Breastfeeding after a C-section: what to expect, and what helps

In Mumbai, many of the mothers I meet have had a caesarean. The question is almost always the same: "Will I still be able to breastfeed?" Yes, you absolutely can. A C-section can make the first few days a little different, but it doesn't stop your body from making milk.

Start as early as you can

If you and your baby are well, ask to hold your baby skin-to-skin as soon as possible, even in the recovery room. Early skin-to-skin and a first feed within the first hour or so help your baby's feeding reflexes and give your milk supply a good start.

If you're separated at first, that's okay too. Ask a nurse to help you hand express within the first few hours. Even a few drops of colostrum are precious, and expressing tells your body to start making milk.

"My milk hasn't come in yet"

For the first two or three days, your body makes colostrum: small amounts of thick, golden milk that's exactly what a newborn's tiny stomach needs. After a C-section, the fuller milk sometimes comes in a day or so later than after a vaginal birth. That's common, and not a sign that something's wrong.

What helps most is frequent feeding: around 8 to 12 times in 24 hours. Watch the wet nappies and weight checks rather than worrying about how full your breasts feel.

Frequent feeding in the first days is the single best thing you can do for your supply.

Positions that protect your wound

• Football hold: your baby tucked along your side, under your arm. No weight on your tummy at all.
• Side-lying: great for the first days in bed, with a pillow behind your back.
• Pillow over the scar: in a cradle hold, a folded towel or pillow across your lap protects the wound from little kicking feet.

I've explained these in more detail in four breastfeeding positions worth trying.

About pain relief

Many mothers worry that painkillers will reach their baby. Most medicines commonly given after a C-section are considered compatible with breastfeeding, and being in less pain actually makes feeding easier. Always check with your doctor, and tell them you're breastfeeding, but please don't avoid pain relief you need.

Let people help

You're recovering from major surgery while caring for a newborn. Let your family bring the baby to you, change nappies, and pass you water (drink a glass at every feed). Your job for the first weeks is to rest, heal and feed.

When to ask for help

• Your baby is very sleepy and hard to wake for feeds
• Fewer wet nappies than expected by day 5 or 6
• Feeds are painful, or your baby can't latch
• You have a fever, or your wound becomes red, swollen or painful. Please see your doctor.

I've supported many mothers through C-section recoveries, in hospital and at home. If you'd like help, book a consultation. I can even visit you on the ward.

General information only. Your doctor is the best person to advise on your recovery and medicines.