Correlation between C-sections and trouble breastfeeding?

Factual Questions
1

This is the first thread I’ve ever started, so I’m just guessing if it’s in the right place. I do have a question, so general questions seemed to be the best place to start.

My question…Is there any phsyical reason why some women who have C-sections are unable to breastfeed? I had 2 C-sections, and was unable to breastfeed either time. With the first child, I had the full complement of nurses coming in several times a day to give me instructions. Finally they decided to pump. Yep, milk me like a cow, then let me give that milk to the baby in a bottle. The idea was that this way she’d still get the benefits of breast milk. Well, to make a long story short, there was no milk. 3 days in the hospital for recovery from the surgery, 3 days of the nurses trying anything they could think of to help me. Nothing worked. Fast forward a few years to the second child. Much the same situation. C-section, no milk, many, many helpful nurses.

My youngest is 4 now, and everyone seems healthy, so I’d not thought about this for years. But Saturday my sister had her first child. Another C-section. On Monday, she told me she has been unable to breastfeed yet. Ok, enough background.

Does anyone know of any studies concerning breastfeeding after a C-Section? Does the body miss some hormonal surge that happens during natural delivery? Some little hormone whose sole job is to run up and say “Hey, boobs…you’re on in five.”

2

Both of my children were born C-section, and my wife didn’t have any trouble breastfeeding either one.

3

There could be a very good therapeutic reason why you couldn’t breast feed - a hormone called "oxytocin. " It is given to women who give birth vaginally to dry up their milk when they don’t want to breastfeed, and to shrink the uterus to assure that all residual placental material is expelled. It is given to women who have had C-sections to cause the uterus to contract, shutting off bleeding blood vessels and helping the uterus (which did not get the benefit of contracting through labor) to return to its normal size. Ask the Drs. involved if they routinely prescribe oxytocin.

4

Children who aren’t breastfed can of course, be healthy and thrive. But I have personal anecdotal evidence to submit. I had three children, all of whom were breastfed until at least 1 yr old. My youngest (22) and I were just talking the other day about how he and his siblings were sick so much less often than their friends growing up (almost never, in fact. No colds, no flu, no strep - only thing they got was chicken pox.) Also, none of my children have needed any dental work - the oldest is 33. Of course, I can’t prove that their diet has made the difference, but I followed very simple and easy to implement precepts:

Breastfeeding as long as they wanted (the longest was about 15 months - every one of the kids weaned themselves - just got bored with it.) Didn’t introduce any solid food until after 6 months old, and started with Gerber oat cereal & bananas. Introduced other food slowly and one at a time, if there was a reaction, postpone that food until they were older (had a nasty experience with carrot juice - let me tell ya.) Except for cereal, didn’t use prepared foods, just used the blender to pureed whatever the grown-ups were having but left out the spices. All through their childhood, no soda (substituted fruit juice mixed with sparkling water) read labels to eliminate artificial stuff as much as possible.

The guideline was food that was as "un-messed-with as possible. No junk food in the house - no processed meats like balony & hot dogs - no chips, cookies, candy, etc. But there were still lots of treats. Yogurt is sweet & delicious, hot chocolate made from scratch, french fries from whole potatos fried in olive oil ( truly just as easy as the frozen kind), more healthy choices for fast food (fish sandwich from McDonalds, no soda - there was milk when we got home) peanut butter cookies from scratch (also so easy, and they freeze) and peanut butter that has no other ingredients but peanuts. There is lots of good food out there - cheap and in mainstream groceries. - Oh, and they could have the odd bag of fritos, & the odd Sprite - junk food that was relatively innocuous.

Had no control over what they ate at daycare because they didn’t allow packed lunches - at school they often traded with other kids for part of their meal. I gave up trying to control everything early on - but I did work to “contain” the bad food. There were two annual exceptions - Halloween & Easter. They could have all the junk they wanted on those days - and they sure made the most of it. It really does seem to have worked. It may only be a matter of genetics & luck, but my philosophy sure hasn’t hurt!

