Cesarean Birth and Lactation

A Cesarean birth should not stop you from breastfeeding or providing your milk to your baby.

As soon as you feel ready, you can put your baby to the breast, hand express, or pump if you are not planning on or able to breastfeed. Ideally, you want to do one of these things within the first 6 hours postpartum to help signal your body to start making milk. If your baby is having health problems, providing your expressed milk for your baby is one of the best things you can do for their health.

• Early feeding at the breast and skin-to-skin contact stimulates the release of oxytocin, which helps the uterus contract down to non-pregnant size and slows postpartum bleeding. Oxytocin is also the hormone that causes milk to let down. Your baby’s suckling signals your body to increase prolactin, which is key in supporting milk production. These hormones work together to create calm and relaxing feelings for you and your baby and help establish milk production.
• If you had spinal or epidural anesthesia during surgery, you should be able to see your baby shortly after they are born. Feel free to ask for skin-to-skin contact with your baby as soon as possible. Immediate skin-to-skin contact may be possible immediately after a cesarean birth right in the operating room – with appropriate safety measures – as long as you and your infant are medically stable. Many parents are ready to hold their baby and start breastfeeding while still in the recovery room.
• If you had general anesthesia, you can breastfeed your baby as soon as you feel awake enough to do so. Once you are awake, the anesthesia medications are very low or gone from your breastmilk. You should have someone assist you in finding a comfortable position, bring the baby to you, and to monitor you to ensure you do not get too sleepy while holding your baby.
• Do not worry if you need assistance in holding your baby after birth. Getting assistance does not detract from the benefits of holding your baby. Your baby will love being close to you. Research has shown that skin-to-skin contact keeps a baby just as warm as being in an isolette or a warming bed. It also helps regulate a baby’s blood sugar and can help to calm both the birthing parent and the baby.
• Once in your postpartum room, you may want to have someone help you position and hold your baby. You just had a baby, and you are recovering from major abdominal surgery. Some people find that the clutch (also known as “football”) hold helps keep the baby’s weight off their incision. Other positions can also work, and pillows can help protect the incision as well. If lactation support from staff isn’t offered, ask for it. This is a new skill for you and your baby. It’s normal to need help and guidance, and this is often even more needed after a cesarean birth.
• During the first 24 hours you will probably have an intravenous line (IV) for pain control. This means that one of your hands will have tubing attached to it. Take your time getting baby situated so that the tubing is not in the way.
• When your baby shows early hunger cues, such as mild squirminess, rooting, or putting their hands to their mouth, have someone (e.g. a nurse, your partner, or a family member) help you position your baby to directly feed. If your baby has not shown hunger cues in 2-3 hours, then have someone help wake the baby for their next feed. Newborns need to eat every 2-3 hours at a minimum, although feeding more frequently is very common and normal. (See our handouts on Latching Well and Positioning).
• Take pain medication if you need it. Pain control is an important part of your healing journey, can help you position yourself and your baby more comfortably, and can help promote milk let-down. The medications typically prescribed for pain after a cesarean birth are safe for your baby, though it is always a good idea to take the lowest effective dose to prevent potential side effects for both you and your baby. You can taper your medications as your pain level decreases. If you have any concerns about the safety of a medication, talk to your physician or healthcare provider.
  • InfantRisk Center is a useful resource with a wealth of information on medication safety during lactation. They are available Monday through Friday 8am-pm CST at 1-806-352-2519.
  • Medication information is also available on-line 24/7 at LACTMED.
• As you recover from surgery, take care of yourself. Rest frequently, eat a balanced diet, and drink fluids to aid in healing.