Breastfeeding in the Hospital after a C-Section

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Baby in blue sleeping peacefullyA reader writes:

Hi Hannah, I had a question in response to your last post about the formula options promoted by the Ministry of Health.  I’m due to give birth to my third child in the next few weeks (in Jerusalem, G-d willing) by elective c-section.

I exclusively breastfed both of my older children for over a year, but I remember from past experience that right after my c-section it was very difficult for me to get up in the middle of the night to go get my baby for breastfeeding, so, feeling left with no alternative, I told the nurses to give the babies one bottle during the night and the rest of the time I would only breastfeed. After a c-section, the nurses are willing to bring the baby into your room for breastfeeding, but refuse to do so during the night. You have to get up yourself.

Since then (my last birth was six years ago) I have become more informed of all the intestinal issues and unbalanced flora in the gut that can start with that first bottle of formula and, this time around, would really like to breastfeed exclusively at the hospital. However, I am concerned that the night feeding will be too much for me to do right after the surgery. My reasoning at the time was that it was a matter of only one bottle a day (for 4-5 days, after which I would only breastfeed upon arriving home) vs. maternal well-being and recovery, as I found it too exhausting after the surgery and really needed my rest. This time, however, I really feel strongly about ensuring a “virgin gut” and would like to avoid any bottles whatsoever, if possible. Then again, am I being too “fanatic” at the expense of my recovery?

A cesarean section is major surgery, and mother’s recovery is important for the whole family. The baby’s health is equally important. Hospitals shouldn’t force mothers to choose between a long trek and exclusive breastfeeding. The hospital policy is the problem, not your desire to be with your baby! In some hospitals, including in Israel, mothers who so choose can have their babies back in their room within a few hours after birth until discharge, including at night.

People like to place their preferred positions in the middle, and label anything that greatly diverges in either direction as “fanatic.” You are simply trying to follow current health recommendations for exclusive breastfeeding.

Once the mother has woken up after surgery, the anesthesia in her system is no longer a concern. Most pain medications are also compatible with breastfeeding. Mothers will vary as to how soon after birth they feel ready to care for their babies and how much help they will need with breastfeeding.

While a few hospitals encourage the baby to be with the mother at all times, including after a c-section, other don’t allow the babies out of the nursery during the night. If a mother has had surgery or has any condition that makes her less mobile, she must find a creative way to be with the baby. Breastfeeding or not, babies belong with their mothers whenever possible.  Here are a few ideas:

  1. Get help.  Perhaps you know a neighbor or a relative, even for pay, who would be willing to spend the night, or part of the night, in the hospital with you.  Confirm that the hospital will allow the person to bring the baby to you, with your signed permission.
  2. Choose a different hospital. If possible, choose a hospital that allows rooming in after a c-section.
  3. Consider pumping for night feeds. Express by hand or with a manual or electric pump, so that the nurses can give your milk to the baby instead of breastmilk substitutes. In the early days, when the amount of colostrum is small, express by hand into a syringe.
  4. Communicate with the staff. Even before birth,  be assertive about your desire to have a good recovery while continuing to nurse your baby. The hospital might be able to find an orderly to bring you to the nursery in a wheelchair, or have a nurse bring you the baby. It’s also possible that the policy has changed since your last birth.

Readers: If you had a c-section in an Israeli hospital, did you have free access to the baby after birth? If hospital policy made it difficult for you to breastfeed, were you able to get around the policy? The reader is planning to give birth in Shaarei Tzedek hospital in Jerusalem.

You may also enjoy:

Breastfeeding Twins in an Israeli Hospital

Miracles of Motherhood: Breastfeeding a Premature Baby

Breastfeeding a Late Preterm Baby

image: Tova O.

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Comments

  1. Shorty
    Twitter:
    says:

    I’m in Canada, and I did breastfeed after a c/s. My husband stayed with me in the hospital (three days here) and he helped me with the baby (as did the nurses). The baby rooms in with the parents here. I agree with Hannah’s comments on getting help if the nurses don’t want to help in the night. I also found it challenging probably around day 2 because my milk had not yet come in, and I hadn’t slept well for 5 days (I was induced over two days in the hospital), the baby was crying and hungry so I gave him a bottle of formula hoping that everyone could get a couple of hours of sleep (didn’t work).

