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Home › Expert Q&A › Breastfeeding Basics › Before Baby is Born › I'd like to try to establish a milk supply before my scheduled Cesarean section. Can you advise me on how to go about this?

Expert Q&A

 

By Ann Calandro
BSN, RNC, IBCLC Lactation Consultant

I had a nightmare of a time trying to breastfeed my first child. I had inverted nipples. My colostrum didn't come in for five days. The milk never came out fast enough for my baby. The drug I took to increase my supply did not work well enough to satisfy my baby, and I developed a fungal infection in my nipples. I ended up mostly pumping with a little bit of frustrating breastfeeding in between for 11 weeks. When blood started to come out of my areola, I decided I had to give it all up – it was only going to get worse. My lactation consultant was surprised I tried as long as I did.

I'm really stressed out about going through the same thing again. I'd like to try to establish a milk supply before my scheduled Cesarean section this time, to give me and my second baby half a chance. Can you advise me on how to go about this?

What a difficult time you had with your first breastfeeding experience! You are quite a special mom to plan to breastfeed again.

It sounds like you have truly inverted nipples. Do they ever evert while you are not pregnant? When you are cold? You could, with your health care provider's permission, gently massage the nipple tissue during pregnancy (some moms use a little olive oil) and practice a little hand expression of your colostrum.

It would not be possible to establish your milk supply before your baby arrives, because a milk supply cannot be established before your placenta comes out. However, there are things you can do to make breastfeeding successful.

  • Breastfeed as soon as possible after your surgery. Be sure that your baby nurses within the first hour while he is still wide awake and interested. Write this in your birth plan and discuss it with your physician.
  • If your baby has difficulty with latching, begin pumping as soon as possible with a hospital-grade, double pump, to help evert your nipples, provide colostrum and encourage your milk to come in for your baby. With stimulation, most moms get an increase in their milk by two to three days after Baby is born.
  • If your baby is a good nurser, nurse as often as you can get him to nurse, hopefully every three to four hours the first day and every two or so hours by the second day. If he is not willing or is sleepy, use the pump instead.
  • If your baby needs supplementation, you can request no bottles and to use alternative feeding methods with him such as a small cup, dropper or syringe.
  • Hold him skin to skin as much as you can – tucked into your nightgown in order to keep him warm and interested in your breast.
  • Consider using a nipple shield if he has not latched by the second day.
  • After each nursing or pumping, gently dry your nipples with a hair dryer (no heat), as the part that is tucked inside is not used to being pulled out, and can get chapped and irritated from moisture. You can use some Lansinoh if you need to on this central area of your nipples.

Hopefully you can avoid yeast this time around. Since each baby is different, you will probably find you have a totally different experience with No. 2. Try to attend a few La Leche League meetings before your baby arrives, and get to know your local Leader so that if you do have problems you can call for assistance. Watch other babies nursing, and get a feel for how to hold and latch your little one deeply onto your breast. You just never know! I wish you a happy nursing experience."

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