Elective Cesarean and breastfeeding? Possible?

[getthecakeready]

I have an ELCS planned for 38 weeks. Also, the baby is very small (5th centile..).. I have breastfed 2 babies without any issues so far (one of them an EMCS).

I read on here that "elective CS increases the time for the milk to come in. normal births will take 3-4 days, sometimes you will need to add on 1-2 days when you have a caesarean, but more so during an elective. The reason being is that labour (so if you have normal birth or emergency caesarean in labour) tells the breasts that the baby will be coming soon. if you have an elective caesarean your body has no idea what is about to happen as it hasn't laboured, so it takes a couple of days to catch up with the milk..." (thanks for that info btw!)

This makes sense..

So i guess the "slow" starting of the milk and the fact that baby is small will mean that the midwives will tell me to "top up". Have you managed to establish breastfeeding even though you topped up already in hospital? (I am happy to do what the midwives say is best for the baby...)

How did breastfeeding go if you had an ELCS?

Have had both an EMCS and an ELCS and both times milk took 5 days to come in, no probs bfeeding either of them, both bf for a year. If anything it was slightly easier after the ELCS as I wasn't so knackered.

My elcs my milk took two days to come in, but DS didn't want to feed at all for three days!

Came in about 2 days. No problem at all. If you're at full term your body knows whats coming.?

I have had two emergency sections and bfed both of my DC with no problems at all (apart from a bit of biting but hopefully that won't be a problem with a newborn )

The midwives were all great and never suggested I "top them up" and helped me with how to position the baby.

I always think that bfeeding is like any new skill you have to learn how to do it and be determined to succeed and it is one of the most rewarding and satisfying experiences. It can be hard when the baby only wants you but that is life as a mum and they are only small for a little while.

Lots of mums I know also had sections and bfed straight away too and the milk doesn't come in until the third day anyway (or something like that)

Good luck with the CS and I hope you manage to bfeed if that is what you want.

Its not labour that makes the milk supply come in but the loss of the placenta. Once the placental hormones have left your body, the mature milk comes forth. Also a second or subsequent pregnancy is associated with a more bountiful lactation, so quantity should not be a problem if you've done it ok before.

Another thought. In some units, mothers are encouraged to express colostrum for a few weeks before birth to prevent low blood sugar in the newborn. This is particularly useful for diabetics. Your hospital might have a lactation specialist midwife who can advise. Colostrum in tiny amounts can be stored in the freezer and can make the difference between supplementing and not supplementing.

Read my rant on that thread . Forgot to mention my DD didn't even register as a percentile, when delivered and only got her .4 percentile badge at around three weeks. I didn't labour and had an EMCS and my milk came in between days 2 and 3.

getthecakeready, I am sorry but that post on the other thread about how long and why milk comes in was badly informed nonsense. I sincerely hope that poster is NOT an actual MW, with pregnant or new mothers under her care. As you point out, anxiety about milk taking over a week to come in (...) means that new mothers are more likely to feed formula early on when they simply do not need to worry about it.

This is proper information - kellymom.com/ages/newborn/newborn-concerns/c-section/

I posted a few tips on the other thread.

Thanks guys for correcting the facts.

you have given me great advice, feel less anxious now!

Milk came in day 4/5 after breech ELCS which turned into EMCS when waters broke early.

She was 9th centile and put on blood sugar protocol after 24 hours as she was small.

Midwife in theatre put her to the breast - fantastic. Other midwives pressured me to top up which I did for my 3 days in hospital as I didn't know any better an they told me if I didn't she'd be in SCBU!!

Once the milk came in she was EBF and continues to be at 18 weeks.

It was HARD learning and waiting but I'm glad we persevered and followed instinct.

Good luck!

DD was topped up once with 1oz of formula on her first night, because I was too dazed and confused to even realise I could express for her instead. This time I'm going armed with syringes of colostrum just in case ;).

I don't want to, but if I have to I'll be ready for battle with the midwives, my armoury consists of syringes of colostrum and my battle-hardened nipples!

Just to reassure you, it is possible to establish bf even if other methods of feeding are required initially. With my dd2, who was prem, we went from NG (tube from nose to stomach) formula feeding, to NG breast milk feeding to exclusively breast milk from the breast in the first 3 or 4 weeks. She then bf for a year. Be prepared to do a a lot of expressing though!

Had an EMCS with first DD and had to top up (using a cup) in hospital as milk didn't come in until Day 5/6. She was very dozy and not interested in feeding and lost her full 10% so the topping up continued. I tried to express around Day 7/8 to see how much I was producing and managed an ounce in 40 mins so in panic started her on formula and despite following on with lots of skin to skin, days and weeks of on demand feeding "to build my supply" I never got to a point where she didn't seem to want her evening bottle.
In hindsight it was not required - she was a v chubby baby and we saw a lot of the BF and formula returned to us so was just greedy I think. Def didn't have reflux or any other/allergy issues. Will be trying to EBF with No 2 and quite concerned that as I am likely to have an elective I will be under pressure to top up again very quickly. Few days of hell to look forward to until the milk shows up.
I found actually found Mumsnet and Kellymom to be particularly useful - esp in the dead of night while feeding. Could google it on the phone.
Best of luck - the top tip I can think of is get your partner to bring you breakfast in bed every morning so you make sure you get a good start to the day. Limit your visitors for the first two weeks so you can get lots of skin to skin if you need to (bit awkward to do otherwise:) ) and GET LOTS OF SLEEP. My milk really came in after a decent nights sleep which I did not get in the hospital and the first night out seems to be a noisy one with a newborn - poss the temperature drop waking them up!

