how to succeed at BF after ELCS

[redwellybluewelly]

I am due an ELCS at the end of this week.

I had enormous issues BFing DC1 due to her being very ill and in a coma then tube fed, but we made.it eventually and she fed until she was 26months, I fell pg the month I finished feeding her.

I have been leaking colustrum since about 30weeks, but being able to BF this baby is very important to me, and I know that sometimes a CS and the stress of a hospital stay and recovery can delay milk coming in.

Does anyone have any tips for ways I can give this the best possible chance? I've rung the lactation consultant at the hospital three times to try to ensure she or one of her volunteers is able to visit the morning of the CS, had no reply. Although our hospital is supposedly BF friendly they've a bit of a reputation for pushing formula.

I had two sections (one an emergency after a long difficult labour, one whisked to theatre after an ante-natal check because I had raging pre-eclampsia and was about to explode, or something) and had no problems establishing BF on either of them, fwiw (I'd actually never heard the CS causing BF problems thing until after I'd already had one). Milk came in normally both times, both babies back to near birthweight by the time I left the hospital.

My one useful tip is to get a good BF cushion, they're very handy for getting comfy feeding with your incision.

I had a section too @ 35 weeks. Lots of skin to skin in recovery room. my milk cam in around day 4. Breastfeeding pillow helped. Ask midwives for help with latch and take painkillers when offered. Still breastfeeding 7 mths later..

Thank you for reassurances, having had to give up a natural birth for a CS the thought of it also causing BFing issues has upset me a lot. With an active toddler I'm praying feeding is relatively straightforward this time!

I am watching this with interest as I have similar concerns about my ELCS later this year.

You are in a different position from DC1. You have already breastfed once and so at least one of you has experience.

I had a terribly traumatic birth with DS1. Three day labour, emergency delivery before we could get to theatre, surgery for me...the end result was he was dehydrated and jaundiced at birth, while my milk didn't come in for days. I couldn't even get colostrum. It did come eventually and I fed for the next year and a half. But it was all very stressful despite a "natural" birth.

I had to have a CS for DS2 because of the complications from my previous birth. As soon as he was born, he was put on my chest for skin-to-skin. I asked for this immediately. I couldn't feed him during the CS (wrong angle) and he was screaming but the second we were in recovery, he latched on like a dream. And then he just proceeded to breastfeed. I could see colostrum dribbling out of the side of his mouth so it was definitely there.

I actually found that because the CS itself was so calm and controlled, it had no impact on my milk coming in. I heard it is the removal of the placenta that stimulates milk production, so that is true for a CS as well as a natural birth.

I would try and feel confident that the CS will cause no issues and then do demand a breastfeeding expert if there are problems (with latch or tongue tie). My hospital were lax about offering any help breastfeeding as I was a second time mum who had breastfed before. But I would have demanded to see someone if there were any problems.

I cannot say how different my experiences of feeding DS1 and DS2 were. The CS honestly made no impact on my milk and if you are leaking colostrum, hopefully this will be true for you too.

Thank you so so much for taking time to reply, I'm so sorry you had such a rough time with your first birth.

The BFing coordinator rang me today, and thankfully also remembered me and the issues we had getting support last time, there will be a volunteer on the ward waiting for me on my return from theatre and she has also been outraged by the poor support of the theatre team so is hoping to get at least the theatre MW on board before tomorrow. Feeling a great deal more positive now.

Thanks again for all the great advice.

I had an ELCS to deliver my twins.

I had non-existent support after the birth (didn't even attempt to feed them for 13 hours post birth because it didn't occur to me to try, and no one reminded me ). We didn't have Breastfeeding established before I left the hospital 48 hours later, both babies were jaundiced and it was suggested that if I stayed any longer my iron levels would fall low enough for them to recommend a blood transfusion, so maybe I wanted to get home now while I could

Despite that, I established Breastfeeding with both of them, and am still feeding them now, at 2 years 7 months :) My community midwife was knowledgable about breastfeeding and very supportive, my milk came in on day 4 and I stayed in bed snuggling for the first two weeks.

