With a caesarean section, there are additional factors that affect the first attachment of the baby to the breast:

• The type of anesthesia used. With epidural anesthesia, the woman in labor remains conscious, drugs are injected into the cerebrospinal fluid and relieve sensitivity only from the lower body. After removing the baby, it is immediately placed on the mother's chest, this allows you to achieve the same result as with natural childbirth. With general anesthesia, more time passes before the first application - you need to wait until the mother comes out of anesthesia.
• Special postures for feeding. Given the presence of a postoperative suture and drainage, you need to feed in positions that exclude pressure on the stomach - from under the arm, on the side.
• Stay in one room. It is necessary that the child be with the mother, as soon as she is strong enough - then she can often apply it to the breast. If the woman in labor is in intensive care, then early first feeding is impossible. In this case, it is important to organize it as soon as possible, to avoid bottle supplementing and to ensure regular pumping of the breast to stimulate the flow of milk.
• Taking antibiotic drugs. If complications arise during the operation, the woman in labor may be prescribed antibiotics that exclude breastfeeding. In this case, it is important to follow two rules: regular pumping and feeding the baby with mixtures from a spoon, and not from a bottle. The first application occurs after the complete release of the drug from the woman's body.

Photo gallery: acceptable positions for breastfeeding after caesarean section

The position from under the arm requires placing a pillow under the baby when feeding to eliminate tension in the abdomen after a cesarean section Attaching the baby to the breast in the supine position is comfortable for the mother after the operation The position when feeding over the shoulder allows you to completely eliminate the effect of the baby on the stomach

Causes of lack of milk after surgery

Lack of breast milk, as evidenced by the crying of the child after feeding, refusal to sleep and rare urination, occurs due to various reasons:

• complications after the operation, an infectious disease of a young mother;
• malnutrition, disturbed drinking regimen - often the cause of a small amount of milk is a lack of fluid and nutrients in the diet of the woman herself;
• taking prescribed medications - after a cesarean section, you can’t do without drugs, they are necessary to prevent complications and speedy recovery of the woman in labor;
• psychological trauma resulting from a caesarean section;
• decrease in lactation due to the fact that the mother did not decant, being separate from the child;
• refusal of frequent feeding due to pain in the suture area.

In the establishment of lactation, not only the correct behavior after the operation, but also the tactics chosen by the doctor for its implementation play an important role. The optimal solution is considered to be a planned caesarean section after the onset of contractions - in this case, the woman's body produces hormones responsible for contractions, and the flow of milk is significantly accelerated. If the date is set in advance and the operation is not preceded by the natural onset of labor, the process may be delayed.

Video: obstetrician about breastfeeding after cesarean section

Methods of stimulation of lactation in the postoperative period

When the first attachment to the breast was successful, and the baby has already learned to actively suck, it is important for the mother to stimulate lactation so that the baby has enough milk. This requires proper diet and breast care.

Power correction

The amount of milk for a nursing mother will help to increase:

• hot broths and soups from lean meat and fish - they must be added to the daily diet;
• buckwheat and oatmeal in water or milk;
• fresh vegetables and fruits (carrots, radishes, pumpkins, onions, figs, prunes, apples, etc.), as well as juices from them;
• fermented milk drinks;
• rosehip broth, hot tea with sugar;
• greens (as an additive to dishes): cumin, dill, anise, lettuce.

Photo gallery: products that help produce milk

Oatmeal and buckwheat contain complex carbohydrates Vegetables are rich in vitamins and minerals Dairy products are rich in calcium and will ensure good digestion. Rosehip decoction has a lactogenic effect Light soups and broths stimulate lactation

For effective breastfeeding, an additional 500 kcal per day is required. It is necessary to get them at the expense of low-fat protein products (meat, cottage cheese, cheese, kefir, etc.), vegetables and fruits, and not bakery products and sweets.

It is important to remember about products that interfere with the abundant production of milk - they should be completely abandoned. Prohibited foods include canned food, smoked meats, spicy dishes and spices, parsley, mint and sage.

breast massage

A gentle massage of the glands before the next feeding or pumping into a bottle will help improve the production and outflow of milk from the breast. It should be done gently and carefully, 5-10 minutes twice a day.

