Newborn after cesarean: features of care and feeding of the baby in the first days

When pregnant women are told about the need for surgical birth, patients usually begin to worry about breastfeeding.

This is not surprising, mothers are convinced that lactation after a cesarean section is inevitably associated with many difficulties, milk is produced in insufficient quantities, and the mother is unable to breastfeed the baby on the first day; she is in the intensive care unit. To avoid serious difficulties, mommy needs to take care in advance about proper feeding.

Experts say that even adoptive mothers, when adopting a baby, can begin to lactate, so milk can be produced in any woman in labor. The main thing is to correctly approach the issues of breastfeeding after cesarean section.

After surgical delivery you need time to recover

About the main reasons

Caesarean section literally 20 years ago was practically unstudied and shrouded in a lot of speculation. Fortunately for modern mothers, today this operation is no longer scary because of the frightening unknown. And if problems arise with lactation, a huge number of measures have been invented so that the mother can quickly establish lactation. To begin with, we propose to understand the causes of possible difficulties.

• It is known that the hormone oxytocin is responsible for the formation of breast milk. There should be no problems if the caesarean section began after contractions: in this case, milk may appear after childbirth. But it is possible that a planned operation cannot be rescheduled. Then milk is also formed, but with a delay of 4-10 days.
• Today it is no secret to anyone that it is advisable to put the baby to the breast as soon as possible after birth. But when a woman is given general anesthesia, a later introduction of the newborn to the mother is inevitable. This can threaten to disrupt the natural “mother + child” connection and mislead the baby.
• Nature has provided the only way of delivery, and it is logical that a caesarean section violates this natural law. If a baby comes into our world in a way not intended by nature, this often guarantees a disruption in the production of essential hormones and proteins. Consequently, the child is confused, and his reflexes (primarily sucking) may be impaired.
• The situation can be aggravated by medications, which cannot be avoided during surgery. Anesthesia drugs used for caesarean sections can change the taste of milk: and not every baby will like such a treat. Sometimes after surgery, the mother is prescribed the necessary course of antibiotics, which can make lactation difficult or even be incompatible with it.
• While a woman is waiting for breast milk to appear or is recovering from a cesarean section, her baby cannot remain hungry and is being fed additionally. In almost all maternity hospitals, the traditional trend of using nipples and bottles continues, which, in turn, can become addictive and subsequently make it difficult for a newborn to feed breast milk.
• Sometimes a woman after a cesarean section is faced with an insufficient amount of milk, which is also an undesirable obstacle to breastfeeding. It can be caused by complications after surgery, poor diet, stress, or taking certain medications.

If you are faced with one or more of the listed reasons, then the main recommendation for you is to avoid stress. It has long been proven that breastfeeding “comes from the head” and if a woman is determined to do it, then oxytocin will be produced and everything will return to normal.

Possible difficulties with lactation after cesarean section

The process of normalizing lactation depends on the complexity of the condition, the correctness of the operation, the condition of the mother and baby, and the first attachment.

A woman in labor may experience pain after surgery. The mammary glands may be painful. At first, a young mother needs outside help. A woman needs to find optimal feeding positions that allow the sutures to fully tighten.

Babies born through surgery are more lethargic. The natural process of birth did not force their body to respond to changed conditions.

Every mother wants to give her baby the best. Mother's milk is a priceless gift. You need to work hard to establish breastfeeding. The full development of the baby depends on the perseverance of the young mother. The support of loved ones is of particular importance during this period. Warmth, attention, and joint efforts will allow your baby to receive the most important nutrition for its full development.

When the operation is planned

If you have been informed that a caesarean section will be a planned operation, then it is important to discuss all the details with the maternity hospital staff before surgery.

It may be possible to start a cesarean section after labor, and for the baby this option will be the most optimal: he will be ready for birth on a hormonal background. Discuss with your doctor whether this plan of action is appropriate for your specific situation. If yes, then great, if not, then don’t insist - doctors still know better.

The attachment of a newborn to the mother's breast should occur in the first minutes of the baby's life. Moreover, the nature of the caesarean section does not matter for this - it can be either emergency or planned. Sometimes doctors independently introduce the baby to the mother, but it’s still better to play it safe and ask about it in advance.

If your health allows, you have the right to demand that the baby be in the same room with you. Of course, this will only be possible if the newborn does not require special care.

You, like many other mothers, may be frightened by the unknown of what awaits you and what to prepare for. In order not to waste precious energy and nerves on unnecessary worries, find out in advance whether the medications planned for you are compatible with breastfeeding. You can simply clarify their names, and find out all the information from the annotation for this or that product.

First meeting

The importance of the first breastfeeding after a cesarean section cannot be overestimated: it is enormous! You need to prepare for such a touching and important event in advance by gaining the necessary knowledge.

It is always better for you and the baby if breastfeeding after a cesarean section begins as soon as possible. This directly determines how well the baby adapts to unfamiliar conditions, and the mother’s emotions will create an excellent basis for restoring the body after surgery and establishing the lactation process.