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  2. I had a c-section in Shaarei Tzedek 6 years ago and exclusively breast-fed my son. The surgery was early enough in the day that I had the whole day to get up and mobile, to practice getting out of bed as carefully as possible. And breastfeeding was simply that important to me that I carefully pushed myself to make it to the nursery when they called for me.

    IMO, the best thing you can do is be as informed as possible (which it seems you are) and have a plan, but also be open-minded enough to be flexible. You have no idea how you will feel after surgery. The best thing is to TRY, see how it goes, and then take it from there.

    B’sha’ah tovah!
    Devo K recently posted..Chinuch vs. Shalom BayitMy Profile

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  3. Alexis says:

    I wound up not breastfeeding successfully, though I don’t think my sections were responsible and that it would have happened anyway.

    With #1 (UK) I had surgery in the evening and was not moved to postnatal until the morning due to complications. I did have the baby with me, but wasn’t in much of a state to breastfeed without help, which I didn’t have (my husband had to go home; overnight partners not allowed; midwives unavailable). Baby did not get formula until she wound up in special care, though.

    #2 was an elective repeat in the USA with considerably better nursing care. However, I lost a lot of blood and again, could not breastfeed without help–at one point, I couldn’t even hold the baby. He did go to the nursery by my own choice, although they brought him back for feeding in the night.

    In both cases, I had an IV and catheter for a long time after surgery–18-24 hours. So getting out of bed was not possible. I would really recommend keeping your husband around if possible–even with good nursing care his assistance was invaluable. And complications aren’t always predictable.

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  4. Observer says:

    I agree that if at all possible, you should avoid the choice. Perhaps they have changed the policy since the last time you were there? If not, perhaps some of the other suggestions would work. I certainly hope they have; it’s a totally ridiculous idea, and I don’t believe there is any really good reason for it.

    But, if you really do get stuck, then, yes, the idea of a long walk at night in order to nurse the baby is probably “fanatic’. Formula is not poison, and your recovery is the best thing that can happen for your milk production.

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  5. I got a response elsewhere from a mom who just gave birth at SZ. She said that her friends’ twins were brought to her at night after being born by c-section. So it seems things might have changed. Be-shaah tovah!
    Hannah Katsman recently posted..New Mothers Get Choice — Between Two Brands of Breastmilk SubstitutesMy Profile

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  6. Thanks for sharing important info. Being informed and getting support helps one and all the other moms
    Allan Katz recently posted..Carl Honore – Slow Fix parenting and CPS – collaborative problem solvingMy Profile

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  7. I think you should try to contact the hospital and see what their current policy is.
    As I see it, it is the first night which is the main problem.

    For some babies even one bottle can spoil their ability to nurse well.

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  8. B”H
    Shalom!
    I gave birth by C-section at the Hadassa Ein Keren to my son past the 41 weeks. After recovery and being taken to the maternity ward, a kind nurse informed me that my son was given formula because he was hungry. My concern was more on the kashrus (it was a halav akum formula unfortunately).
    Now here it comes the best: The nurse told me that there is a policy to not bring the baby to mom’s on c-Section only after 24 hours. I was also unable to move without pain, but with all that I demanded to have my son with me. That night I was the only one in a room of two, so they brought to me my son and I plugged him to breasfeed the whole night (I didn’t sleep, and well, he slept and ate) until next morning at 6:00 a.m. that the same kind nurse came to help me to begin to move again, wash me, take out my cateter. Yes, at 8:00 a.m. I was already taking breakfast. That same nurse took care that my son crib was labeled “only breastfeeding”. The rest of the nights I had to go to the nursery to breasfeed. They came directly to my bed to notify me that my son was crying so, slowly, slowly I had to go.
    I believe if I would have not began that night to breastfeed, I would not have produced milk at all: my milk production began 4.5 days after birth.

    I believe that not only policy have to checked before hand, but also try to plan ahead with the maternity ward in advance. There are forms to fill where one can already tell them that your baby will be exclusively breastfeed. Also do not allow that the nurses give the child water with sugar and you should specify that and only speak with doctors regarding any changes in the feeding and not with nurses. And on the line with advices for you to have a companion, it is the best advice, because yourself it is difficult to be on top of all the tips, advises, and things needed to do once you are in pain (even if you are taking pain killers) in the hospital. By the way, I refused to take painkillers because I was afraid of contaminate the breastfeeding.

    Be shaa tova.

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