• Moving from above, make circular movements with your fingers with moderate pressure. In one zone, fix for a few seconds, then move lower to the nipple. It is important to carefully work out each zone.
• Stroke the breast from top to bottom, towards the nipple.
• Leaning forward slightly, gently shake your chest.
• Pinch the nipple between the thumb and forefinger and stimulate it with light movements.

After the massage, a warm shower is useful with the direction of a jet of water in turn on each of the mammary glands.

Breast massage before feeding will facilitate the flow and improve milk production

Massage should not tire or bring discomfort.

Video: how to establish breastfeeding after cesarean section

The formation of lactation after caesarean section has certain difficulties. But it is possible to overcome them. Believe in yourself, put the baby to the breast more often, follow the recommendations of the doctors, and everything will definitely work out.

Every mom who knows what she has to do begins to worry about the subsequent breastfeeding of her baby. The stereotype about the impossibility of establishing it properly is based on the fact that milk does not come at all or there is very little of it.

In this case, lactation has its own characteristics. But if a pregnant woman learns all the necessary information in advance, then in the postpartum period it will be easier for her, and most importantly, calmer. After all, success does not depend on the method of childbirth, but on the desire of the mother to breastfeed the baby. And now in more detail.

Apply to the chest as soon as possible!

Contrary to popular myth, it is quite possible to breastfeed a baby after a caesarean section. There are chances of the first feeding even in the operating room if the operation was performed under local anesthesia. With such feeding, you will have to wait in a situation where a caesarean section was done under general anesthesia, and also when the baby requires medical care.

In any case, try to pick up your child from the children's ward as soon as you return to normal. After all, some factors can make it difficult to attach a baby to the breast, for example, ordinary fear can become the cause of the first unsuccessful feedings.

Feed even sleepy

Sometimes milk may appear only on the 5-9th day due to the use of general anesthesia. That is, you just have to make a little more effort in establishing the process of breastfeeding than women who gave birth themselves. And this is where some tips come in handy.

• Ask your doctor for help if you are not allowed to feed your baby in the postpartum ward. It must be brought to you.
• Often, after cesarean, medications are used that are absolutely normal combined with breastfeeding. Ask a doctor about it. Write down the names of the drugs.
• Sometimes during the time intended for feeding, the baby will sleep. Wake up the baby. Start feeding. After all, the production of milk depends on your confidence in the possibility of feeding and on his sucking activity. Therefore, whenever they bring it to you, apply it to your chest. Newborns can suckle while half asleep.
• Patience! After a difficult birth, the child may very slowly bounce back. If you are taking sedatives, the baby will be sluggish at the breast for several days. Don't worry! The need for food in the baby is small. He needs, above all, love and affection. Therefore, hold the child close to you, say kind words - and the baby will recognize your heartbeat.
• Do not feed your baby glucose water or weak tea, as is sometimes done to soothe him. This will reduce appetite - and the baby will not suck milk. In addition, the child will get used to the method of feeding from the nipple, will begin to suckle sluggishly at the breast and, as a result, may refuse breastfeeding altogether.
• Feeding your baby more frequently is one way to adapt to breastfeeding after a caesarean section. After all, the mechanism of lactation is simple: the more and more often the child sucks, the more milk is released. Feeding, as before, every 3 hours is a thing of the past.

About supplementary feeding

If your child is still losing weight, do not rush to supplement him. Weight loss is characteristic of all newborns, regardless of the method of birth. The need for supplementary feeding is determined depending on the number of urination per day. So, in the first 3 days there can be 2 of them, from 3 to 6 days - 4, then 6, 10. If there is a discrepancy with such standards, then supplementary feeding should be given.

Premature and weakened babies are supplemented even with expressed milk. And you do not need to limit the child in sucking! The baby will be calmer, and mommy's milk will begin to arrive.

After a caesarean section, there are other problems with breastfeeding. They directly depend on the health and condition of the mother. But in most cases, such deviations do not differ from the problems of mothers who have given birth.

Patience and joy to you, moms!

Especially for Elena TOLOCHIK

Is it possible to breastfeed after a caesarean section? How to organize natural feeding when mother and baby are separated? What are the nuances of the formation of lactation? What is important for a mother to know when preparing for surgery? Features of breastfeeding cesareans in the reviews of consultants on breastfeeding.

