Things to help nursing go well post c/s

[happyblessedmama]

My last nursing experience post emergency c/s was a resounding failure. My milk didn't come in as was typical for me. I actually requested formula in the hospital as baby was acting hungry... After that he settled down. I nursed as usual his first couple months but he didn't gain weight. Ended up using a SNS with formula and attempting to pump, but my milk supply was next to nothing. He ended up formula fed at 5 months because I didn't have time to nurse a pump for 2 hours a day with little result and he just wanted food NOW.

I had never had such a tough time nursing before. I'm hoping for ideas that might make this time around more successful, as I'm accustomed to being able to nurse my babies for a much longer time. I don't know what else to blame if not the c/s.

[alittlesandy]

Originally Posted by happyblessedmama 

My last nursing experience post emergency c/s was a resounding failure. My milk didn't come in as was typical for me. I actually requested formula in the hospital as baby was acting hungry... After that he settled down. I nursed as usual his first couple months but he didn't gain weight. Ended up using a SNS with formula and attempting to pump, but my milk supply was next to nothing. He ended up formula fed at 5 months because I didn't have time to nurse a pump for 2 hours a day with little result and he just wanted food NOW.

I had never had such a tough time nursing before. I'm hoping for ideas that might make this time around more successful, as I'm accustomed to being able to nurse my babies for a much longer time. I don't know what else to blame if not the c/s.

It sounds like you went through a lot. I hope you have an easier time this time around!

I have a couple of questions for clarification. At what point did you ask for formula? You said in the hospital so I'm assuming within the first few days? How soon does your milk usually come in? Mine took four days, which my midwife said was normal, even for vaginal births. In the hospital they told me to nurse on demand around the clock and that my baby was getting colostrum, even if it seemed like nothing was coming out. My midwife and pediatrician also told me that a 10% weight loss in the beginning is normal. Forgive me if you already knew all this and I'm stating the obvious. I've heard so many different things about what people are told in the hospital and by their pediatricians.

I think the things that helped me were nursing within 20 minutes after my c/s and nursing round-the-clock on demand (for the first few weeks I set a timer at night to make sure I was nursing at least every 2 hours).

I hear again and again the c/s is the problem, but I know just as many women who had problems after vaginal births. My midwife told me that it's the delivery of the placenta that brings in the milk (which happens in any case), but I know some women believe it has more to do with labor, etc.

[happyblessedmama]

My last several children milk was in before 24 hours. Like actual engorgement, etc. I am aware that a 10% weight loss is normal, but my babe wasn't gaining, as in at 4-5 weeks he was still at his birth weight. He cried a lot and that quit after we began using the sons, and he began to gain weight... It was pretty clear all he wanted was additional food.

I did request 1 bottle of formula in the hospital because baby was very unhappy despite repeated nursing sessions, and he was a large baby. He quieted right down after that. Even if babies are biologically set up to acceptably lose weight in the first couple weeks I genuinely think he needed the food. I think that was sometime on the night of day 2.

Im very experienced with nursing on demand, that's what I do. My supply just never really happened this time, and it didn't respond to "demand" from my baby, or a few months later, the pump.

[alittlesandy]

Originally Posted by happyblessedmama 

My last several children milk was in before 24 hours. Like actual engorgement, etc.

Wow! That's amazing! I've never known anyone whose milk came in that fast, even the homebirth mamas I know.

Well, it doesn't sound like it was anything you did. I'm at a loss. I do know that it's possible to not have nursing problems after a c/s. I didn't have any, and know quite a few women who did fine. Sometimes I think it's hard to isolate all of the variables. It might be the c/s, it might not.

[tracymom1]

WIth my c-section, it took SIX day for my milk to come in!!!! I thought for sure it would never come. With my others, it was in within 2 days. Maybe it just takes longer after a c-section for the prolactin to get going. The only advice I have is to be persistent. And maybe have some More Milk Plus tincture or fenugreek on hand in the hospital to help with building your supply.

Good luck, mama!

