World Breastfeeding Week: Making it work after a cesarean birth

Every year, I celebrate World Breastfeeding Week by blogging about breastfeeding throughout the week of August 1-7. I enjoy sharing about my nursing struggles and successes, with the hope of encouraging other moms. It's a fun week on my blog, with lots of comments and often personal emails and Facebook messages, as friends, acquaintances, and strangers ask nursing questions or share their struggles too.

This year, I have celebrated WBW in the best way possible, by nursing my brand new baby boy, who was born on the first day of WBW 2012.

As I blog, my baby rests in my chest, kangaroo style, snoozing soundly as I alternate between mobile blogging and watching the Olympics, with my giant cup of water sitting beside me. Alexandre's belly is full of milk, so he's in that deep newborn sleep. But like almost any nursing situation, this could've been a far different story.

Like some of your babies, my children have all been cesarean births. I love the idea of natural labor and childbirth, and all the positive implications it has on breastfeeding, but that's just not how it worked out for my babies.

Surgical births present many challenges to breastfeeding. Specifically, both mom & baby are medicated, leaving little room for those wonderful, God-given instincts and hormones to function as they should. My latest delivery left us with even more challenges than usual. They were not huge, they were not insurmountable. But as I laid on the operating table after delivering my son, waiting for the doctor to finish surgery, I silently prayed for breastfeeding to work out once again. I asked God to provide strength where I had none. And once again, He did.

That morning, my husband and I arrived at the hospital, excited about our son and ready to be prepped for surgery.  The nurse tried to start an IV in my arm but couldn't get the needle into my vein, so she had to move it into my hand.  Somewhere in there, I passed out for a few seconds and then woke up vomiting.  It was a rough morning and this was only the beginning.

I met with the anesthetist and explained to her about vomiting during the c-section for my second baby, Andrew.  She said she would do anything she could to prevent it from happening again, but it might just be the way my body responds to a drop in blood pressure. Sure enough, after she administered the spinal block, I began vomiting.  I vomited several times before, during, and after the c-section.  It was a miserable experience.  By the time my son was born, I was completely exhausted from all that we'd gone through, and I was also very weak.  I wasn't sure how I would hold my son, much less nurse him. 

That first nursing session with a baby is incredibly important.  It forms a sort of imprint on the baby's mind of how nursing is supposed to happen.  This is also when a baby will be most alert and ready to nurse.  Later, the baby will be very exhausted and sleepy, so this is the best time to establish nursing.  In fact, my first time to nurse my first child did not go well, and it took two weeks and lots of hard work and tears to undo all that had been done that first hour after she was born.  When my second child was born, I wanted to avoid all of those problems, but I felt that as an experienced nursing mom, I was competant enough to address any issues that might arise.  If I couldn't handle something, I was going to demand good help or ask that my mom be permitted to come in and help me get nursing off to a good start.  Fortunately, my second baby was a good eater and I knew just what to do, so we had no issues.  But this time, I felt completely helpless.


I was brought to my room for recovery with a very low body temperature (93) and low blood pressure too, which left me very weak.  Mentally, I felt like my IQ had been cut in half, thanks to the morphine.  I was groggy and exhausted.  Shortly after surgery, a happy, smiley nurse walked into my room, pushing a bassinet with my hour-old son.  I had no idea how I was going to hold this little guy and maneuver him into a good nursing position.  I looked at the nurse, who appeared very pleasant and helpful, and I decided just to lay it all out on the table.

"I need to let you know that I'm loopy right now," I told the nurse.  "I'm drained and exhausted.  I'm committed to breastfeeding, but I just don't know how I'm going to do it.  I need some help." 

The nurse grinned and confidently said "Girl, I've got this."  She walked over with Alexandre and latched him on.  Within seconds, he was eating and happy.  I did nothing to help.  I couldn't.  This nurse did all the breastfeeding work for me.  She was completely amazing.

What I didn't know is that my nurse had been hand-picked by a friend of mine who now lives out of town.  She had called her friend, the happy pleasant nurse, and asked her to take care of me.  And she did!  Isn't God wonderful in how creatively He provides?

The next time I had to feed the baby, my husband took care of positioning the baby, something neither of us knew he could do, but he made it look easy.  After that second time, I had enough energy to handle Alexandre, though I still needed my husband to lift the baby for quite a while.      

Our baby will be one week old tomorrow, and he is thriving and doing well.  In fact, so far he seems to be my easiest baby!  He's such a blessing.

Here are my tips for making breastfeeding work after a c-section.  They really apply to any nursing situation, but they're especially helpful to keep in mind after a c-section.

1. Ask for help:  Ask the nurse, ask to see the lactation consultant, ask your husband, ask your mother.  But ask!
2. Room in if you can, don't if you can't:  I know, I know..."Rooming in" (keeping the baby in your room) is the best way to get breastfeeding established.  But what about the mom who just had her tummy cut open?  You need rest!  So if the baby is keeping you from resting with it's little squawks and noises, then let it go to the nursery.  They'll bring him back when he's hungry, or if it's been too long, you can call and ask for him to come back.  We do a combination of rooming in and nursery care.  I try to feed the baby around midnight and then let the baby go back to the nursery for the night, so that I can get some theoretical sleep, which never seems to happen in a hospital.  Don't feel guilty about putting the baby in the nursery.  It's really OK for you to take care of yourself too.
3. Experiment with Positions:  This is true with any situation, but certainly after a c-section.  Play around with different positions until you figure out what your baby likes.  Alexandre, my third baby, is actually my first baby to nurse in the traditional cradle or cross-cradle positions.  With my first baby, I discovered that the clutch (football) hold was the easiest for me, and it's especially easy on your incision.  With my second baby, I also tried the latest buzzword in breastfeeding, biological nurturing, or "laid back breastfeeding."  It worked really great in the hospital bed, since I could recline back and let the baby eat at his leisure.  He wanted to nurse constantly, so he would eat & sleep on me while I dozed in the bed.  Once we were home, we found that the clutch hold was still the best for us.  My breastfeeding books recommend the side-lying position for c-sections, which makes me wonder if any of the authors have even had a c-section.  I don't know about other moms, but it is still quite painful for me to lay on my side, and my surgery was almost a week ago.  But hey, if that's what works for you, go for it.

Having a c-section doesn't mean you can't nurse your baby, but you may have to work a little harder to make it happen.  Like most things in life, the extra effort is completely worth it to give your little one the best start in life.