There is an opinion that it is much more difficult for a woman who has survived a caesarean section to establish natural feeding. This statement contains only a fraction of the truth. “The number of problems that a woman faces after a cesarean is no more than that of a woman who gave birth naturally,” comments Natalia Razakhatskaya, a breastfeeding consultant. “Women who are in intensive care after difficult and long births face similar difficulties.”

It is much more difficult to break social foundations, psychological uncertainty. They are backed by numbers. In 2014, researchers at Peking University conducted a study to find out which mother-baby pairs are most likely to be bottle-fed. A survey of almost half a million women and an analysis of data collected from 1993 to 2006 showed that a planned caesarean section doubled the likelihood of artificial feeding of a child. Whereas after natural childbirth, women decide to feed with a mixture much less often.

The formation of lactation after unnatural childbirth

It has been scientifically proven that the level of milk produced by a woman is affected exclusively by the frequency of applying the baby to the breast. And the sooner the baby is attached to it, the better.

WHO insists on early breastfeeding. According to some data, the first hour of life is optimal, according to others - an interval of half an hour after childbirth. At this time, a child born naturally shows sucking activity. However, things are a little different for Caesars.

Passage through the birth canal forces the child to adapt to new living conditions. Babies born by caesarean are deprived of this opportunity. Their birth causes a "failure" of the genetic program. But the body still adapts quickly enough. Lethargy, the absence of sucking urges, which are observed in cesareans immediately after birth, disappear within one to two hours. Accordingly, for the first time they can be applied to the mother's breast at this time.

“According to international practice, the first application to the breast of children born by caesarean section is carried out an hour after birth,” says Marina Mayorskaya, consultant on breastfeeding. - If the sucking activity of the baby is low or absent, it is necessary to apply it to each urge, "squeak", until he begins to suck actively.

The nuances of the first application to the chest of a cesarean.

• Depends on anesthesia. If sparing epidural anesthesia was used during the operation, it is possible to apply immediately after childbirth. If general anesthesia - you should wait for the end of the anesthetic.
• Six hours are important. As world practice shows, during the first six hours, cesareans begin to show sucking activity. Compliance with this time interval will help the development of lactation.
• Only chest. It is her, and not a pacifier, a pacifier, a bun, that the child should taste for the first time. The use of breast substitutes after birth reduces the chances of full breastfeeding.
• Comfortable postures. The optimal position of feeding from under the arm, which eliminates pressure on the woman's stomach.

In medical facilities that allow women to stay together after caesarean section with children, the percentage of normal lactation formation is high. If the caesarean is planned, try to agree in advance with the medical staff about the possibility of your joint stay with the child in the same room.

Inability to apply early

Unfortunately, the global practice of early caesarean breastfeeding is rarely observed in Russia. Various circumstances contribute to this. The woman and the baby are in different wards, the mother is prescribed antibiotics. Is it possible to breastfeed after caesarean in these situations?

Stay in intensive care

Traditionally, the mother stays in the intensive care unit for one to three days. This excludes the possibility of natural feeding due to the absence of a child nearby. The tactics of a woman's behavior should be as follows.

• Demand to bring the baby to you as soon as possible. The International Convention on the Rights of the Child obliges medical personnel to organize a joint stay of the mother and the newborn, even in the intensive care unit. The exception is situations when a woman or a baby needs to use an artificial respiration apparatus. Demand, negotiate, ask, connect relatives. The sooner the baby is near your breast, the less problems you will have with the organization of breastfeeding.
• Forbid supplementary feeding on the first day.“On the first day after giving birth, a woman produces about ten milliliters of colostrum. In the second - no more than thirty. Of course, colostrum is extremely important for the baby, but its absence does not doom him to the pangs of hunger, says lactation consultant Marina Mayorova. - Significantly more harm will be brought to the child by the introduction of complementary foods from a bottle, which is practiced in our maternity hospitals, than a day without food at all. But it will be impossible to fulfill your demand without the control of one of the relatives.
• Agree on spoon feeding. If the mother is in intensive care for a long time or the doctor insists on supplementary feeding, ask the husband or grandmother to supplement the child with a spoon, syringe without a needle, or a special drinker. The absence of objects that would allow the baby to realize the sucking reflex will help to establish breastfeeding in the future.
• Express yourself. The arrival of breast milk is observed on the third day after childbirth. Caesarean section prolongs the time interval: milk comes on the fourth, fifth, even ninth day. The more actively you organize pumping, the sooner you can start breastfeeding. Express your breasts with your hands or with a breast pump every two hours for ten minutes. From midnight to six in the morning, take a break for sleep. Even if there is little or nothing coming out of your breast when you express, keep doing it. Your task now is not to express milk as much as possible, but to give your body a signal that it is already needed.