I know you only asked about breastfeeding, but what they eat after babyhood is as least as important and ought to figure in.

5

Both my sister and my wife have confirmed that lactation nurses (those who teach you how to express milk and breast-feed properly) have ALL attended the Hitler School of Compassion for New Mothers! They’re all BITCHES!!! (Why?)

One thing we had to find out on our own is that some drugs delay lactation! So, the bitch nurse :mad: makes my wife feel so miserably useless she could die JUST BECAUSE she can’t lactate! For the record, she was on a Magnesium I.V. (i.e.: Mag Drip, is the lingo) which…surprise, surpsire…delays lactation! Duuh!

Now, shouldn’t the Lactation Nurse have known this??? I wouldn’t be surprised if C-Section mothers have used the same or other drugs which…surprise, suprise…delay lactation!

It’s not you, mommies…it’s the holier-than-thou medical profession even in this 21st century, so modern USA…ignorance still prevails! - Jinx

6

I had a c-section and had a real struggle to breastfeed. After the first two weeks the baby had lost so much weight I was forced to combine with formula, despite all the advice from the breastfeeding advocates that introducing the bottle is the ‘kiss of death’ for breastfeeding. I managed to produce 2-4 oz milk at each feed for just under three months. FTR my son has thrived and is one of those children, like violet9’s, who hardly ever seems to get sick, compared to others. He’s four and a half now. I am fairly strict about healthy eating, more so when he was too small to have a say in the matter.

My sister gave birth vaginally and had an even harder time than I did. I don’t think she lasted a month, and was having to combine from early on. She was induced, so that may have had something to do with it. Her 3 year old is also the picture of health.

7

I’m not sure where this information comes from, but it’s not what I’ve learned in childbirth and doula trainings. Oxytocin is produced by breast feeding mother’s bodies. It does cause uterine contractions, as well as a feeling of euphoria and bonding. Bottle moms are given it intravenously to contract the uterus because they’re not going to be making it themselves through nipple stimulation while nursing. But it certainly doesn’t stop the milk. In fact, some women who let their milk dry up and then decide to nurse two weeks later find that oxytocin nasal sprays let them regain their milk. (#6 on this page)

Extradural buprenorphine, a common painkiller given after caesarians does suppresses milk production, however. I should say once common. Word has gotten around most hospitals that it’s not the best choice anymore.

Still, you probably weren’t on medications for more than a few days, and it takes up to two weeks for some women’s milk to come in. (Two weeks is a long time, most women it takes about 3-4 days.)

I can find no data which correlates c-sections with failure to breastfeed. It can be harder, certainly, given the phsyical trials both you and the babies have been through, but there’s no reason to believe that c-sections or appropriate care afterwards make nursing impossible. I suspect it’s more likely that you and your sister share some genetic or phsyical foible that makes it difficult or impossible to breastfeed. What could that be? Only your doctor can tell you. Some common problems are undeveloped milk glands or ducts, too low a body fat percentage or wonky hormonal levels.

Breastfeeding is a wonderful thing, but it isn’t the only, or even neccesarily the best thing you can do for your baby, well-meaning nursing advocates and Nursezillas aside. The best thing you can do is love them. That’s it. All else is secondary. Some women can’t nurse. Some can nurse, but for some strange reason have nutritionally poor milk (often because their own diet is poor, but not always.) Some have severe psychological issues relating to abuse or rape that makes breastfeeding a time of shame and horror. There are plenty of women for whom formula is the best, most loving choice. I wish people would see that and not judge women who already feel awful because they can’t nurse like they always envisioned themselves doing.

8

Oxytocin (trade name Syntocin) WILL NOT dry up your milk. The milk flow is controlled by an inhibitor/promoter system in the brain. Prolactin is the hormone that cause milk production, Oxytocin is the hormone that causes milk let-down. Dopamine inhibits prolactin secretion, and thus is a brake on lactation.