[alittlesandy]

Here's a great article from the Kellymom site about c-sections and breastfeeding:

http://www.kellymom.com/bf/start/concerns/c-section.html

The site states:

"The abrupt hormonal shift that occurs at the separation of the placenta from the uterus is what signals your milk to come in. Thus mom's body will get the same signal whether she has a cesarean or vaginal birth."

There are some great tips for nursing every two hours, positions, etc.

[happyblessedmama]

Yeah, I'm aware of how it's "supposed to" work. That didn't happen last time for me, and the only variable was the delivery method. I suppose I will just hope things go differently this time and be prepared to supplement if they don't.

[Megan73]

Originally Posted by happyblessedmama 

Yeah, I'm aware of how it's "supposed to" work. That didn't happen last time for me, and the only variable was the delivery method. I suppose I will just hope things go differently this time and be prepared to supplement if they don't.

You know your body best.
I had a tough time breastfeeding with DS1 (a vaginal birth) so I was ready to supplement with DS2 (an emergency section) but things went better than I hoped and I was able to EBF after a rough start. What I did while pregnant was assume I would have to supplement again and lay in supplies - a baby scale, hospital-grade pump and domperidone and washed my Lact-Aids so I would never have to use bottles. If you haven't used them before, they are MILES better than the Medela SNS for long-term supplementation and meant that I could feed DS1 at the breast until he weaned in toddlerhood.
Another thing I did differently is hand express colostrum from birth to feed to my babe after nursing sessions. My milk did seem to come in quickly.
I also highly recommend the book "The Breastfeeding Mother's Guide to Making More Milk."
I hope you don't need any of that stuff, though, and have an easy breastfeeding relationship this time!

[Parker'smommy]

I've had 3 csections, and had a terrible start with my first child. We ended up having a successful nursing relationship, but it was a tough road that lasted almost 4-5 months before things started to turn around. So, like you, I was determined to have a happier beginning with my other two births. Things went well with my middle child, but I would say the things I did for my last birth REALLY set me up for a successful nursing relationship. 

What I did.....

WHen I was being prepped for my csection, I told the nurses that I had had a bad experience nursing after a csection and that I wanted to nurse this baby exclusively very badly. I really had a heart to heart with those nurses. Seriously. I told them NOT to wash the baby after birth. They were to just rub her down and get the big chunks off of her. I then made an official request that she not be pricked for anything including glucose levels until after I had nursed her. She was not administered any medications like eye drops after birth. When I went to recovery, she was immediately unwrapped from her blanket and put on my naked chest, skin to skin, and then we put blankets on top of her and I together. I nursed her within the first 30 minutes after birth. That alone, I think helped her become successful. I didn't unlatch her for over an hour. She would stop nursing and fall asleep and I would compress my breasts and get her sucking again. I also didn't let her sleep more than 2 hours that first day. I woke her to nurse, nurse, nurse. I didn't have visitors ( besides my children)  until that evening, and then kept them to a few minutes at a time. My milk came in less than 24 hours later. I never got SUPER engorged, but was leaking and baby was swallowing and gulping. 

Good luck! I hope you are able to have a successful nursing relationship this time around!

[jgallagher66]

I think all of the advice that you've gotten is great. I'm pregnant with my 5th and am having a scheduled c-section which is medically necessary. 3 of my previous babies were c-section and only 1 was vaginal and I honestly haven't noticed much difference. I did make sure that I nursed immediately after birth for all except the last one which was premature and had to go to the nicu. For her, I immediately started pumping every 2 hours. Like I said I think all the advice that everyone has given is great, the only other thing would be to work with a lactation consultant and to try some of the well known herbal supplements to increase supply such as fenugreek, but there are others as well. Kellymom has some great suggestions. My milk supply did come in at different rates for each of my kids as well. It took the longest for my first and my daughter who was premature. Mostly it took 3-5 days, even for my 2nd which was a vbac. I also am a big believer in the old standby The womanly art of breastfeeding which I think is a great resource for all nursing moms. And it's important to get plenty of rest which is sometimes hard to do when you have other kids to take care of. Persistence is also important. My youngest didn't nurse until she was 3 months old because of being premature, but I kept pumping and she finally caught on at 3 months. We had a wonderful nursing experience after that. Lots of pumping also helped increase my milk supply for all of mine. Good luck and I hope this time is much better for you and your little one.