With the observance of this tactic of actions, the correct formation of lactation is ensured.

Taking antibiotics

Prescribing antibiotics after caesarean is a standard procedure. It is designed to protect a woman from complications. If there were no difficulties during the operations, the mother may be prescribed antibiotics compatible with breastfeeding.

There is no need to be afraid to breastfeed if you are prescribed drugs of acceptable groups (check with your doctor). Their secretion into breast milk is either completely absent or so minimal that they are not able to cause any harm to the baby.

If the mother is prescribed antibiotics that prevent breastfeeding, the tactics of action should be almost the same as with a separate stay.

• Introduce supplements from a spoon. Typically, the timing of antibiotics is 5-7 days. During this time, the baby will be formula fed. If the baby is in the same room as you, you can feed him with a spoon or syringe yourself.
• Express yourself. Use a breast pump or hand expressing technique. This will allow lactation to reach normal levels by the time the baby can be applied to the breast. And the problem of what to eat for a baby when lactation after a cesarean section has not been established will not affect you.

Clinical breast pumps are commonly used in maternity hospitals. These are powerful, effective devices that make it much easier for an inexperienced mother to express. Ask the medical staff to bring the pump to your room.

Lack of milk

When the difficulties of resuscitation are already behind, and the baby is allowed to be applied to the breast, it may turn out that there is practically no milk in it. This situation is likely even if the woman has been pumping regularly. It is caused by several reasons.

• Pumping is not as productive as breastfeeding. However, it creates the necessary "minimum" stimulation, which triggers the production of milk.
• The arrival of milk is possible within nine days after a caesarean section. A mother's small amount of natural food does not necessarily require temporary supplementation.

“According to the WHO, La Leche League organization, the introduction of supplementary feeding should be carried out, depending on the condition of the child,” says lactation consultant Marina Mayorova. “The wet diaper test can tell if a baby needs extra food.”

In the first day after birth, the child should write only twice. Over the next two days, the number of urination will be the same. From the third day of life, urination should be at least four, and the sixth - at least six. This means that the child does not need supplementary feeding. And while maintaining urination at the indicated level, it can exist without additional food, except for mother's milk in a minimum amount, up to ten days.

Supplementation is necessary in the following situations.

• The baby was born premature. Such crumbs also have a sucking reflex, but often they are too weak to suck milk from the breast in sufficient volume. It is ideal to supplement with your own milk, which will require regular pumping.
• Your baby is missing your milk. If the “wet diaper” test showed insufficient food for the baby, it is necessary to introduce supplementary feeding. A child who does not receive nutrition in the right amount is weakened, exhausted, nervous under the breast, which prevents him from eating and stimulating lactation.

The introduction of supplementary feeding requires the mother to follow several rules.

• The way is important. Even if in the maternity hospital the baby was fed from a bottle, being at home or with the baby in the same room, use only a spoon, pipette, syringe.
• The sequence is important. Give supplements only after the baby is attached to the breast. Finish feeding with one more application.
• Volume matters. Regardless of how much milk your mammary glands produce, the amount of supplementary food should not exceed thirty milliliters per feeding during the first ten days of the baby's life.
• The transition to natural feeding is important. Do a wet diaper test every three days. If there is more urination, reduce the amount of formula in the supplement. Once your milk supply is sufficient, artificial formulas should be discarded entirely.

“The baby was bottle-trained, and now he doesn’t want to take the breast at all” - young mothers often turn to breastfeeding consultants with such a problem. But even if the first subject that the baby met after birth was the nipple, it is possible to restore lactation in full and transfer it to natural feeding! Use a relactation technique that requires immediate nipple rejection and frequent attachment of the baby to the breast.

The question of how to establish breastfeeding after a cesarean section is fraught with many nuances. But according to lactation consultants, it is not as difficult as it is commonly believed. The correct sequence of actions of the mother will allow to establish lactation at the required level already on the fifth or seventh day after childbirth. And with the early introduction of supplementary feeding - within two weeks.

Print