Hello, I had an ELCS in April this year and my milk came in after 3 days. Baby had no problem suckling colostrum prior to that; she was put to my breast in theatre and it was great :)

I would say that I had an easier time getting BF started with the ELCS than after my first baby's instrumental vaginal delivery, which was quite traumatic (for us both). I think that had something to do with it.

Good luck x

MammaT

The slow starting to the milk coming in has nothing to do with method of delivery and everything to do with stimulation of the breast.

Stimulation of the breast can be slow because of the drugs in the baby from the c-section, the drugs in the mother or simply the recovery making it difficult to respond quickly to her baby.

If you can get the baby to the breast often (more than 12 opportunities a day to feed with no gaps of more than 2 hours) then milk is likely to come in as quickly as a pain-relief-free vb.

Oh, and colustrum is enough for however many days it takes for your milk to come in. The baby doesn't starve. Think of colustrum as simply clear coloured milk, or milk as white coloured colostrum. It's there. It will feed your baby.

The whole drop in weight thing after the birth, has more to do with inefficient feeding due to the learning process than the availability of milk.

Was really concerned when I read that on the other thread as well - not sure if I have to have a section yet (need presentation checked in 2 weeks, currently breech) but would be gutted if I couldn't breastfeed her! Thankfully some more knowledgeable posters clarified the facts pretty quickly. May report the 'midwife' post as it's caused people undue concern over sections and breastfeeding...

ELCS first time, milk came on day 4 in after GALLONS of colostrum and I thought my tits were going to blow off! Breastfed exclusively for over a year.

Yes, definitely can be done.

My twins were born by emcs last year, with me under GA. They were whisked to SBCU, where both were tube fed for 24 hrs. I started expressing the day after they were born but they did have some formula via tube and then via bottle in the first few days as I couldn't express enough for both of them at that early stage. Milk came in on day 3, by day 4 they were both exclusively bfed direct from source. They're now 13 months and we're still going strong. So despite having many factors against us, it worked out.

I think having bfed before (I had, twice) makes a huge difference as both you and your boobs, in terms of milk coming in etc, know what you are doing.

Best of luck, I'm sure it will work out just fine

hiya,
i think thats my message you have quoted! what i have said shouldn't affect your outcome as to whether you can breastfeed or not, it just may take a little bit more time. breast milk coming in is mostly down to the placenta coming out, but it definitely is quicker in those who have laboured. there is no reason you need to top up, as you will have plenty of colostrum in your breasts. it might be a good idea to express as much as you can when the baby is born, preferably every 3-4 hours if the baby is not goign to the breast as often as that. breastfeeding is obviously on demand, but the more stimulation your nipples get in the first few days, the quicker your milk will come in

you can express colostrum into sterile syringes at the hospital, and that can be fed to the baby as top ups or if the baby is a bit reluctant to feed in the first days.

colostrum has really high levels of sugar in it. the baby's tummy is only the size of a small marble at birth therefore the baby only needs a few drops to get its sugars up. so there's no reason you will need to top up, don't let midwives (or paediatricians especially) tell you that the baby needs topping up because its small. they may do blood sugars on the baby if the baby is born below the 10th centile. as long as you put the baby to the breast as much as possible, and keep baby warm so its sugar reserves arent used up (so lots of skin to skin - this will also help with your milk coming in) then there's no reason your baby won't be fine just on colostrum and feeding from the breast alone.

good luck!
Emma

If blood sugar is low you can request IV rather than formula. This would be my preference.

I had 2 ELCSs, milk in within 48 hrs both times.

Get your baby to the breast ASAP, and feed on demand.

Can't believe in 2012 people still buy into the CS will slow establishment of breastfeeding myth.

Had ELCS at 39 weeks for DD2. Milk in on day 3, fed beautifully from the off. Bf couldn't have been easier.

Contrast that with my 1st birth, a traumatic VB. Milk didn't come in until day 6. Contrary to some of the advice upthread colostrum was not enough to sustain her until my milk came in. She became weaker and sleepier and so less able to feed and suckle as the days went on which became a vicious circle and she ended up hospitalised with a gastro-nasal feeding tube. She came out of hospital on formula top ups but was ebf after about 2-3 weeks.

So, it possible for bf to be a breeze after ELCS, it was for me. But if you are being advised by medical staff to top up with formula, please do not feel you shouldn't/it's unnecessary/you've ruined the ebf halcyon because I fell into that trap 1st time round and it did DD1 no good.