Since nearly one-third of deliveries in the US occur via cesarean section, it’s important that moms who plan to breastfeed are prepared no matter how their baby is born. While giving birth isn’t typically easy (hence the term “labor”), C-sections add a whole new dynamic to delivery and breastfeeding for which many moms aren’t prepared.

Research shows that moms who deliver via C-section may stop breastfeeding earlier than moms who deliver vaginally, so it’s especially crucial for belly-birth moms to start off on the right foot in order to meet their breastfeeding goals. As an IBCLC, lactation counselor, nurse, and mom of three, I’ve put together some tips to help you get your breastfeeding journey started out right.

1. Set breastfeeding goals.

Your decision to breastfeed may be based on lifestyle, family support, previous breastfeeding experience, and personal health. After making this decision, it can be helpful to set a goal for how long you’d like to breastfeed.

You may even want to set a reach goal in case you meet your initial goal. For example, my breastfeeding goal is one year. My reach goal is two years. I haven’t made it there yet, but I have surpassed the one-year mark with each of my kids.

Whether your goal is two weeks or two years, concrete breastfeeding goals can contribute to your overall breastfeeding success no matter how you deliver.

2. Learn how to hand express.

Since hand expression can increase milk production, learning how to hand express your breast milk can help you feel more confident about breastfeeding. In addition, the milk you express can be fed to your baby if you’re separated after delivery.

To hand express, gently massage your breast to help get the liquid gold flowing. Then, with your hand in a C-shape, cup your breast, gently compressing it while pushing the tissue toward your breast wall. Start with your fingers outside of your areola, and gently roll them towards your nipple.

Need some more pointers? Watch this great video demonstrating proper hand expression by Jane Morton, MD, from the Lucile Packard Children’s Hospital at Stanford.

3. Do skin-to-skin after delivery.

Before delivery, tell your birth team that you want your baby placed skin-to-skin with you immediately after birth. Skin-to-skin is part of a set of evidence-based practices that are highly recommended in the first hour after birth, which is often referred to as the Golden Hour. Skin-to-skin can help initiate breastfeeding, regulate your baby’s body temperature, and stabilize their heart rate and blood glucose levels.

As long as mom and baby are healthy, skin-to-skin contact can occur in the operating room and recovery room. If you’re unable to have your baby skin-to-skin due to medical circumstances, consider having your birth partner hold your baby skin-to-skin if possible. Make sure to check your hospital’s policies, especially in light of frequently changing protocols due to the coronavirus.

4. Breastfeed early and often.

Research shows that initiating breastfeeding within two hours of delivery significantly increases breastfeeding rates. Early breastfeeding also increases overall milk volume and decreases the amount of time until lactogenesis-II, the onset of copious milk production.

Since C-section delivery may cause a delay in milk production, moms who are breastfeeding after a cesarean can prevent this delay by nursing and/or using a breast pump as early and often as possible (ideally at least 10 - 12 times every 24 hours to build your milk supply), even if immediate skin-to-skin can’t happen.

5. Have a support person.

Since you may be drowsy or uncomfortable after a C-section, a support person can help you position yourself and ensure you and your baby are safe; this assistance can help reduce your anxiety and get your baby latched on. A nurse or lactation consultant can also answer any questions you may have about breastfeeding and achieving a good nursing position.

6. Nurse however you’re most comfortable.

To keep your newborn away from your incision site, try breastfeeding in a laid-back position on the couch or in bed with your baby on your chest (ensuring they have a clear airway), or in a football hold. Once you’re home and have recovered for a few days, side-lying can be a comfortable position that allows you to rest while nursing.

Some moms prefer to nurse while sitting on a couch or recliner while others prefer to sit up in bed. For more information, check out this blog or the video below, which shows several different nursing positions.

7. Use pillows while nursing.

Whether you’re nursing at home or at the hospital, pillows can be your best friend when finding a comfortable breastfeeding position. Nursing pillows are great, but any pillow you have will work just as well.

Place the pillows behind your back and neck, under your arms, and even across your belly to protect your incision site. If needed, pillows can help with positioning your baby (e.g., place a pillow under your baby to help bring them closer to your breast).

8. Rest, rest, rest after your C-section.

Due to medications from the surgery, you may be groggy and incredibly tired, especially if you had a long labor prior to delivery. Ask for help when you need it. Your nurses and lactation consultants are there to help you heal and rest, so take advantage of the amazing professional help available.

Those first few days and weeks are filled with wonder and excitement, and while you’ll likely want to share the joy with your loved ones, you may want to consider asking visitors to wait (especially when you’re having a baby during the coronavirus). This will allow you time to bond with your newborn and begin your recovery.

Prepare to-do lists for those who want to help out. Before you deliver, you can also make freezer meals that are easy to heat up after you return home.

9. Pay attention to your pain level.

A C-section is a major abdominal surgery. I can’t stress enough how important it is to rest and take your prescribed medications as needed to keep your pain level manageable. High levels of pain can negatively impact newborn care and breastfeeding. Many pain medications are compatible with breastfeeding, so talk to your health care team about your options.

10. Wear the right nursing clothes.

Ask any mom who has had a C-section and she will tell you to be sure your clothes don’t rub on your incision site. It’s also important to wear nursing tops that allow easy access for skin-to-skin and breastfeeding. Nursing bras, nursing tanks, pajamas, postpartum underwear, and high-waisted maternity leggings are all great options for a recently postpartum mama who is recovering from a C-section.

Being prepared to start breastfeeding – whether or not your delivery went according to birth plan – can increase your confidence and help you make the adjustments necessary to comfortably feed your baby. Need more breastfeeding help? Check out these resources, and please comment below with your favorite tips for breastfeeding after a C-section.