Every day, around the world, women give birth. Some have vaginal deliveries. Some have cesarean deliveries. Some have medication during labor and delivery, some do not. Some doctors, midwives and nurses are very helpful and supportive of breastfeeding and others know very little about breastfeeding.
As much as you may dream up your perfect birth experience, things don’t always go as planned; which is why it’s wise to understand how labor and delivery can impact breastfeeding.
There are a lot of factors that go into what each mother’s labor and delivery look like. Below is some key information to be aware of as you make choices about your birth plan and navigate breastfeeding your newborn.
Vaginal Delivery
Vaginal deliveries are most conducive to breastfeeding initiation since baby can usually go straight from “in mom” to “on mom” for some uninterrupted skin to skin time. If given some time and opportunity, newborns even have the ability to crawl to the breast and latch on, typically within the first hour after birth. They do this by using the smell of amniotic fluid on their hands to locate the same smell coming from the breast. The darkened nipple and areola, which act as a bullseye, also aid them in finding where to latch on. This is one reason why it is important not to wash or dry baby off when first born so they can use their sense of smell to initiate breastfeeding.
Medication & Other Labor Interventions
Having a medicated delivery has been shown to increase breastfeeding challenges in the beginning. This can mean an extra sleepy baby who doesn’t want to wake up and nurse frequently and/or breast swelling which can make latching difficult in the first few days (check out When your Newborn is too Tired to Breastfeed and What to Expect When Your Milk Comes In for tips on these topics).
Another common challenge with medicated births is inflated birthweight in newborns due to the extra fluids given to mom in labor. This means it can appear that these babies are losing more weight than they actually are, because they are shedding the extra fluids, and can sometimes mean supplements are given unnecessarily. Looking at your baby’s 24 hour weight as a baseline gives a better indication of true weight loss in these instances. You can request a 24 hour weight check in your birth plan if it’s not already common practice with your doctor.
The possible side effects of medicated births can quickly spiral into other challenges if not addressed. This does not mean breastfeeding will not be successful, it just means that birth interventions often lead to the need for breastfeeding interventions, so if this is the path you find yourself on you will be smart to reach out for lactation help soon after delivery to get support in getting off to a great start with breastfeeding. *Note: This in no way is meant to shame mamas who choose or need medications and other labor and delivery interventions, it’s just important to know how those can impact breastfeeding so you can feel more prepared to handle any potential challenges with confidence.
Cesarean Delivery
C-sections have saved the lives of countless mamas and babies. Like any other birth intervention, there are some unique breastfeeding challenges that can result from c-sections that are worth understanding, whether you are planning for a cesarean or find yourself in a situation that requires one.
Below are some common challenges and concerns particularly related to breastfeeding after a c-section.
Anesthesia:
Anesthesia can cause mama and baby to feel sleepy, sluggish and weak. Having little energy physically can make breastfeeding initiation feel a bit more overwhelming for moms, so don’t hesitate to ask for extra support and encouragement from your birth team and give yourself some extra grace and patience; things will get better.
Having a sleepy newborn can mean baby has little interest in nursing in the beginning and/or falls asleep soon into trying to nurse. Take heart, this won’t last forever and you may need to help your baby a little more until they wake-up and start showing hunger cues. Check out our post on Waking a Sleepy Baby to Breastfeed for tips and ideas on what to do if your newborn is too tired to latch.
Skin to Skin:
The benefits of skin to skin right after birth are many, and even if breastfeeding initiation is a bit delayed due to the circumstances of the c-section, talking to your doctor about doing skin to skin with your baby as soon as medically possible will be an important step in getting breastfeeding off to a great start. Doing skin to skin as soon as possible after delivery helps babies regulate their body temperature and blood sugar levels and gives opportunity for them to potentially latch onto the breast. If you are unable to do skin to skin right away, your spouse can do skin to skin until you are able.
Incision:
The incision site from a c-section can be tender and painful and requires careful navigation in terms of breastfeeding positions that don’t interfere with that area.
Managing pain so you can better relax while breastfeeding is key to helping your milk flow easily, since pain and stress can inhibit the hormones that trigger the milk letdown reflex. Talk with your doctor about pain medication that is safe to use while breastfeeding. When in doubt about a medication’s compatibility with nursing, contact the InfantRisk Center for the most up to date research.
Two great breastfeeding positions to try after a c-section include the football hold and the laid back reclining position. Your spouse or birth team can assist in getting baby positioned if you are limited in mobility or feeling tired and weak.
Delays in Colostrum Transitioning to Mature Milk:
What do super sleepy babies, medicated births, and delays in skin to skin time/ breastfeeding initiation all have in common? They all have the potential for delaying the transition of your breastmilk from colostrum, your first milk, to mature milk.
Often referred to as your milk “coming in”, moms typically worry or wonder about when their milk will go from teaspoonfuls to ounces. Mature milk usually comes in by day three or four but sometimes it takes a little longer. This just means it might take more time for baby to start gaining back their birthweight. (All babies lose some weight after birth, this is normal, but more than a 7-10% loss is a concern).
So what can be done to avoid the delay of mature milk coming in?
Get plenty of skin to skin time as soon as possible after birth.
Initiate breastfeeding as soon as possible, and nurse frequently.
If baby is not latching and nursing yet, hand express every 2-3 hours around the clock beginning as soon as possible.
Take care of yourself by eating good nutrition and resting when you are able.
Regardless of the birth you hope for, it’s wise to prepare for a variety of breastfeeding scenarios since birth can be so unpredictable. Almost all moms and babies can go on to have a successful breastfeeding experience with the right knowledge and support. Reaching out to a lactation professional prior to birth and/or soon after delivery can make a big difference in your breastfeeding journey.
Check out When Breastfeeding takes an Unexpected Detour for more on this topic.
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