When a caesarean section is performed under regional anesthesia, it almost always guarantees that there will be no difficulties with breastfeeding. In this case, the child is introduced to his mother even before the sutures are completed, which is ideal for both.

If the operation is more complex, it is performed under general anesthesia. In such a scenario, mommy may wake up only after a few hours and feel, to put it mildly, not very well. But, nevertheless, all the most difficult things are already behind you, your baby has been born and is looking forward to meeting you.

If you can, despite your health, feed your baby within 6 hours after birth, this will ensure healthy lactation in the future.

In the first days of life, a newborn must eat fully, therefore, if all conditions are favorable, the child should be fed 8-12 times a day: this frequency also has a positive effect on milk production.

For domestic maternity hospitals, a typical situation will be when a woman, after a caesarean section, lies in the intensive care unit for 1 to 3 days. But you have the right to ask a doctor to stay with your child if your health condition is not a contraindication for this. When this is not possible, you can ask that your baby not be supplemented with formula while you are recovering, or you can ask for it to be fed from a cup or spoon.

If the start of breastfeeding is delayed for some reason, the most important thing for a woman is not to worry. You also need to be prepared that you will be able to establish breastfeeding, you just need to wait a little.

Already on the second day after surgery, you can express milk, if you have any. The time period during the day should be 2 hours, and at night no more than 6 hours. The entire pumping procedure should last about 5 minutes. For hormonal stimulation, you can stroke your nipples.

When to expect milk

We have already written earlier that milk comes in earlier if a cesarean section begins after labor. In this case, lactation after cesarean section is most often already established by 3-4 days.

Of course, surgery after contractions is not always possible. But even with this sequence of actions, breastfeeding will be possible. True, milk comes much later. As practice shows, this takes an average of 5-9 days. It will be mandatory to put the baby to the breast to stimulate lactation.

Until your milk comes in, you may produce colostrum, a yellow, nutrient-rich liquid. It, like future milk, is suitable for feeding a newborn. If you are in the intensive care unit and meeting your baby is impossible, it will be useful for you to express colostrum.

With this action you will inform the body that it is time for the “milk factory” to start working and that there is a small hungry mouth that needs food.

What you need to know:

1. Already on the first day after birth, while in the anesthesiology and intensive care unit, express your breasts with your hands.

Both glands for 15 minutes every three hours, and at least once at night. This will promote good stimulation of the gland, milk will arrive earlier (on the third day). When expressing, do not wait for a good and large amount of milk (colostrum), at least a couple of drops. The main thing here is breast stimulation.

2. When the baby is with you, try to put him to the breast.

The most optimal positions for latching, taking into account the postoperative condition of the mother, are the “relaxed position” (when the baby lies on the mother’s stomach and grasps the breast from above) and the “lying on its side” position. Mom should be comfortable!

Photo source: detvoraonline.ru

3. It is important to attach the baby to the breast correctly:

• The baby should be completely turned towards you, tummy to tummy.
• We hold the baby tightly to ourselves.
• We support the newborn so that nothing prevents him from straightening his head.
• The first time you need to offer the breast to the baby, make a wide fold (thumb and index finger behind the edge of the areola)
• The baby should open his mouth wide, grasp the breast so that the lower edge of the areola is completely in the baby’s mouth, the upper edge may be slightly visible .
• The chin is pressed tightly to the chest.
• It shouldn't hurt when your baby sucks on the breast! If it hurts, don’t endure it, otherwise there will be cracks. Try to apply it better, pay attention to the baby’s frenulum.

Photo source: uplady.ru

4. If your baby is latching correctly and sucking well at the breast, do not give in to the temptation to feed him formula. We feed the baby on demand, the duration of feeding is also regulated by the child. Long and frequent feedings are not an indicator of a lack of milk!

5. We feed on demand, BUT!!! If the baby sleeps more than two hours during the day and four at night, he needs to be woken up and fed! This is important to observe in the first weeks of a child’s life. Long, uninterrupted sleep in a newborn is most often not an indicator of the baby’s satiety.

6. If additional feeding is necessary, supplement with either expressed milk or formula NOT from a bottle. Feed from a spoon or syringe under finger control.

Photo source: doc-baby.ru

7. Do not offer a pacifier to your child.

8. If engorgement of the mammary gland (edema) appears - the breast feels like a forehead, then follow the following algorithm of actions:

• Lie on your back.
• Lymphatic drainage massage of the breast: use your fingertips to apply moderate pressure on the areola area, hold for a few seconds, then move your hand over the gland in the direction from the nipple to the base of the gland. Repeat several times until you feel a decrease in the “bloating” of your chest.
• Next, carefully express a couple of drops of milk. The breasts will become softer and then it will be possible to offer the breast to the baby.
• We remember that the best “breast pump” is a child !
• should your actions towards the breast !!! We do everything very carefully and carefully. Breast tissue is delimited from the external environment by a 2 mm layer of skin. This is a gland that should not be roughly massaged or squeezed! No one would think of handling roughly, for example, the thyroid gland... And the mammary gland...

