C-sectioned mothers are at higher risk for producing insufficient milk, having attachment difficulty and early termination of breastfeeding (Dewey 2003). Peripartum events, including anesthesia, infant-mother separation, and delayed initiation of suckling contribute to these risks. Initiate preventative measures within the first hours to reduce these risks (AAP Policy 2005, Kurinij, 1991).
- Reestablish the connection of the un-bathed infant with his/her mother within the first post-partum hour and offer hands-on assistance with the first breastfeeding, if needed. Explain to the mother that scent and touch are the key imprinting senses for early feeds, and bathing can come later (Schall, 2003, K Mizuno, AAP Policy).
- Provide skin-to-skin contact, as much as possible, especially during the first day, and focus the teaching on attachment, effective suckling and increasing milk production (Hurst, 1997, Kirsten 2001).
- Teach the mothers to manually express colostrum into a teaspoon as often as possible (at least with each breastfeeding session) and feed this to her infant. (See Appendix G).
- On day 2, add pumping if the infant is too sleepy to attach and nurse effectively. The frequency should be 8 times every 24 hours, with no more than a 5 hours interval at night.
Even though you have exactly the amount of colostrum your baby needs now, for these first couple of days, we have learned that babies born by C-section may require a little more help to learn how to latch on and nurse effectively. By offering your baby frequent tastes of your colostrum, and stimulating your breasts by manual expression to “phone in your order for Day 3”, we can make sure that by the time you go home, your production will be higher. This will make it easier for your baby to learn just how to breastfeed and get a full feeding.
I know you are recovering from surgery right now, but it is important for your breasts to get the message to make lots of milk for your baby. Be sure to keep your baby with you all the time, and have your (husband, mother, partner) and the nurses help you with feedings both day and night.
Babies At Risk
- C-section Mothers
- Mothers with multiples
- Infants who have not latched-on or nursed effectively for 12 hours
- Mothers of NICU or PSCN infants
- Infants supplemented more than once in 24 hours
- Infants < 38 weeks or less than 6 pounds
- Infant with loss of 10% birth weight
- Mothers with breast surgery
- Mothers with a history of breastfeeding failure
- Antepartum mothers at risk of preterm delivery