Reasons for breast feeding failure include:
low prolactin levels (rare, but possible)
low Oxytocin levels (could be caused by stress)
high Dopamine levels (due to medications or stress)

Other reasons:
some problem with the breast tissue itself
pain/sensitivity problems for the mother (an abdominal wound from a c-section can cause some difficulties if the woman finds it painful to hold the baby while she breastfeeds)
not putting the baby to the breast often enough (30mins out of every 2 hours in the first few days should be spent breastfeeding)
breastfeeding at night will have the greatest effect on prolactin levels, so mothers are encouraged to feed for longer and more often in the evenings to increase milk production.

Placental separation is the biggest cue for the hormones involved in lactation to get going. For that reason, women who have c-sections aren’t missing out on anything, as their placentas will be separated and removed during the surgery. The differences are that they have had a major abdominal surgery, will require substantial pain relief, and the circumstances that have lead to the c-section may have been very stressful and traumatising.Opiate analgaesics and some psychiatric medication will have detrimental effects on hormone levels and thus milk production, but it won’t apply to most women unable to breastfeed. However, stress reduces oxytocin secretion, and a woman who has undergone a c-section would definitely fall under the “stressed” category in anyone’s book.

Violet9 the drug used to decrease milk supply is Bromocriptine, a dopamine agonist, hence it reduces prolactin activity.

If you cannot provide enough milk to maintain you baby’s weight and health or find it too painful NO-ONE should make you feel bad about swapping to bottles, you gave it a go, it didn’t work for you and your baby, you made a sensible decision to stop.

The people breastfeeding campaigns try to target are women who don’t even want to TRY breastfeeding and who are depriving their children of breastmilk WITHOUT GOOD REASON.

It is, however entirely up to each woman to work out what is a good reason for her to bottlefeed. If she feels she has a good reason to bottlefeed, despite education on the benefits of breastfeeding, you let her get on with it.

In case anyone is interested the current WHO guidleine say that infants should be breastfed exclusively for the first 6 months of life, and on demand from 6 months until 2 years, and possibily longer.

Bear in mind those guidelines are world-wide, and may be less appropriate in developed countries or cultures where breastfeeding after infancy is not widely practised.

9

Like most others in this thread, all I have is anecdote…

MsMicco has delivered two mini-miccos, both by C-section. Both breast fed very well, from day one through six months. In both cases, we made special arrangements with the lactation nurse (who was very sweet, Jinx) to bring the baby to the recovery room within minutes of the C-section. We did this because that early period is very important for both bonding and learning. The lactation nurse said that in many cases, women who deliver by C-section are better at breastfeeding because they can feed during this important early time when mothers who deliver naturally are too exhausted or drugged-up to try. If you wait longer, the baby may be less receptive.

10

Jinx, come on, you can’t expect those comments to fly in GQ. As another person has suggested, lactation advocates are trying to change the attitudes that lead some people to refuse to even try bfeeding. Helping people who have good intentions, but whose bodies are giving them trouble, calls upon some different skills. Maybe not all lactation consultants and nurses have both, or maybe their messages get misinterpreted. Who knows. But you will find wonderful ones. And that’s all the IMHO I’m going to add to the thread that is supposed to be factual!

11

Oh, thanks Cranky, I forgot.

Jinx, I’m gonna have to call you on a “cite” for that play, as well. All the sources I can find say that while Magnesium from a Mag drip is found in the breast milk of neonates, it’s not a concern and Mag IV is not contraindicated in breastfeeding newborns. I can find no mention of Mag IV causing a delay in lactation.

Can you please point me to where you got your information from, so I have accurate info for my breastfeeding moms?

Thanks.

http://www.google.com/search?q=cache:D40N2wXFme4J:www.druginformation.co.nz/pdfs/magnesium_milk.pdf+Magnesium+iv+breast+milk&hl=en&client=firefox-a

http://www.barttersite.com/magnesium_dosing.htm
On preview: Er. There’s a smiley in the name of that link. But it still works for me…working for everyone else?

