Breastfeeding after planned c-section

[TeainanIV]

Hello all! I had an elective C-section on 6th Nov and welcomed another gorgeous DD to our family. We're home now and settling but I'm really struggling with breastfeeding as my milk is showing no signs of appearing yet. Baby girl is constantly wanting to be on the boob - and won't settle unless she has a nipple in her mouth. But now is getting increasingly frustrated as it's clear there's very little coming out now - colostrum is there but she's been on it for hours at a time that I think there's just nothing left! I don't know whether I should be topping up with formula or whether to carry on and hope my supply comes soon? Her latch is great, nothing wrong with that at all and no tongue tie.

I breastfed my first DD until she was 2 years old and I'll be devastated if I can't feed my DD2 😞

I topped up with formula with mine. It worked well as they got used to the bottle and meant I could express and my husband could take over for a bit and I could get some sleep!

@Grepes thank you? Can you remember what day your milk came in? Did they still successfully breastfeed?

@Grepes sorry shouldn't be a question mark after thank you!

Congratulations! So the baby is only 48 hours old? I don't think my milk was in that early on either of mine (both sections). I think maybe day 3? I think day 2 is pretty standard even with natural deliveries isn't it? I'm sure you'll get there. Just let her do her thing and odds are it'll come in soon.

I can't remember when my milk came in as such but could you pump to try and encourage it to come through ?
Keep going your doing a great job xx

My milk didn’t come in with my eldest until day 5. She was a big baby but was just fine. There’s no need to top up.

@BarbaraHoward yeah, I hadn't thought of it in terms of hours 🙈 she's just screamed for hours on end now in frustration - poor baby! I think she's so hungry and just wants to be on the boob permanently but is getting annoyed as there's nothing coming out! Really hoping it makes an appearance tomorrow, I actually think it was day 3 for me with my DD1 which was a vaginal birth!

@OchAyeTheN00 was she getting frustrated/appeared hungry? My DD is getting so worked up - screaming and crying unless on the breast, but then getting worked up on it as there's nothing left!

@howluckyami25 digging out my pump as we speak!!

OP there’s a free NHS feeding helpline - but there shouldn’t be any need to top up. New babies often cluster feed to bring milk in, she’s doing her job. And it’s not unusual for it to take a few days (I’ve three born by c section and my milk tended to come in 2.5 days to 4.5 days after birth).

One bottle won’t harm her if it’s what you want but please don’t feel under any pressure to pump additionally to feeding. Baba is the best tool you can use to prompt milk.

Hope she settles soon. In the meantime; can you take care of yourself? Are you sore with the cluster feeding? Silver cups? Soft/non disposable breast pads, creams? Painkillers?

She’s very young and it’s great that she’s constantly on the boob. I would keep going, the milk will come imminently. I breastfed my second after a c section with no major problems.

Oh god it's hell isn't it. 🙈 My second was pretty settled from the off but my first was so unhappy. That second night in hospital was awful.

Hang in there. I think the second time around I'd blocked out how awful the newborn bit is and it surprised me all over again.

Are you seeing the midwife today? You could ask about top ups. Or just give one if you're happy to.

Yeah I don't know that I'd bother with the instrument of torture pump if the baby is latching well. She'll be at least as effective surely, and you need something of a break when she's not latched.

Day 3 is normal for your milk to come in. She’s feeding constantly as she’s trying to bring your milk through. It’s completely normal for babies to cluster feed on day 2, as exhausting as it is! Personally, I wouldn’t recommend pumping until feeding is established.

I remember my milk came in properly on day 3 or 4, so it might just be a bit early for you.
I regrettably never got on with breastfeeding as both of mine had severe tongue ties but from what I've read from other similar posts you are doing the right thing keep putting her on the boob as they cluster feed a lot in the beginning.

@BarbaraHoward oh god I'd completely forgotten, absolutely horrendous. So glad to be home from that! Yes, community midwife should be here today 🙏🏼 not been given a time so hoping it's sooner rather than later! I'll ask her for some advice, I really want to avoid giving top ups to be honest - just feeling at my wits end already and she's just so miserable and frustrated on the breast as she's not getting what she's after. It must be so annoying for her!

It took exactly 3 days.

I'd been planning on mix feeding though so had alternated with bottles so I don't think she was hungry. She then promptly rejected bottles and strongarmed me into EBF 🙄😂

Hi OP, yes I had this too.

I had a ELCS brought forward to just under 38 weeks as I had pre-eclampsia and there was no sign of my milk coming in at that point whatsoever. My daughter was fine but small (5lbs 10oz) and that first night in hospital was probably the worst of my life - it was during covid and there was no one to help me whatsoever, no lactation consultant, no advice or assistance. None of the women in my family ever breastfed before so they couldn't give any advice and just told me to give up and give her formula.

