From the Guidelines
To increase breast milk production after a cesarean section, it is crucial to manage pain effectively, as uncontrolled pain can significantly inhibit milk production. According to the most recent and highest quality study, 1, a systematic review and procedure-specific postoperative pain management recommendations for elective caesarean section under neuraxial anaesthesia, suggest that intrathecal morphine 50–100 μg or diamorphine 300 μg administered pre-operatively, paracetamol, non-steroidal anti-inflammatory drugs, and intravenous dexamethasone administered after delivery can be effective in managing pain. Additionally, frequent nursing or pumping every 2-3 hours, including overnight, ensuring proper latch and positioning, and using skin-to-skin contact with the baby whenever possible can help stimulate milk production.
Some key points to consider:
- Stay hydrated by drinking water throughout the day and maintain a nutritious diet with adequate calories
- Consider galactagogues like fenugreek, blessed thistle, or oatmeal to help increase milk supply
- Prescription medications such as domperidone or metoclopramide may be recommended by a healthcare provider in cases of significant milk supply issues
- Rest as much as possible and seek support from lactation consultants, family members, or support groups
- C-section recovery can delay milk production by 24-72 hours due to surgical stress, pain, and delayed skin-to-skin contact, but with effective pain management and these approaches, most women can establish adequate milk supply within the first week postpartum, as suggested by 1 and 1.
It is essential to prioritize pain management and follow a comprehensive approach to support breast milk production after a cesarean section, considering the potential risks and benefits of each intervention, as highlighted in the studies 1, 1, and 1.
From the Research
Factors that Increase Breast Milk Coming in After C-Section
- Skin-to-skin contact: Studies have shown that immediate or early skin-to-skin contact after a C-section can increase breastfeeding initiation, decrease time to the first breastfeed, and reduce formula supplementation in hospital 2, 3, 4.
- Early skin-to-skin contact in the operating room: Research has found that early skin-to-skin contact in the operating room can be feasible and beneficial for healthy mothers and infants after C-section, leading to lower rates of formula supplementation and higher rates of breastfeeding 3.
- Mother-infant skin-to-skin contact: A study found that skin-to-skin contact with the mother after C-section was associated with higher exclusive breastfeeding rates at discharge, and this effect was maintained at three and six months 4.
- Women's experiences and preferences: Women who had immediate skin-to-skin contact at C-section birth reported a positive birth experience, improved satisfaction, and a sense of control and empowerment 5.
- Pro-lactation C-section techniques: A study found that immediate skin-to-skin contact during C-section, along with counseling on breastfeeding, was associated with prolonged breastfeeding and higher maternal satisfaction 6.
Benefits of Skin-to-Skin Contact After C-Section
- Increased breastfeeding initiation and duration
- Decreased time to the first breastfeed
- Reduced formula supplementation in hospital
- Improved maternal satisfaction and sense of control
- Increased bonding and maternal-infant interaction
- Maintenance of newborn temperature and reduction of newborn stress 2, 3, 4, 5, 6