12

Uh… that should be breastmilk **for **neonates. It’s **of **their mothers, obviously. :smack:

13

Wow…thanks, everyone. I thought this would be the place to get quick answers, and it is. :slight_smile: I think that I’m going to suggest my sister talk to her doctor about some “genetic or phsyical foible that makes it difficult or impossible to breastfeed.” (I had to quote because foible is such a cool word.) This isn’t something I’m going to have to worry about again personally, but she might need the information in the future. Maybe it’s not too late for it to help her this time?

14

I just wanted to point out that mag is not a medication that is prescribed willy-nilly for pregnant women. It is a serious medication needed for serious medical issues. It’s not like “the nurse” ordered that for your wife. I’d rather have mag than a siezure due to PIH during a pregnancy.

FTR (and because Irishgirl posted so well), my delivery was technically previable (23.5 weeks), I was mag toxic with a mag level of 7.5, didn’t even start pumping until day 5, and was still a milk factory.

15

According to that link I posted above (and it’s not from a breastfeeding mafia site - they advocate solids at four months), mothers can often relactate even when their milk has dried up. I’d say a check of her hormone levels and a good physical exam are definitely in order, It’s certainly not too late if she had her baby less than a week ago and she wants to breast feed. If she doesn’t - meh. Don’t guilt her into anything, please!

16

Just wanted to pop in to mention “hypoplastic breasts” as a possible cause for problems with breastfeeding. Apparently this is what I have, and though it was difficult at first and I had to supplement with formula in the beginning with both babies, I was able to establish a full milk supply around 6-8 weeks both times and wean them from the supplements.

And I have to agree that all the lactation nurses I dealt with (you deal with a LOT of them when you have a baby in the NICU) were super helpful and very kind and sympathetic. Of course, YMMV, as with any health care professionals.

17

I had two C-sections, and two breastfed babies. No trouble at all. Two SILs, two C-sections, one breastfed, one quit early on for other reasons. No trouble there either.

I agree that it may be a genetic thing on the part of the OP and her sister. That seems more likely to me, just because I know an awful lot of nursing mommies, and breastfeeding trouble doesn’t seem to have any correlation with mode o’ birth.

18

I’d say that although “foible” is a good word, “relactate” is pretty good, too.
xo, C.

p.s. Beautiful, Irishgirl. The quality of your answer is the reason I’m here.

19

:smiley:

Words are fun.

20

I’d like to point out that not all Lactation nurses are created equal. I frankly found the ones at my local hospital to be anything but warm and fuzzy, and was glad not to have to deal with them, but the ones at the hospital where my twins were born (by c/s@34 weeks) were wonderful. Many of the ‘lactation nurses’ in hospitals are not IBCLC (international board certified lactation consultant). And of course, if one doesn’t work well with you, you can ask for another, or even seek one who isn’t associated with the hospital.

Some women won’t have their milk come in for 4, 5, 6 days. 7 would be pushing it, and the cardinal rule is feed the baby. If somebody told me I was a failure because my milk hadn’t come in by 3 days post-partum, I’d wonder where they got their information.

Now, I had c/s with #1, milk came in around day 4.
c/s with twins #2 and #3, milk began to come in around day 3 (I was pumping 8X/day for them)
VBAC with #4, I think milk came on day 2.

I can’t think of any reasons for milk never coming in, if baby is being put to the breast to provide stimulation regularly, other than those already noted: hypoplastic breasts, or a retained piece of placenta. Even a little piece will cause a problem. But hypoplastic breasts will already have shown themselves by not changing at all during pregnancy, no soreness, no enlargement.

It shouldn’t be the cesareans, because as I and other women have noted, we’ve done okay. In your sister’s case, encourage her to hold on. 3 days is still a short amount of time. Her body has been jarred by a major surgery. That doesn’t mean it won’t recover and begin to feed the baby. But, she’ll have to be adamant about putting the baby to breast, which tells the body ‘Hey, there’s a live baby out here!’ (And of course, if the baby needs fluid, or loses too much weight, then formula comes into play.)