Did anyone express straight after c-section to encourage milk flow?

[Writerwannabe83]

May be a strange question....

I had a planned c-section with DS and we had a very difficult start to breast feeding for the first two days post delivery. He was really reluctant to attempt to suckle, he would start getting angry at the breast because there was nothing there if he did suk and then he eventually stopped trying and he became a very sleepy baby. He had to been seen by the Neonatal Team because they were quite worried about his low energy and blood sugars. I genuinely can't remember him having a proper feed in the first 24 hours of his life.

On day 2 of life the midwives did have to give him a small volume of formula because it was clear I had nothing to offer him. Immediately prior to that I'd had a midwife hand expressing my breast (oh how pleasant that was) and despite her best efforts for quite some time she barely got 1ml of colostrum so there was no option but to give formula.

Anyhow, by day 3/4 everything was back on track and I went home breast feeding but those first 48-60 hours were awful, both physically for me and DS and especially emotionally difficult for me.

I have since been told that following planned c-sections it is very common to have problems with breast feeding because there's been no hormonal warning to the breasts that a baby is imminent in the same way that hormonal changes occur during natural Labour and so the milk isn't prepared for baby's arrival. I don't know how true this is?

Anyhow, I'm due DC2 in three months and this will also be a planned section and I'm dreading the same thing happening again and my friend suggested that I buy a breast pump and from as soon as the baby is delivered I should start pumping every few hours to encourage the milk to start flowing in order to avoid having the same issue again. She said it quite confidently as though it is done quite routinely?

Has anyone else done this or have any thoughts?

[grainmum]

Also interested in this -have heard of people in certain circumstances harvesting colostrum in advance, not sure if this is a good idea before a planned section?

[Writerwannabe83]

Yeah, my friend mentioned that too. I hated seeing DS be given formula so at least if I had some harvested colostrum to give I might not be such an emotional wreck about initial difficulties.

[mimiholls]

Not true at all that c section causes problems with milk coming in- it's the removal of the placenta that triggers milk hormones so mode of birth not to do with it. It's very normal for milk not to come in until day 2 or 3 and for there only to be colostrum until then. Colostrum comes out in tiny amounts so 1ml is not bad although it seems like a very small amount. I hand expressed colostrum after birth too and was given 1ml syringes to collect it in- so literally expressing and feeding 0.5 to 1 ml at a time on day 1. Baby suckling also helps with supply so this will help with milk coming in- you can pump to start stimulating the breast for milk if baby won't suckle but it's not efficient to actually collect colostrum with a pump because it comes out in such small amounts, that's why you hand express. You can hand express colostrum before birth believe it or not and store so you have a small supply for baby. I was given details of how to do that prior to c section so you could ask your midwife if interested.

[Herefornow1]

Yes, I did.

Baby was taken to nicu after delivery and remained there for 5 days. I was on a different floor in the hospital and nurses and dr were adamant breast is best (not UK).

I had no colostrum and no engorged breasts. Used a pump supplied by the hospital and pumped every 2 hours for at least a day and a half (even at night the nurses woke me up) before the sign of even a drop. It did work and I went on to exclusively breastfeed for 6 months but after those initial days I had the most unbelievably cracked nipples from the expressing.

[Blahblahblahyadayadayada]

I just wanted to reassure you that c section does not necessarily mean it will adversely affect your milk flow. I am not an expert but a traumatic experience can affect it. I had a horrible birth resulting in a very bad tear with my first and struggled with breastfeeding. With my second baby, I had a semi-planned C-section (was supposed to be fully elective but I went into labour) and breastfeeding has so far been much better.

If you post in Feed the World under infant feeding you might get some advice from experienced mothers there.

[Metalhead]

I had an ELCS with DD2 and my milk came in on day 2 or 3, same as with DD1 who was delivered vaginally, so no difference in my experience.

