Having a C-section can delay when your breast milk comes in, but it does not mean you won’t be able to breastfeed successfully. With some extra support and patience, most mothers who deliver via C-section are able to establish a good milk supply.
Why does a C-section delay breast milk?
There are a few reasons why a C-section can delay the onset of breast milk production:
- The medications given during a C-section can interfere with the hormone signals that trigger lactation.
- The recovery period after major abdominal surgery can delay when you are able to start breastfeeding.
- The lack of labor hormones released during vaginal delivery can impact milk production.
During a vaginal delivery, the physical pressure of contractions and the hormone oxytocin help signal the breasts to start producing milk. This is interrupted with a C-section. However, once the effects of the medications wear off and nursing is established, the breasts can respond and produce milk.
How long is breast milk delayed after a C-section?
On average, mothers who deliver via C-section will experience a delay in breast milk coming in of 24-48 hours compared to a vaginal delivery. So if milk is typically produced around days 2-4 after a vaginal birth, it may not come in until days 3-5 after a C-section.
However, there is a wide range of normal when it comes to milk production. Some mothers may only have a delay of several hours, while others may not see mature breast milk until a week after giving birth. Factors like whether you labored beforehand and how easily breastfeeding is established can impact the timing.
Tips for producing breast milk after a C-section
If you are concerned about breast milk production after a C-section, here are some tips that can help:
- Begin breastfeeding as soon as possible after delivery, within the first 1-2 hours if you are able.
- Nurse frequently, at least 8-12 times per day in the early days.
- Keep the baby skin-to-skin as much as you can.
- Get assistance from lactation consultants to ensure proper latch and feeding technique.
- Stay well hydrated and eat a balanced diet.
- Try massage techniques and warm compresses before nursing sessions.
- Pump after nursing to fully empty breasts and increase supply.
How to supplement until breast milk comes in
Until your mature breast milk supply is established, you may need to supplement feedings with formula or donor breast milk. Here are some tips for supplementing:
- Always nurse first before offering any supplements.
- Use a syringe, cup, or spoon for supplementing rather than bottles.
- Pump after nursing to signal to breasts to produce more.
- Limit supplementation only to the amount needed based on baby’s weight and input/output.
- Consider using donor milk from a milk bank instead of formula if possible.
- Work closely with your pediatrician and IBCLC to determine how much and how often to supplement.
How long until milk supply is established after C-section
Most mothers are able to establish a full milk supply within 1-2 weeks after a C-section. However, it may take up to 4 weeks or longer in some cases, especially if breastfeeding got off to a difficult start. The most important thing is to keep nursing and pumping frequently.
Signs that your milk supply has come in include:
- Breasts feeling fuller, heavier, and leaking milk.
- Hearing or seeing your baby swallow and gulp during feedings.
- An increase in your baby’s wet and dirty diapers.
- Baby seeming satisfied after feedings and gaining weight appropriately.
As long as your baby is showing signs of getting enough milk and gaining weight, try not to stress too much about the timeline. Focus on ensuring proper breastfeeding technique and nursing often. Talk to a lactation consultant if you have any concerns.
Does milk supply decrease with C-sections?
While a C-section may delay milk production, there is no evidence that it impacts long-term milk supply once established. Most mothers are able to produce just as much milk as those who delivered vaginally.
In one study looking at milk production after C-sections, researchers found that while onset of lactation was delayed, the mothers were able to produce adequate milk volumes by 2 weeks postpartum. Their supply continued to increase and matched the supply of mothers who delivered vaginally by 8 weeks.
Can I breastfeed immediately after a C-section?
Current recommendations are to place babies in skin-to-skin contact with mothers as soon as possible after a C-section, ideally within the first hour after delivery. Early skin-to-skin helps stabilize babies and initiates breastfeeding behaviors. Whether you are able to actually breastfeed right away depends on your condition and recovery.
If you are awake, alert, and relatively pain-free, attempting to breastfeed immediately after surgery is encouraged. But if you are still groggy from anesthesia or in severe pain, it may not be possible. Work closely with your medical team to determine the best time to start breastfeeding based on both you and your baby’s condition.
Breastfeeding positions after a C-section
In the first days after a C-section, finding comfortable positions to breastfeed can be challenging. Here are some options:
- Laid-back/biological nurturing: Recline back on pillows at a 45 degree angle and allow your baby to self-attach in a tucked position on top of you.
- Side-lying: Lie on your side with a pillow supporting your back and put your baby facing you.
- Cradle hold: Hold your baby so their head rests in the crook of your arm and their body extends along yours.
- Football hold: Tuck your baby under your arm like a football with their legs extending back along your side.
Avoid positions where your baby’s weight rests directly on your abdomen. Pillows can help support your baby and take pressure off your incision.
Signs of insufficient milk supply after C-section
If your milk supply is lower than your baby’s needs after a C-section, you may notice some of the following:
- Baby seems hungry and frustrated at the breast shortly after feeding.
- Decrease in wet or dirty diapers compared to the first days after birth.
- Little to no breast fullness or leaking between feedings.
- Poor weight gain or failure to return to birth weight.
- Excessive fussiness that seems related to hunger.
- Not hearing or seeing baby swallow frequently while nursing.
Talk to your pediatrician right away if you suspect an issue with milk supply. A lactation consultant can also assess a full feeding session and provide suggestions for improving milk production and transfer.
Increasing low milk supply after C-section
If your supply is lower than expected after a C-section birth, the most important thing is to remove milk from the breasts frequently. This signals your body to produce more. Here are some tips:
- Nurse at least every 2-3 hours, minimum of 8 times a day.
- Use breast compression and massage during nursing.
- Offer both breasts at each feeding.
- Pump after or between breastfeeding sessions.
- Power pump 1-2 times per day by pumping for 10 minutes on, 10 minutes off, 10 minutes on.
- Ensure proper breastfeeding technique and treat any issues like poor latch.
- Stay hydrated and eat foods that support milk production.
Medications like domperidone, herbal supplements, and prescription drugs may also help support supply. But always consult with a doctor first.
Having a C-section poses some unique challenges when it comes to breastfeeding. But with proactive management in the early days, most mothers can overcome issues with delayed milk production and establish a full milk supply. Nursing frequently, skin-to-skin contact, and reaching out for professional support are key to getting breastfeeding off to the best start after a surgical delivery.