Choices in Birth Affect Breastfeeding

How do labor choices and paths affect breastfeeding?

Getting Breastfeeding Help
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Birth affects breastfeeding in many ways that most families don't even think about. Often they think of the birth as being totally separate from the breastfeeding experience. But how you give birth can affect how your baby nurses. Here are some of the most common ways that various birth practices interfere with breastfeeding:

Length of Labor

The length of labor is really out of your control. But we do know that babies actually help during the labor process.

So a very long labor or a very short labor may actually increase breastfeeding difficulty. This can be because of the exhaustion you and baby feel after birth, even for a short labor because they can be quite hard. This is true even if no other interventions are used.

Medications in Labor

Medications you accept in labor can hinder breastfeeding, but not always. Obviously some mother/baby couplets sail through after giving birth with medication, particularly epidural anesthesia without a hitch. But some studies show, as moms report, that other babies are less likely to nurse. While using narcotics for labor may increase this problem area, epidurals are not immune. Fewer doses, less time on medications and other factors may or may not help.

Early Separation of Mom and Newborn

The American Academy of Pediatrics (AAP) recommends that you breastfeeding beginning immediately after birth and preferably within 30 minutes.

This is because your newborn has a very quiet, alert state of mind at this point where breastfeeding is imprinted on baby's brain very well. Skin-to-skin contact can really help facilitate this process. When mom and baby are needlessly separated during this period, it can have a detrimental effect on breastfeeding without cause.

Suctioning

Suctioning is a practice that is questionable in a normal, vaginal birth, particularly where the perineum is intact. Though it's one that persists. Deep, vigorous suctioning can irritate the baby's mouth, leaving it sore. This can mean that your baby does not wish to nurse. Ask for minimal suctioning and gentle suctioning.

Bathing

This really falls under early separation, though there is some research that shows the smell of the amniotic fluid can help baby's nurse. (More on delayed bathing of the newborn.)

Cesarean Section

Cesarean section has been shown to cause a delay in milk production. While not every mother will experience it, it is normal and you should not be concerned. Early, frequent pumping sessions may help with this problem. A cesarean after labor begins may also be less likely to experience this than a planned cesarean before labor.

Induction of Labor

Induction of labor, because of the potential of added intervention and the increased likelihood of the baby being born prematurely, even slightly, can cause difficulties in breastfeeding.

Prematurity - Premature Baby

A baby who is born early may have more trouble nursing either because of a lack of mature sucking ability or other confounding medical issues. Pumping breast milk for this baby is very beneficial until you can get them to breast.

Multiples - Twins and More

The greater the number of babies, the harder breastfeeding can be. When you add the fact that many multiples, even twins, are born early, you add these factors in as well. Though breastfeeding multiples is often very successful.

Other Interventions

Interventions like forceps and vacuums can also interfere with breastfeeding.

Overcoming Issues

If you feel like you are having problems or issues with breastfeeding, because of labor interventions or something else, here is your plan of action:

  • Get help early and often.
  • When in doubt start pumping your breasts with a hospital grade pump. If you haven't had a good feed by four hours postpartum - start the pumping, every 3-4 hours until the problem is resolved - this will help protect your milk supply.
  • Do not use bottles or supplements. If you need to give baby feedings away from the breast, use an alternative like a cup, syringe, finger feeding... Supplements should be last resort with pumped breast milk from you or donated breast milk next.
  • Skin to skin with baby can help, no matter what is going on.

Source:

Bar G, Sheiner E, Lezerovizt A, Lazer T, Hallak M. "Early maternal feeding following caesarean delivery: a prospective randomised study." Acta Obstet Gynecol Scand. 2008;87(1):68-71.

Chang ZM, RN, MN, IBCLC, and Heaman MI, RN, PhD. "Epidural Analgesia During Labor and Delivery: Effects on the Initiation and Continuation of Effective Breastfeeding." Journal of Human Lactation 2005 21:305-314.

Goma HM, Said RN, El-Ela AM. "Study of the newborn feeding behaviors and fentanyl concentration in colostrum after an analgesic dose of epidural and intravenous fentanyl in cesarean section." Saudi Med J. 2008 May;29(5):678-82.

Meier PP. "Breastfeeding in the Special Care Nursery: Prematures and Infants with Medical Problems." Pediatr Clin North Am. 48(2):425-442, 2001.

Pasupathy D, Smith GC. "Neonatal outcomes with caesarean delivery at term. Arch Dis Child Fetal Neonatal Ed. 2008 May;93(3):F174-5.

Pérez-Ríos N, Ramos-Valencia G, Ortiz AP. "Cesarean Delivery as a Barrier for Breastfeeding Initiation: The Puerto Rican Experience." J Hum Lact. 2008 Jun 6.

Smith LJ. "Impact of birthing practices on the breastfeeding dyad." J Midwifery Womens Health. 2007 Nov-Dec;52(6):621-30.

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