How To Make Breastfeeding More Manageable For Mother’s With C-Section Deliveries spoke with Dr Manzer Altamash Shaikh, Consultant Obstetrician, Gynecologist and Fertility Specialist, Masina Hospital, Mumbai, to understand all about what a new mother who has had a Caesarean section should know about breastfeeding .

Breastfeeding involves feeding an infant directly from its mother’s breast without using any accessories such as bottles, spoons, etc. Breastfeeding is essential for the health of infants and young children. Colostrum is the “perfect food” for newborns. WHO recommends that breastfeeding be initiated within the first hour after childbirth. The mode of delivery influences breastfeeding practices. This can negatively affect the initiation of breastfeeding, milk production, continued breastfeeding and receptivity of the infant compared to vaginal deliveries. With the high rate of caesarean sections, whether planned or urgent due to maternal or fetal indications, it has become a major public health problem. spoke with Dr Manzer Altamash Shaikh, Consultant Obstetrician, Gynecologist and Fertility Specialist, Masina Hospital, Mumbai, to understand all about what a new mother who has had a Caesarean section should know about breastfeeding .

Benefits of breastfeeding

Breastfeeding has major health benefits for both mother and baby. In the mother, it prevents uterine bleeding, promotes the mother-child bond, a natural form of family planning, prevents the future development of ovarian and breast cancer and, most importantly, it can be given directly to the baby without any preliminary preparation. For the baby, it provides the best possible nutrition, essential for optimal physical, emotional and mental development, protects the baby from colic, asthma, eczema, food and respiratory allergies.

In our day-to-day experience, most women who deliver by Caesarean section and their loved ones did not intend to start breastfeeding within the first 24 hours citing various reasons such as pain, positioning, etc. women planning a caesarean section and adequate counseling for relatives. Breastfeeding preparation and counseling should begin during pregnancy. Pregnant women should be informed of the importance of breastfeeding during the prenatal period, regardless of the mode of delivery. Prenatal breast care and motivation are of the utmost importance when the attending physician has a great influence on the expectant mother. The quality of support a new mother receives after a cesarean can help breastfeeding to a great extent.

10 Breastfeeding policies

It is important to have a written 10 point breastfeeding policy in the hospital to facilitate breastfeeding. Some of the main features of this include

  1. Have a written breastfeeding policy that is routinely communicated to maternity staff.
  2. Train staff in the skills needed to help mothers breastfeed.
  3. Inform all pregnant women about the benefits of breastfeeding.
  4. Help mothers start breastfeeding within half an hour of giving birth.
  5. Show how to breastfeed and how to maintain lactation.
  6. Do not give newborns any food or drink other than breast milk.
  7. Do not give pacifiers.
  8. Encourage on-demand feeding.
  9. Practice cohabitation, that is to say, allow the mother and the baby to be together 24 hours a day.
  10. Establish breastfeeding support groups.

Breastfeeding stations

Depending on the type of anesthesia the patient has received, breastfeeding may be initiated. Promote breastfeeding for as long as possible within half an hour after childbirth, by asking nurses to initiate breastfeeding on the operating table itself by helping to position the baby. If the patient has received general anesthesia, breastfeeding can be initiated once it begins to subside. While if the patient has received spinal or epidural anesthesia, breastfeeding can be started within the operating room itself or in the recovery room. However, if for some reason it is not possible for the mother to start breastfeeding immediately, practice cohabitation by having the baby hold the baby skin to skin with the mother.

It is very important to position the baby. Immediate postoperative period The mother may be sedated, ask the nurses to help her position the baby. Involve the partner or attendant to help position the baby correctly to develop a good latch.

The correct positioning of the baby is very important to ensure that it is not painful for the mother during the immediate postoperative period while ensuring efficient feeding and avoiding sore nipples and engorgement of the breasts, this includes Support of the whole body of the baby, the head, neck and back are on the same level while the whole body of the baby faces the mother and the baby’s abdomen touches the mother’s abdomen.

Football holding position

The most comfortable positions for mothers having a Caesarean section are the “football holding position” and the “lying on your side”.

Football holding position: The infant is placed under the arm, like holding a soccer ball,

  • The baby’s body is supported by the forearm and the head is supported by the hand.
  • But many mothers may not be comfortable with this position.

Lying on your side

Lying on your side: the mother is lying on her side, supporting her head and shoulders with a pillow.

  • The infant is also lying in front of the mother,
  • This is a traditional position and many mothers are comfortable in this position.
  • These positions ensure that there is no direct pressure on the suture line in the immediate postoperative period.
  • Once the pain is less and the mother is able to sit up, she can use a nursing pillow to raise the baby to breast level so that it is easier to breastfeed.

It is very important that the patient receives adequate pain relief so that she feels comfortable while breastfeeding and that pain at the operation site is not a reason to dissuade her from breastfeeding. Emotional and physical exhaustion after a cesarean can add barriers to eating. Therefore, emotional support through counseling, adequate rest, hydration and a nutritious diet can make this trip enjoyable.

On a positive note, cesarean delivery ensures that the patient will stay in the hospital longer, so be sure to get help from the nursing staff and the lactation consultant to learn more about the aforementioned intricacies of breastfeeding.

So, in conclusion, the promotion of mother-friendly policies by institutions implemented in a baby-friendly manner is important. Knowledge of breastfeeding practices and motivation are important factors for successful feeding after cesarean section. It is essential to initiate breastfeeding early while practicing cohabitation, additional supportive care should be available to breastfeeding mothers in the first 24 hours as well as at the start of the postpartum period. Therefore, even if a cesarean delivery adds barriers to effective breastfeeding, continue to get help and continue to feed yourself.

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