How to have enough milk to breastfeed after cesarean section?

How can I have enough milk to breastfeed my baby after a cesarean section, when I have to take antibiotics and still have pain in the incision? Should I supplement with formula milk in the first days after a cesarean section? (Trang, Ho Chi Minh City)

Reply:

The most important mechanism of milk production is the supply-demand mechanism, which means that the baby must suckle so that milk is drawn from the breast, thereby emptying the milk sacs continuously. From there, the mother's body understands that the baby needs milk and continues to produce milk. If the mother adds a bottle of formula to the baby, the colostrum is not drawn from the breast, the body does not understand that the baby needs milk, and will reduce the production of milk.

Colostrum is available from week 16-22 of pregnancy, not after giving birth as many mothers think. Therefore, whether giving birth naturally or by cesarean section, the milk production mechanism is the same. Mothers who have had a cesarean section still have enough milk for their babies if they are persistent in holding their babies to breastfeed. Many people mistakenly think that cesarean section will cause milk to come in slowly, so they do not persist in exclusively breastfeeding their babies immediately after giving birth. Many mothers also find their breasts soft in the first few days or when they try to express their milk by hand and do not see any milk, they think they do not have enough milk, so they also give their babies bottles.

Colostrum in the first few days is small but just enough for the baby's small stomach. Because the amount of colostrum is small and very thick, the mother will find her breasts soft and difficult to express. This is a normal phenomenon, only the baby can help get the colostrum out of the breast most easily.

Baby bottles and formula are easily purchased, combined with pressure from families who fear that their babies will be hungry, so many babies are supplemented with formula at the wrong time. Before giving birth, mothers need to learn about breast milk, learn how to hold and latch on to the mother's breast deeply so that the baby can get milk effectively and the mother does not feel pain.

Prenatal studies will help mothers understand how to monitor the signs of adequate feeding in their babies, especially in the first week after birth. Regarding diapers, mothers should count the number of diapers in 24 hours (at least 1 on day 1, at least 2 on day 2, then gradually increase by 1 diaper each day, and from day 5 onwards, at least 5-6). Regarding diapers, mothers should observe the color of the meconium from black to dark green, moss green, and gradually change to yellow, at the latest on day 6-7 after birth. The color change is due to breast milk pushing out the meconium and gradually lightening its color. During a cesarean section, if there is pain, mothers should inform the doctor to get good pain relief. Mothers can lie on their side to breastfeed instead of having to sit up.

When using antibiotics after surgery, the doctor will use prophylactic antibiotics that can be used while breastfeeding, so mothers can rest assured to breastfeed their babies. When the mother's health condition is special, strong antibiotics must be used, and breastfeeding is not possible, the doctor will advise.

In short, if a mother who has had a cesarean section wants to have enough milk for her baby, she needs to remember that colostrum is already in her breasts from weeks 16-22 of pregnancy. Master the skills of holding and latching properly. Breastfeed 100%, no bottles, no formula. Master the signs of enough milk to feel secure when holding and breastfeeding your baby without fear of hunger.

Dr. Le Ngoc Anh Thy
BMC Breastfeeding Consulting Center

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