If you can get peer support/the infant feeding coordinator to help on the ward, that will help. If you can line up a Breastfeeding support group for afterwards, that will be even better. Most of all though, having the desire to do it and confidence in your ability to do it will go a long way.

ELCS should not be a barrier to breastfeeding :)

Happy to hear there will be support RedWelly. I found the CS recovery quite difficult with a toddler but the feeding bit was (and is) a breeze!

although I am currently trying to go home from the park but 12-week old DS2 is on a feeding marathon and DS1 is obsessed with running into a bush where someone has done a large smelly poo so it's not that breezy as we speak

I had a crash section with DS (DC2) under general anaesthetic and didn't get to meet him for a few hours as I was unconscious/having a blood transfusion and he was in NICU.

Despite this, he latched on straight away and has fed beautifully since day one, averaging 1lb weight gain a week.

I think the fact you've already BF is a huge advantage. I'd heard bad things about sections (especially under GA) causing problems with milk coming in, but it seemed to be there straight away in my case! It was much easier than with DD (normal delivery).

Definitely get a feeding pillow or similar to protect your wound. Experiment with different positions to get comfortable. Don't worry about ringing for the MWs to pick up baby for you if needed, no matter how many times that may be. Keep ringing for water if you're thirsty.

I just had an ELCS with DD1 (so no experience at all) a few weeks ago and this was one of my concerns as well. But I found the support at the hospital exemplary - they're also meant to be very pro-BF. We got a quick cuddle at the operating table and then loads of skin-to-skin in recovery with help latching. MWs and nurses etc. were around all day and all night at the press of a button (and I pressed it fairly often as I had a million questions!) and were very kind, helpful and patient. When I got home the community MW had a lactation consultant from the hospital come by to observe and give additional advice - so I'd say don't be afraid to ask for help!

I had EMCS and bf went smoothly and brilliantly - I can share what we did in case it helps though I respect different things work for others.

I had a water birth birth plan and no signs of any need for a cs but just in case I wrote a backup 'plan b' emcs birth plan as well and shoved it in my hospital bag in the highly unlikely event I had an EMCS. Guess which one I used! And I am so glad I had it because it helped w breastfeeding. In it I said-

• I want skin to skin I stanly as soon as baby pulled out - not weighed etc first- give straight to me on my chest while sew me up
• monitors etc on arms rather than chest where possible
• please give me no sedatives after surgery since I want to feed straight away
• please help me breastfeed as quickly as possible

They did all these things! Baby in my chest immediately, so half hour skin to skin right then, then briefly took to wash/weigh and then me and her wheeled to recovery where a bf counsellor was standing waiting, and she showed me an awesome lying-down feed position and helped baby latch(since of course with spinal block I couldn't sit up still). Baby fed for fifty minutes! Continued to feed well and my milk came in massive a day early. Breastfeeding totally in demand in the first days made a huge impact on my milk supply - was so so wonderful.

All good wishes and I hope the staff are as lovely and supportive as those I encountered.

Thank you all, unfortunately the hospital has denied my requests for any skin to skin until I'm out of theatre.

Despite the evidence for the benefits of doing so it seems that the need to weigh and measure baby override anything else.

Are they allowed to refuse that?

OP, I had an EMCS with DD, crash under GA, didn't meet her for a few hours, couldn't hold her for a couple more after I woke up. Time with a good midwife helped establish bf'ing, milk came in on day 3. Had an ELCS with DS, didn't get to hold him until they were ready for me to go to recovery (I didn't ask, but I shook a lot during the CS, which is apparently normal, and want to not be shaking when I held him!). I did skin to skin then, and popped him on as it felt natural to do. The lack of immediate skin to skin was no issues, it couldn't have been more than 30 mins before I got my hands on him for cuddles. Because I had fed DD, I knew much better what to do and how. Good luck!

Redwelly that is bizarre, when other NHS trusts do it even with emergency caesareans on request!

Can you appeal it somehow? A 'Supervisor of midwives' is often a handy ally despite having no power over surgeons etc.

What RedWelly! Why would they deny you skin to skin?