In the days that followed at home, the struggle continued. Babies weight dropped 12% and I was told she'd be admitted back to hospital the next morning if her weight didn't start to go up. I was told at this point to top up every feed with the pre made little actimel bottles for 2 weeks as my milk gradually came in. It's not necessary for everyone but it was for us.

It worked! Her weight started creeping up straight away and my milk slowly came in until she no longer needed any top ups. It was a tough start but so worth it.....i breastfed for a year and she is now a healthy 4 year old.

I never got much joy out of pumping but we still used those little actimel bottles in emergencies when I wasn't around, they were a god send and thankfully the top ups meant DD1 was used to bottles and dummies from the beginning with no effect on her breastfeeding.

I'm pregnant with my second more and fully prepared to do the same this time as well.

What you're experiencing sounds completely normal to me OP. Milk production is initially driven by a cascade of hormonal changes started off by the delivery of the placenta and it typically takes 3-5 days regardless of the type of birth.
It's really hard work and you're also recovering from major surgery but hopefully it won't last too much longer. Make sure you are eating and drinking plenty, rest as much as possible (easier said than done I know!) and hopefully your milk will be along very soon. It's unlikely that your baby desperately needs topping up with formula but it's not the end of the world if you give some ‐ your well being matters too. Personally I would use a syringe or cup rather than a bottle if possible if you do decide to give formula and I wouldn't bother trying to express at this stage. Your baby is already feeding very frequently and most people find it very difficult to express colostrum as it is so thick and sticky anyway. Pumping is unlikely to be beneficial and will probably just add to the anxiety/exhaustion/pain that you're experiencing now. Feed your baby whenever she needs, look after yourself and lean on other people to do everything else right now if you can.* *
Obviously check with your midwife, but honestly, this all sounds very normal for day two to me. You're still well within the normal range for milk coming in and colostrum should be everything she needs right now.
I remember the night before my milk came in with each of my 3 (1 section, 2 vaginal births) being absolutely miserable and feeling desperate - it doesn't seem like colostrum can possibly be enough does it, but most of the time it is. It's brilliant stuff full of goodies and you're doing a great job. Hang on in there, things will get better I'm sure.

@TeainanIV
About two weeks I think! Same as you, they were permanently attached to the boob and crying as they weren’t getting much. It was horrendous, I remember spending evenings wailing. The mixed feeding worked out really well for us and I would definitely do it again.

Milk doesn't properly come in until around day 3. Even a small amount of Colostrum is surprising nutritious. Having a c-section shouldn't stop your milk coming in or getting a supply going, however some women just don't produce enough milk regardless of the birth experience, and there's no shame in supplementing.

I hear you. DS was born by urgent CS and I think my milk finally came in on day 5 (and boy did it come in, I had to pump a bit so my breasts became soft enough so he could actually latch on). But after that I successfully breastfed him for a year. I was told - although bear in mind this was 19 years ago so research may have changed - that milk was often later to come in after a CS.

My milk came in day 3 with DC1 and DC3 - one ventouse birth and one unassisted vaginal birth with a just-about-haemorrage, both fairly petite babies (just under 7lbs). DC2 was 8lb 6, ventouse birth with a larger haemorrhage, my milk didn't come in until day 5. They all breastfed fine though albeit painful for me to start with. DC1 and DC3 had actually both gained weight by their day 5 weigh in and DC2 had lost a tiny marginal amount.

If you want to give formula for whatever reason then an odd one isn't going to ruin your breastfeeding plans. However from what you describe it doesn't like it's needed assuming baby is having enough wet and dirty nappies?

Also you said baby is attached for hours, do they definitely not have a tongue tie? And finally usually when that's happening baby is actually only actively feeding for 10-20 mins, then they're just dozing on the breast, as they still suck in their sleep. You can tell their sucking pattern changes to light flutter sucks, little to no swallowing heard, and long gaps between sucking bouts, and sleet breathing. When this happens, use your little finger in baby's mouth to break the suction and get them off the breast so you/your nipples can have a break. If baby roots or cries immediately they're not done feeding and you can pop them back on or switch sides. But chances are they will actually just be asleep after 20 mins and won't react.

This is really normal. There's never "nothing left" although at times flow might be slower.

If baby is having plenty of wet and dirty nappies, you're producing enough colostrum and the mature milk will come through when it's needed.

Is she having wet and dirty nappies? That is the key indicator she’s getting enough rather than frustration if she’s latching well enough.

Her tummy is absolutely tiny - the size of a walnut - so she can’t actually take that much in. Shes wanting the boob non-stop because she’s trying to help to get your milk to come in.

https://www.lllc.ca/newborns-have-small-stomachs

I had a section on a Monday and my milk came in on Thursday, so yours should be imminent.