[docpeppa]

I delivered vaginally with DD1 and my milk came in properly 2 days later, I struggled a lot and we ended up mixed feeding as I panicked that she wasn't getting enough.
I had an elective section with DD2 and my milk came in 2 days later too, but baby was constantly on the boob for the first few days. I thought she wasn't getting enough milk, but she was fine tho as she was building up my milk supply and that behaviour is normal at first. I persevered with it and managed to establish breastfeeding.
This time round I am having another vaginal delivery (if all goes to plan) and hopefully breastfeeding will be fine again this time.

[docpeppa]

I did express a few days after with DD1 to try and build up my supply, it never seemed to work with me. I had a bad experience with first baby and a great experience with second, who was section. So I guess really it depends on the baby

[Bear2014]

I had massive problems and my milk didn't come in until day 5/6 after my C-section. I lost 1300ml of blood and I'm sure this had something to do with it. DD was re-admitted to hospital on day 5 with 13% birth weight loss and severe jaundice.

BUT isn't it true that no ones' milk isn't really supposed to come in until day 2/3 and 1ml of colostrum is entirely reasonable up until that point? Sucking isn't supposed to result in milk flow at that point, rather encourage the milk flow to start later. We were discharged with DD not having had a 'proper feed' but she was at that point still latching on so they were happy.

I will pump this time (due again in the summer) to encourage my milk production, in case the same thing happens again, but wouldn't expect actual milk before about day 3.

[ShowOfHands]

I've had two emcs. First was extremely traumatic and a crash cs. I then had a PPH. Breastfeeding was straightforward and my milk came in on day 3.

Second emcs was calmer but ds was a bit early and small so tired easily. I expressed a few mls of colostrum several times on day 1 (around 2/3mls maximum ) and syringe fed them but also persevered with putting him to the breast as often as possible and again, my milk came in seamlessly on day 3 with no engorgement.

It is the placenta removal which stimulates milk production and at first you will feed only tiny amounts of colostrum.

[sycamore54321]

Sorry to hear you had such a tough time previously. Can I suggest the complete opposite - that you consider topping the baby up with a little formula if he is still hungry after colostrum feeds and otherwise maximise your rest until your milk comes in? The initial milk-coming-in is almost entirely to do with the massive hormone drop that happens when the placenta is removed and there is zero evidence to show that pumping at this stage helps. Being as well rested as possible would be helpful in encouraging good milk production.

[WillowB]

I've had two sections. Milk didn't come in until day 4 after the first one. Came in a lot quicker the second time, could feel things happening around 48 hours later, almost like my body knew what to do. There's nothing wrong with a small formula top up before the milk comes in though. I asked for one as DS was ravenous by the second night!

[JOMH1982]

Hi,

Sorry to hear you've had such a rough time.

I had a planned section on Tuesday after a traumatic emergency section with my first child. I'd say my milk came in around day 3 with both. On Tuesday night after delivery my daughter slept for five hours and wouldn't feed, so o enjoyed the hand expressing courtesy of a midwife (not my finest moment, lol!) but I was lucky that with my daughter's persistence (and with a tongue tie too) we seem to have a bit of a milk supply going. I was worried that I wasn't giving her enough, she wasn't interested enough and that the tongue tie was making things difficult, bit the midwives helped me.

I was going to keep hand expressing to stimulate production of o got more worried, but wouldn't have thought about it beforehand so may be worth discussing with your midwife? A friend topped up with formula for the flesh few days to avoid dehydration and they've established a strong breastfeeding routine, so you probably have a few options (this one mah be less stressful, if like me expressing was never easy).

I wish you all the best. Sorry if I've rambled, just didn't want you thinking you were on your own xx

[Chrisinthemorning]

Certainly true that I had a CS with no labour and DS couldn't bf and was very sleepy. We had to bottle feed him after the first day. I tried hand expressing but it hurt and nothing came out so I had to stop. I spent lots of time skin to skin and trying to get him to latch but he never managed it. He was early though.
I think they should warn you more that bf might not be an option if you are having to have a CS- no one really tells you this. They just assume it'll be fine and then blame you and make you feel rubbish when it doesn't work out.

[feesh]

I too had problems breastfeeding after my last c section, so this time round I have been doing antenatal colostrum harvesting which I started about 33 weeks. I'm now 38 weeks and have a good stash in the freezer.

