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Supporting Lactation After a Cesarean Section

A large U.S. Study (Flaherman et al., 2015) found a significant relationship between cesarean birth and delayed increase in milk production compared to infants born vaginally, leading to infant weight loss and insufficient milk supply. A 2003 Australian study (Evans, Evans, Royal, Esterman, & James, 2003) provided some clues as to why that might be:

* Delayed first feed * Shorter first feed * Shorter feeds in general, even though they were feeding as regularly as babies who were born vaginally. * Birth weight regained by day 6 (40% vaginal, 20% cesarean)

Although there are other factors that can affect infant weight loss such as the birther receiving IV fluids in labour, babies born by c-section lost more weight, whether they were nursed or formula fed.

It is common for care providers to suggest supplementing with formula when weight loss is more than 7%, however, weight loss in the range of 8-10% may be within normal if a physical exam indicates the baby is well. It is more-so an indication that careful assessment of health and breastfeeding assistance is needed. So what can be done to prevent insufficient milk supply and infant weight loss after a cesarean birth? Here are 6 tips:

1) After checking with your care provider, hand express or pump colostrum during your pregnancy. Store it in your freezer and, if needed, use it for top ups when baby is born instead of formula.

2) Tell your care provider that you'd like immediate skin to skin and breast/chest feeding initiation when your baby is born.

3) Express or pump for 5-10 min after each feed if baby is not actively feeding (big jaw movements & audible swallowing) more than 15 min at a time. Use the expressed milk for top ups.

4) Cup feed instead of bottle feed to support nursing skills and prevent artificial nipple preference. Cups also can we washed in soapy water while bottle teats need to be sanitized due to small crevices.

5) Seek out support from friends, family or a Postpartum Doula so that you can heal and rest. Be sure to drink lots of water and eat nourishing foods such as leafy greens, yams, oats, lentils, garlic etc.

6) See Pamela for support in making a personalized feeding plan! Book online here !


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