As a midwife I have supported many families through the first feeds after a caesarean, and the message I most want to get across is that a caesarean is not a barrier to breastfeeding. Whether your caesarean was planned or unexpected, with a little more support in the early days most mums go on to feed well. Here is how to give feeding the best possible start while you recover.

Skin to skin and the first feed

Skin to skin can often happen soon after a caesarean, sometimes in theatre or in the recovery room, and it helps your baby stay warm, calm and ready to feed. If you and your baby are separated at first, your birth partner can do skin to skin until you are ready. The first feed often happens within the first hour or two, and there is no need to worry if it takes a little longer. You can read more about why those first moments matter in Skin to skin and the golden hour.

Comfortable positions that protect your wound

After abdominal surgery, the aim is to keep your baby's weight off your tummy. Positions that tend to work well are:

  • Laid back feeding, leaning back with your baby resting on your chest.
  • Side lying, feeding while you both lie down, which is restful in the early days.
  • The rugby ball hold, with your baby tucked along your side away from your wound and supported on a pillow.

Use plenty of pillows for support, and ask for help getting comfortable before each feed. A good, deep latch matters just as much here, and you can read more in Latch and nipple pain.

Colostrum and your milk coming in

Your body makes colostrum, the rich first milk, from before your baby is born, so it is ready for them straight away. After a caesarean, your fuller milk can sometimes take a little longer to come in, so frequent feeding and skin to skin in the early days really help. If your baby is sleepy or not feeding much at first, hand expressing colostrum and giving it to your baby keeps things moving. Many parents having a planned caesarean find it helpful to collect a little colostrum before birth, as in Collecting colostrum.

Getting help while you recover

  • Ask for help lifting and passing your baby, especially in the first days.
  • Keep your pain relief regular. The pain relief used after a caesarean is usually compatible with breastfeeding.
  • Rest when you can, and accept help at home.
  • Your emotional recovery matters too, especially after an unexpected or emergency caesarean. Support is there for how you are feeling, as well as for feeding.

Get help from your midwife, health visitor or an IBCLC if:

  • Feeding is painful, or your baby is struggling to latch.
  • Your baby is very sleepy, or not feeding often in the early days.
  • You are worried about your baby's weight or nappies.
  • You are finding recovery and feeding hard to manage together.

Call 999 or take your baby straight to A&E if your baby:

  • Is floppy or unresponsive
  • Will not wake for feeds
  • Is having trouble breathing, or their lips, tongue or gums look blue or grey
  • Has a sunken fontanelle
  • Is visibly jaundiced and unwell with it, for example floppy, hard to wake or not feeding. Yellowing shows most clearly in the whites of the eyes, the gums, and the palms and soles
  • Has dark urine or pale, chalky stools

How a consultation helps

Feeding after a caesarean is often just a matter of getting comfortable and protected while your baby latches, and that is much easier with someone alongside you. When I visit I help you find positions that keep the weight off your wound, get a deep, comfortable latch, and make sure your baby is feeding and your milk is coming in, all worked gently around your recovery. As a midwife as well as an IBCLC, I understand what your body is healing from, not just how your baby is feeding.