During my ECLS, they asked if we wanted to see DS2 come out. DH enthusiastically said yes, they pulled him out and showed him to us, checked him over and weighed him then put a nappy on (I think) and wrapped him in a blanket. I asked for skin to skin and they put him on my chest and unwrapped him a bit so we were touching.

I thought they were supposed to promote skin to skin unless medically it couldn't happen (because it was a crash section or there were complications).

PS. I too had the shakes but they gave me a lovely inflatable covering which they pumped hot air into. So then I felt safe to hold DS2.

(That was lovely. I'd like one for everyday use.)

Because they are very good at giving their word and then pulling the rug out from under you days before.

Apparently there is no room to put baby on me as I am a sterile field (funny that - thought I was a mother), DH has been briefed he is staying with baby no matter what.

Even the infant feeding coordinator said their OR procedures went against guidelines, and I also found out that a few weeks ago a natural CS was arranged - fucking been asking for that for 19 weeks!

Anyway. The extra confidence from you all has at least reassured me about BFing not being as big as issue as I thought, now I just have to keep calm!

I had an EMCS and can also reassure you that BFing is perfectly possible after the CS. We were also denied immediate skin to skin because of the emergency nature of the CS, but baby was given to DH almost immediately and he held him as close to my face as he could manage while I was stitched up. As soon as I was in recovery (maybe 10 mins after birth? I have no idea!) DS was placed on my chest and literally rooted until he found my breast. The rest was simple. The MWs helped teach me to feed lying down and showed DH how to help me get in the right position. DS did the rest We had lots of other problems, but BFing wasn't one of them.

I hope you get the same level of support. Please don't let this be something you worry about. It is perfectly possible to establish BF after a CS.

Skin to skin works with your DH - it still calms the baby and gets them receptive. I agree about taking a feeding cushion in with you!

Honestly though, it should come in quicker the second time around, and leaking already is a very good sign!

Do you have any good bf groups near you? You may be able to get a visit from a bf counsellor/supporter or similar on the ward. The hospital may limit it to visiting hours, but it might help? And all free! (I'm a bf peer supporter, and it is something we are doing).

I had an ELCS at 38+3 although my waters broke that morning but I never went into active labour. I had skin to skin at the theatre and my mild came in 2 days later. Try to think positive, there is no reason why it all won't work really well for you!

I have two ELCS's. I fed DD1 till she was 22 months (her choice) and DD2 is still a newborn.

My milk came in by day 3-4 or so. I had a really hard time getting started with DD1 but that was due to nipple damage and bad advice from community midwives, not related to the section. With DD2 everything went fine.

I think I would have been "allowed" skin-to-skin in theatre but the sheet was so close to my head and I was lying at such a funny angle that I didn't want to. (DH held baby.) I have heard that as long as it's within 2 hours of birth, it's OK, although obviously the sooner the better.

With both babies I did allow very small amounts of formula (10-20ml/day) in the hospital before my milk came in. Both of them were really enthusiastic nursers and got distraught at times (like after feeding for hours) when there was no milk, and MWs thought they might end up jaundiced. It's not what everyone would do, and not all babies need it, but if your milk is taking a while to come in and baby is upset, it's an option.

Had a traumatic emcs with dc1 in a hospital with no rooming in or bf support. Was taken from me while in recovery (nothing wrong with her) and not allowed to see her for hours. Maybe was sheer bloody mindedness but eventually my milk came in and was able to bf.

Dc2 was elective and in a much calmer hospital environment. Didn't have any problem establishing bf, although milk did come in quicker this time - maybe because I was less stressed and was allowed to keep her with me.

Don't panic. It's perfectly possible.

Just to say baby girl welly (not her real name) arrived this morning, perfect in every way.

Spoke to both surgeon ans anaesthesiologist (? Sp) who agreed without question to skin to skin immediately. This was done and it was perfect until I had a low blood pressure drop and DD2 went to DH. Took a while to stabilise me but then in recovery less than an hour after birth DD2 was put to the breast, latched on perfectly and fed and fed and fed for three hours, then slept for four, then fed again.

So happy we've started out well, I certainly seem to have a good amount of colostrum and a few students have been sent my way to see a good example of newborn feeding.

Thank you for the reassuring advice.