1) Talk with your physician ahead of time

Regardless of your birth plan, it’s a good idea to have the conversation about the possibility of a cesarean birth. Request breastfeeding compatible pain medications and anesthesia, and try to use the medications only as needed to keep you comfortable, to reduce sleepiness in both you and your baby. You can also request that your hospital gown and monitoring equipment be arranged in such a way to allow your baby to be placed on your bare chest immediately after birth. Immediate skin-to-skin contact is important for breastfeeding initiation.

2) Arrange for a lactation consultant visit

If your c-section is planned, seeing a lactation consultant prenatally can help you prepare and to know what to expect. After delivery, your lactation consultant can help you position your baby as painlessly as possible for skin to skin and nursing, and show you how to pump effectively (if necessary). Once you’re home, she can help monitor the situation, adjust your positioning as you heal and your mature milk comes in. If supplementation is deemed medically necessary, your LC will help you facilitate that while protecting the breastfeeding relationship.

3) Nurse immediately and often after birth (if possible)

It has been shown that bringing baby to the breast within the first hour of life results in easier breastfeeding and less engorgement. Holding your newborn skin-to-skin is often all that is needed, and your partner or nurse can help hold baby on your chest. If you are feeling too ill or if direct feeding is not possible in the first hour, hand expression or pumping is recommended as soon as possible. Newborns have tiny stomachs, and need to feed often. In the early weeks, 8-12 feeds per day is normal, with no more than a 4 hour stretch during the night. In order to signal your body to produce an adequate milk supply, lean on your support system to help bring baby to the breast/pump as often as possible, and try to resist supplementation if there is not a medical indication.