If you're intending to breastfeed you may wish to consider the following:
- For a number of reasons some baby's need more support with establishing a good breastfeeding technique following a caesarean section. There are lots of great videos and resources online which can help with this. It would be advisable for you to watch these videos now and familiarise yourself with what a succesul breastfeeding technique looks like. Please see: Global Health Media, Emma Pickett or Kellymom for more info.
Also try and find a hardcopy or download a pdf of the NHS leaflet: Off to the best start. This pamphlet is amazing and tells you everything you need to know about breastfeeding in those first few hours, days and weeks. It also contains very helpful images.
In real life you may want to find out if you have any breastfeeding peer support groups locally: Breastfeeding Network (BfN), Association of Breastfeeding Mothers (ABM) and La Leche League (LLL) are the key charities/ organisations supporting family's with breastfeeding. Your local children's centre should be able to sign-post you to your nearest real life support. Again, it would be advisable to contact them today, maybe pop in and introduce yourself, children's centres are great places for meeting new mums and babies and accessing great support in those early days, weeks and months!
- Antenatally - I.e. over the next 72 hours you may wish to consider hand expressing some of your colostrum.
Ideally it would be great if you could collect anything expressed into multiple 0.5ml oral syringes (colostrum is produced in ridiculously tiny amounts and is essentially equivalent to liquid gold). Your GP, local pharmacist or neonatal ward at your maternity hospital will be able to provide these syringes for you.
Hand expressing colostrum serves a few purposes. One, the ability and knowledge of how to successfully hand express is a great skill to have, there may be occasions in the coming days and weeks where you need to express, for e.g. for comfort or to top-up a breastfeed (an electric pump is not appropriate for expressing colostrum). Two, milk production works on the basis that - the more milk which is removed from the breast, the more milk is produced by the body. If the breasts always remain full, this sends a signal to the body to slow down milk production. Three, it is very helpful if you can establish breastfeeding whilst you are still in theatre, however, sometimes this is not possible. You could remain in theatre for a good hour or more following the birth of your baby. If you or your birth partner can start feeding the baby your colostrum within that 'golden hour' it will improve your chances of successful breastfeeding later on. The boost from the energy kick that baby receives from the colostrum you've produced will help keep your baby awake and alert.
- On the morning (or afternoon) of surgery discuss with your surgeon, anethetist and midwife that you intend to have skin-to-skin with your baby as soon s/he is delivered and that you wish to establish breastfeeding in theatre whilst they deliver the placenta and sew you back up. Explain that you would like their support to help this happen.
One, explain that you have brought in some colostrum which needs to be kept in a fridge close to the theatre. They will direct your birth partner to where it should be stored. Two, explain that you do not wish to wear a hospital gown in theatre as once baby is delivered s/he needs to be brought straight onto your chest for immediate skin-to- skin and her/his first opportunity to breastfeed. This cannot happen if you are wearing a hospital gown. Your baby needs to be able to lie completely naked across your breasts and chest area. Three, with the above in mind, you will need to request that the canula needs to be placed as high up your forearm as possible. For some reason they always site cannula's next to the wrist, which is v annoying and makes it extremely difficult to hold your baby. They will also need to position any monitoring equipment (ECG, blood pressure etc etc) on your back. Again, for most surgeries monitoring equipment is placed on the chest, however, you need your chest completely clear to make space for your baby to lie across it. Your baby cannot lie on your chest if there are wires and chest pads running across it.
- Hospital theatres are usually freezing. You should bring a baby towel, tin foil (large enough to wrap around the baby) and a baby's hat into theatre. The hospital may supply you with a towel or blanket that you can wrap around yourself and baby whilst you're still in theatre.
To support you with all of the above your birth partner/s need to be fully up to speed with all of this and be prepared to support and advocate on yours and your new baby's behalf. Some members of your surgical team I hope will support you, others might be sceptical, hopefully as long as you're clear about what you would like to happen and you've come prepared the team should do everything in their power to support you.
I had an unhelpful anaesthetist insist that it was hospital policy that I wore a gown in theatre. Luckily her more senior colleagues advised her that she was talking absolute utter tosh and supported my naked surgery 😂.
If you're interested in finding out about slow/ natural caesareans Google: Belinda Green, motherland, natural caesarean.
Wishing you all the best for next week!
Ps: on both occasions i found the hospital floors and bathrooms to be pretty grim and was very thankful that I had brought my flip flops as I could keep them on during my showers and trips to the oftentimes wet bathrooms!