If after reading the article you still have questions or if you are currently setting up a guard after a cesarean section, I’m ready to answer in the comments.

Lactation, come!

We found that caesarean section and necessary breastfeeding are compatible phenomena. Although this method of childbirth can make it difficult to establish lactation, it rarely eliminates it completely.

But for many mothers, it is simply unbearable to wait patiently for the milk to come and worry about every day of delay. Then the woman asks the question: “Is it possible to somehow speed up the milk?” Fortunately, most often breastfeeding stimulation takes place. Especially for mothers who want to influence the situation, we have prepared a list of universal actions:

1. Even if breastfeeding is not possible, it will be useful to put your baby to the breast and spend as much time with him as possible. This is especially true at night, specifically from 2 to 4 o’clock, because at this time prolactin is produced the most.
2. While waiting for milk, it will, of course, be unacceptable to deprive the baby of food. Therefore, unfortunately, it will not be possible to refuse additional feeding. But you can do this personally with a syringe or spoon.
3. Caesarean section is a surgical intervention, and this is a priori a blow to the body. But it is in your power and interests to speed up recovery. Get enough sleep, get positive emotions and eat well - this should help you come to your senses as soon as possible, and therefore soon normalize breastfeeding.
4. If you and your baby are in the same room or are already at home after discharge, you can practice co-sleeping. There is a theory that this has a beneficial effect on stimulating lactation.
5. Even if the milk after a cesarean section is not yet coming, it will be useful to express. Or rather, try to express, and preferably every 2-3 hours. You should not torture your breasts with strong squeezing movements, but a light massage will be very helpful.
6. When you put your baby to the breast, try to motivate him to suckle, even if there is no milk. Your baby's natural actions will promote the production of oxytocin.

Let's take care of the milk

The first feeding took place no earlier than the 3rd day and the child is kept separately (is he premature, in intensive care, or just in the children's department)? While in the room separately from the baby, from the beginning of the second day, express both breasts - it is better to make 8-10 short attempts for 5-15 minutes (per day), every 3 hours. Some maternity hospitals (for example, all in Irkutsk) have Medela electric clinical breast pumps. While your baby is away, you can use them or individual manual or electric breast pumps. Don’t be alarmed: initially, the amount expressed is small, since your baby has just been born and little colostrum is being produced. So expressed 5-10 grams is a lot.

If your maternity hospital allows you to feed expressed milk, collect colostrum or milk in a sterile bottle (it can be stored for 4-6 hours without refrigeration, at room temperature) or, according to hospital rules, give it to your nursing sisters. Give colostrum to your baby as soon as possible, preferably from a spoon, placing the baby on your elbow so that he is semi-vertical on your elbow.

If the baby is brought to you to feed by the hour, breastfeeding is sometimes ineffective due to the fact that the baby is supplemented and he is accustomed to sucking from a bottle. If during feeding the baby actively sucked at the breast in the correct position, consider this a full feeding . If the baby was sucking sluggishly or was sleeping and you couldn’t wake him up, express your breasts after feeding. Whenever you breastfeed, you should focus on how your baby latch onto the breast.

Be sure to place the baby on both breasts at one feeding to better stimulate lactation . Do this until there is a significant flow of milk, which can begin on the 2-5th day after the baby begins to be brought in regularly for feeding.

Stagnation came from where we didn’t expect it

Sometimes milk appears in the breast after a cesarean section quite quickly and it would seem that lactation is on track, but suddenly milk stagnation occurs. This is a common phenomenon of breast engorgement, which can be triggered by infrequent feeding or pumping.

Sometimes the reason may be difficulties in establishing breastfeeding. Even if you have plenty of milk, the newborn, due to a break after surgery or additional feeding, may refuse it. Then there is a high probability of fluid stagnation.

The solution to the problem is to pump your breasts regularly, regularly and completely. If your baby is breastfed, but stagnation nevertheless occurs, then in this case, pumping will save you. Usually once a day is enough.

As practice shows, there is one strong circumstance against the difficulties of breastfeeding. As you might have guessed, this is a mother’s great desire to breastfeed her baby. Her body often simply cannot ignore this signal for help, and the appearance of milk after a cesarean section does not take long to appear. Therefore, believe in yourself, and everything will certainly work out!

After discharge

Now the mother’s task is to start feeding the baby on demand, at least every 3 hours, controlling the number of urinations per day, especially if there was severe weight loss in the maternity hospital or supplemental feeding was prescribed.

If you are concerned about anything - a small amount of urination in your baby, nipple pain, a question about the need to pump, or any other, do not hesitate to call or visit a lactation consultant at home.

It is advisable that during the first weeks someone helps you around the house, and you can devote time to establishing breastfeeding. Good luck!