At first I barely got half a ml, and ended up with very bruised boobs, but I did it every few days and gradually I started to produce more and more and now I can sit down and get 5ml without really trying.

Hopefully I won't need it, but if I do it's there. I think the act of expressing has also helped me to understand my body more and has also stimulated my boobs to produce more than they otherwise would have done.

By the way, it's normal to only be able to express a TINY amount after birth. It takes a few days for the milk to come in properly (for me it was day 4) and until then your baby only needs tiny amounts, but frequently. (It was the frequently bit that we struggled with last time - babies were too sleepy to feed).

[FastForward2]

It is 18yrs since my antenatal classes but I am sure they said baby does not need much, if any, food in the first 24 hours. A few drops of colostrum and a cuddle perhaps, to rest from the trauma of birth?

[FastForward2]

My 1st was away from me in scbu for a couple of days after ecs and I should have expressed but didn't. Long and boring story.
My 2nd was planned cs, was with me all the time and did not need scbu, and so no need to express, just fed on demand.
Keep yourself fed and hydrated, and get as much rest as possible, and it should work.
Enjoy your baby.

[cudbywestrangers]

I had a similar experience to you op. Emcs with ds1 and he ended up on nnu. He was getting distraught every time i tried to feed him then having formula because of low blood while I pumped forever for a couple of drops. It was miserable. We were in hospital for 3 days going through this rigmarole and then went home with no bottles or formula in the house. Fortunately my milk came in that day so did manage to breast feed after that.

Ds2 was so much easier. Had skin to skin and fed as soon as he was born. Milk seemed to come in much quicker as well. I do think that feeling that I knew what I should be doing helped, as did milk coming in quicker and a less stressful birth.

I hope you also find it easier this time!

[drinkingtea]

Your milk will probably come in quicker with DC2. I had 3 c sections, the first with labour that didn't progress and the second and third planned. My milk came in quicker with each subsequent birth despite the early I did go into labour the first time and not the later two times.

[MrsNuckyThompson]

I'd highly recommend expressing colostrum in advance - it will buy you some time as you wait for your milk to come in. With both my sections my milk didn't come in until day 4/5 so it is a long wait! I harvested colostrum from about 2 weeks before the sections, froze it and then DH brought to hospital in small batches to give to DCs. The feeding team / lactation consultant at your hospital should be able to advise you how.

I did ask this time about encouraging milk flow by using the hospital grade pump immediately but they don't advise it before day 3. Before that there is unlikely to be anything much there and it will end up painful to be pumping away with nothing to get. It can also mean when it comes you have a big over supply problem.

Getting your baby suckling away for colostrum is most important.

Both my DC lost tons of weight after birth (they were both also jaundiced) but I refused to give formula and then things started to turn around as soon as the milk came in.

Good luck!

[C4Envelope]

From 38/39 weeks I began to hand express colostrum and actually moved onto using the hand pump to express and was fortunate enough to get 20/30mls at a time which I stored in little pots in the chest freezer. Baby wouldnt latch so I was exclusively expressing and was lucky to have a massive supply. Expressing is such hard work. Hats off to any who does it. I did it for 3/4 months and it was the exhaustion which led me to stop and move to formula but I had built up an adequate store in the freeze to combine breast and formula for about two months thereafter.

Should add I had emcs.. stimulation before labour can bring it on apparently but I was at it for 3 almost 4 weeks and didnt go into labour until the morning I was induced. Everyone is different but stimulation should definately help. Hth best of luck

[feesh]

Just an update - I had my baby and was SO glad of my stash of antenatal colostrum! He had the same feeding issues as his big sister (basically total breast refusal and massively sleepy) and was also low blood sugar at birth - I am positive that without my stash he'd have ended up on formula. I had enough to last 3 days. On day 4 my milk came in and it all came together. I was producing a lot of colostrum after the birth too which I am sure was down to the antenatal expressing.

[C4Envelope]

Congratulations thts great news, Best wishes with your lovelly new baby x