[Monkey Keeper]

Christine, I am so sorry you are having such a tough time. I know you have a ton of nursing experience under your belt, so how hard it had to be for you to have such a rough go!  

I think Parker'smommy may be onto some things, if you haven't considered them. You had the hormonal cascade that led to labor, so whatever went awry was likely later. Was the whole newborn procedure routine different? Perhaps your pain response somehow interfered a la 'fight or flight'?

Other things to consider: 

- deep posterior tongue tie

- thyroid or other maternal hormone issue

I'd be terribly upset and apprehensive too since I have had 3 easy nursing relationships if a subsequent one were to be difficult.

[McGucks]

Originally Posted by happyblessedmama 

My last nursing experience post emergency c/s was a resounding failure. My milk didn't come in as was typical for me. I actually requested formula in the hospital as baby was acting hungry... After that he settled down. I nursed as usual his first couple months but he didn't gain weight. Ended up using a SNS with formula and attempting to pump, but my milk supply was next to nothing. He ended up formula fed at 5 months because I didn't have time to nurse a pump for 2 hours a day with little result and he just wanted food NOW.

Happyblessedmama, the bolded statements from your post indicated that your last nursing experience was anything BUT a resounding failure.

Your child got your breastmilk.  Lots of it.  A couple of months is HUNDREDS of nursing sessions.  That is more than many, many moms can achieve.

You listened to your child's needs, weighed your options, and made the best decision you possibly could have, with love.  There can be no failure in that.
 

[sunflwrmoonbeam]

It sounds like to me there was a milk transfer problem. Was he ever evaluated for tongue tie? Did you ever see a LLL Leader or lactation consultant?

From what you've said here, my guess is that it wasn't the c-section but an issue with the baby.

[justKate]

Quote:

Originally Posted by tracymom1 

WIth my c-section, it took SIX day for my milk to come in!!!! I thought for sure it would never come. With my others, it was in within 2 days. Maybe it just takes longer after a c-section for the prolactin to get going. The only advice I have is to be persistent. And maybe have some More Milk Plus tincture or fenugreek on hand in the hospital to help with building your supply.
Good luck, mama!

It took six days for me, too.  I do blame the c-section for that, mostly because I wasn't staying adequately hydrated after the surgery (and while DD was in the NICU) and because the of the drugs.... I felt waaay over medicated.  I DON'T think that giving him formula hurt.  DD had nothing but formula for 3 weeks in the NICU (bottle and tube) and latched perfectly for the first time at 3+ weeks old.  It sounds like an issue with the babe, not you.  So hopefully you won't have to worry about it next time.  Maybe have a LLL gal on call.  I know it sucks to "blame the baby" but I really don't think you should blame yourself at all.  As you know every babe and birth is different, so don't get down about it!

[E m i c h i e e]

I had an emergency c-section. The first three days I had to nurse with colostrum, luckily I had plenty and saved some even. My Milk came in after 3 days.

Everyone was surprised because I have conditions that can cause problems with milk supply (Hashimoto's Thyroiditis, Pituitary Tumor).

While still in the hospital I co-slept skin to skin with my lo and let him nurse on demand. I think it helped my body understand that the baby is really here now.

At 5 weeks my milk was getting a bit low, because my lo had an improper latch. Fenugreek helped me a lot. He is a bit better at nursing now,but somewhat sloppy with emptying my breasts and very impatient, and so I still boost with one fenugreek capsule a day = perfect.

We bed share at night and I function as a human pacifier during his nap time <_<....lots of stimulation.

Anyhow almost 5 months and my supply is going strong, I know thats not very long but it is as strong as ever :)

[Partaria]

Don't know if this has already been mentioned to you, but what about placenta consumption?

I had my first via c-section, and my milk came in right on schedule. I'm convinced it was because I ate some of my placenta after the birth, then finished it in smoothies in the rest of the post-partum days.