Last update: Nov. 13, 2014

Cesarean Section

Very Low Risk for breastfeeding

Safe. Compatible.
Minimal risk for breastfeeding and infant.

C-section by either general or epidural anesthesia is not a contraindication to breastfeeding.

It is highly recommended to initiate early attachment (skin-to-skin contact) just after delivery if epidural anesthesia was used (intra C-section attachment) or right after the mother has recovered from general anesthesia.

It is not justified to separate the mother and the infant after a C- section or admit the child to the nursery just to wait for the mother to recover.


We do not have alternatives for Cesarean Section since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.


Cesarean Section belongs to this group or family:


  1. NHS. Royal Berkshire. Expressing colostrum in pregnancy. Brochure. 2018 Full text (link to original source) Full text (in our servers)
  2. Wszolek K. Hand expressing in pregnancy and colostrum harvesting—preparation for successful breastfeeding? British Journal of Midwifery 2015 23:4, 268-274 2015 Abstract
  3. Alus Tokat M, Serçekuş P, Yenal K, Okumuş H. Early Postpartum Breast-Feeding Outcomes and Breast-Feeding Self-Efficacy in Turkish Mothers Undergoing Vaginal Birth or Cesarean Birth With Different Types of Anesthesia. Int J Nurs Knowl. 2014 Abstract
  4. Simşek Y, Karabiyik P, Polat K, Duran Z, Polat A. Mode of delivery changes oxidative and antioxidative properties of human milk: a prospective controlled clinical investigation. J Matern Fetal Neonatal Med. 2014 Abstract
  5. East CE, Dolan WJ, Forster DA. Antenatal breast milk expression by women with diabetes for improving infant outcomes. Cochrane Database Syst Rev. 2014 Abstract
  6. East CE, Dolan WJ, Forster DA. Extracción prenatal de leche materna por pacientes con diabetes para mejorar los resultados del lactante. Cochrane Database Syst. 2014 Full text (link to original source) Full text (in our servers)
  7. Kutlucan L, Seker İS, Demiraran Y, Ersoy Ö, Karagöz İ, Sezen G, Köse SA. Effects of different anesthesia protocols on lactation in the postpartum period. J Turk Ger Gynecol Assoc. 2014 Dec 1;15(4):233-8. Abstract
  8. Lawrence RM. Circumstances when breastfeeding is contraindicated. Pediatr Clin North Am. 2013 Feb;60(1):295-318. Abstract
  9. Suppa E, Valente A, Catarci S, Zanfini BA, Draisci G. A study of low-dose S-ketamine infusion as \preventive\ pain treatment for cesarean section with spinal anesthesia: benefits and side effects. Minerva Anestesiol. 2012 Abstract Full text (link to original source) Full text (in our servers)
  10. Kranke P, Frambach T, Schelling P, Wirbelauer J, Schaefer C, Stamer U. [Anaesthesia and breast-feeding: should breast-feeding be discouraged?]. Anasthesiol Intensivmed Notfallmed Schmerzther. 2011 Abstract
  11. Matsota PK, Markantonis SL, Fousteri MZ, Pandazi AK, Manikis DE, Christodoulopoulou TC, Loizou MM, Kostopanagiotou GG. Excretion of ropivacaine in breast milk during patient-controlled epidural analgesia after cesarean delivery. Reg Anesth Pain Med. 2009 Abstract
  12. Cardwell CR, Stene LC, Joner G, Cinek O, Svensson J, Goldacre MJ, Parslow RC, Pozzilli P, Brigis G, Stoyanov D, Urbonaite B, Sipetić S, Schober E, Ionescu-Tirgoviste C, Devoti G, de Beaufort CE, Buschard K, Patterson CC. Caesarean section is associated with an increased risk of childhood-onset type 1 diabetes mellitus: a meta-analysis of observational studies. Diabetologia. 2008 Abstract Full text (link to original source)
  13. 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. Abstract
  14. Jordan S, Emery S, Bradshaw C, Watkins A, Friswell W. The impact of intrapartum analgesia on infant feeding. BJOG. 2005 Abstract Full text (link to original source) Full text (in our servers)
  15. Sener EB, Guldogus F, Karakaya D, Baris S, Kocamanoglu S, Tur A. Comparison of neonatal effects of epidural and general anesthesia for cesarean section. Gynecol Obstet Invest. 2003 Abstract
  16. Al-Takroni AM, Parvathi CK, Mendis KB, Hassan S, Qunaibi AM. Early oral intake after caesarean section performed under general anaesthesia. J Obstet Gynaecol. 1999 Abstract
  17. Hirose M, Hara Y, Hosokawa T, Tanaka Y. The effect of postoperative analgesia with continuous epidural bupivacaine after cesarean section on the amount of breast feeding and infant weight gain. Anesth Analg. 1996 Abstract
  18. Dailland P, Cockshott ID, Lirzin JD, Jacquinot P, Jorrot JC, Devery J, Harmey JL, Conseiller C. Intravenous propofol during cesarean section: placental transfer, concentrations in breast milk, and neonatal effects. A preliminary study. Anesthesiology. 1989 Abstract

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