How To Make Breastfeeding More Manageable For Mother's With C-Section Deliveries

TheHealthSite.com spoke to Dr. Manzer Altamash Shaikh, Consultant Obstetrician, Gynecologist and Fertility Specialist, Masina Hospital, Mumbai, to understand everything about what a new mother who has gone through C-Section should know about breastfeeding.

Breastfeeding is feeding an infant directly from the mother's breast without the use of accessories like bottles, spoons, etc. Breastfeeding is essential to the health of infants and young children. Colostrum is the "perfect food" for newborns. WHO recommends that breastfeeding be initiated within the first one hour of delivery. The mode of delivery influences breastfeeding practices. It may adversely affect breastfeeding initiation, milk supply, continuation, and infant breastfeeding receptivity compared to vaginal deliveries. With the high rate of caesarian section, either planned or emergency due to maternal or fetal indications, it has become a major public health concern. TheHealthSite.com spoke to Dr. Manzer Altamash Shaikh, Consultant Obstetrician, Gynecologist and Fertility Specialist, Masina Hospital, Mumbai, to understand everything about what a new mother who has gone through C-Section should know about breastfeeding.

Benefits of Breastfeeding

Breastfeeding has major health benefits for the mother as well as the baby. In the mother, it prevents uterine bleeding, promotes mother and child bonding, a natural form of family planning, prevents the development of ovarian and breast cancer in the future and most importantly it can be directly given to the baby without any pre-preparation. For the baby, it gives the best possible nutrition, essential for optimal physical, emotional, and mental development protects the baby from colics, asthma, eczema, food, and respiratory allergies.

In our day-to-day experience, most women who deliver by c-section and their relatives had no intention to initiate breastfeeding during the first 24 hours citing various reasons like pain, positioning, etc. These can be broken by providing anticipatory guidance to women planning a c-section and adequate counselling of the relatives. Preparation for breastfeeding and counselling should begin during pregnancy. Pregnant women should be counselled regarding the importance of breastfeeding during the antenatal period regardless of the mode of delivery. Antenatal breast care and motivation are of utmost importance where the attending doctor has a great influence on the expectant mother. The quality of support that a new mother receives post-c-section can help to breastfeed to a great extent.

10 Breastfeeding Policies

It is important to have a 10-point written breastfeeding policy in the hospital to facilitate breastfeeding. Some of the salient features of this include

1. Have a written breastfeeding policy that is routinely communicated to the maternity ward staff.
2. Training the staff in necessary skills for helping mothers with breastfeeding.
3. Inform all pregnant women regarding the benefits of breastfeeding.
4. Helping mothers initiate breastfeeding within half an hour of delivery.
5. Show how to breastfeed and how to maintain lactation.
6. Give newborn infants no food or drink other than breast milk.
7. Do not give pacifiers.
8. Encourage feeding on demand.
9. Practice rooming-in, i.e. allow the mother and the baby to be together 24 hours a day.
10. Establish breastfeeding support groups.

Breastfeeding Positions

Depending on the type of anesthesia that the patient was given, breastfeeding can be initiated. As long as possible promote breastfeeding within half an hour of delivery, by asking a nursing staff to initiate breastfeeding on the operation table itself by helping in positioning the baby. If the patient has been given general anesthesia, breastfeeding can be initiated once it starts wearing off. Whereas if the patient has received spinal or epidural anesthesia, then breastfeeding can be started within the operation theatre itself, or in the recovery room. However, if due to some reason it is not possible for the mother to initiate breastfeeding immediately, practice rooming-in by asking to hold the baby skin to skin with the mother.

It is very important to position the baby. Immediate postoperative period mother may be sedated, ask the nursing staff to help position the baby. Involve the partner or attendant to help position the baby properly to develop a good latch.

Proper positioning of the baby is very important to ensure it is not painful for the mother during the immediate post-op period at the same time it ensures effective suckling and prevents sore nipples and breast engorgement, this includes supporting the whole of baby's body, baby's head, neck and back are at the same level while baby's whole body is facing the mother and baby's abdomen touch mother's abdomen.

Football Hold Position

The most comfortable positions for mothers undergoing c-section are "football hold position" and "side laying position".

Football hold position: The infant is placed under the arm, like holding a football,

• The Baby's body is supported with the forearm and the head is supported with the hand.
• But many mothers may not be comfortable with this position.

Side-Lying Position

Side-lying position: the mother lies on her side, propping up her head and shoulder with a pillow.

• The infant is also lying down facing the mother,
• This is a traditional position and many mothers are comfortable in this position.
• These positions ensure that there is no direct pressure on the suture line in the immediate post-operative period.
• Once the pain is less and the mother is able to sit, she can use a lactation pillow to raise the baby to the level of the breast so that it's easier to breastfeed.

It's very important that the patient is getting adequate pain relief so that she is comfortable while breastfeeding and the operation site pain is not the reason to dissuade her from feeding. Emotional and physical exhaustion after a c-section may add obstacles to feeding hence emotional help by counselling, adequate rest, hydration and a nutritious diet can make this journey pleasurable.

On a positive note caesarian delivery ensures that the patient will be in the hospital for a longer duration so ensure that you get help from the nursing staff and lactation consultant to learn about the aforementioned finer nuances of breastfeeding.

So, to conclude promotion of mother-friendly policies by institutions implemented in a baby-friendly manner is important. Knowledge of breastfeeding practices and motivation are significant factors in successful feeding after a c-section. It is essential to initiate early breastfeeding while practicing rooming-in, additional supportive care should be made available to the breastfeeding mothers in the first 24 hours as well as early post-delivery period. Therefore, even though caesarian delivery adds obstacles to effective breastfeeding, hold on getting help, and continue feeding.