By: Jordan Berns

People often say that breastfeeding is a journey! This journey starts with its own tour de force: childbirth. Mothers that decide to breastfeed face a unique set of challenges that can begin in delivery room. Two research studies published on December 16, 2012 by the CDC, and in the July 2016 issue of The Journal of the American Osteopathic Association, both discus that the method of delivery (MOD) can affect breastfeeding success. According to these studies, women who give birth vaginally are more likely to exclusively breastfeed for a longer amount of time than women who’ve had cesareans (c-sections).

Many medical professionals recommend breastfeeding for up to one year postpartum, and the WHO (World Health Organization) recommends that women breastfeed until their children are two-years-old. For many, though, this is no easy feat. Immediately after birth, 74.8% of vaginal deliveries begin exclusively breastfeeding (EBF), while 25.2% of mothers start exclusively breastfeeding right after a cesarean. Upon discharge from the hospital, 79.9% of mothers who had vaginal births are exclusively breastfeeding, and 70.6% of mothers with cesareans are exclusively breastfeeding. Women who are exclusively breastfeeding when discharged from the hospital were more likely to continue at home, says a 2010 research study. In fact, women who established the intention to exclusively breastfeed while still pregnant were more likely to do so once they left the hospital.

Mothers who give spontaneous vaginal births are more likely to exclusively breastfeed, but why?

Women who had induced vaginal deliveries are less likely to exclusively breastfeed than those with spontaneous vaginal deliveries. The groups least likely to breastfeed more than six months include induced vaginal and emergency cesareans. The median time for breastfeeding with spontaneous vaginal births was 45.2 weeks, planned cesareans went for 38.7 weeks of breastfeeding, induced vaginal births breastfeed 25.8 weeks on average, and emergency cesareans breastfed for 21.5 weeks.

The WHO estimates about 10-15% of deliveries will be cesareans; most countries exceed this number. In 2012, 27.1% of Canadian births were cesareans. In the United States, cesareans accounted for 32% of births in 2017. 

The best chance of breastfeeding success starts with a good support system.

Although there’s evidence of cesareans resulting in fewer breastfed babies, doctors can’t pinpoint exactly why. One of the biggest predictors of breastfeeding success is having skin-to-skin contact right after birth. This encourages mothers to produce milk and makes babies nice and hungry. A prolonged start to breastfeeding after birth can cause problems such as decreased milk supply and infant latch and sucking issues. Skin-to-skin contact is not always possible for mothers who’ve had cesareans, as often doctors are tending to mothers medical needs and she is unable to experience skin-to-skin.  A stressful and premature birth can result in a delayed onset of milk. It’s definitely possible for women with cesareans to exclusively breastfeed; sometimes all we need is a little lift!

For women who’ve had cesareans and want to exclusively breastfeed, a good support system can make all the difference in the world! Providing support for emotional and physical healing to those who’ve had traumatic births can help women nurse from a more relaxed place. Certain nursing positions, like the side-lying position, can allow women with cesarean scars to breastfeed more comfortably. Talks with doctors and lactation consultants, like those at Lactation Lab, can give women from any birthing scenario the help they need to fulfill whatever their breastfeeding plan may be!