Cesarean Section

Cesarean section, with spinal or epidural anesthesia, or with general anesthesia, does not contraindicate breastfeeding.

The onset of breastfeeding is delayed and there are more breastfeeding problems in cesarean sections with general anesthesia compared to spinal and epidural anesthesia and vaginal delivery. ^{(Kutlucan 2014, Alus 2014, Lawrence 2013, Sener 2003)}

It is advisable to start early skin-to-skin contact and breastfeeding as early as possible (in the first minutes if the anesthesia is epidural, as soon as it is born, intracesarean, or nothing else wakes up the mother, if the anesthesia is general. ^{(Kranke 2011)}

A cesarean section does not justify the removal of mother and child for a few hours, nor the admission of the child while the mother recovers.

The longer the duration of early contact, especially if it is 90 minutes, there are better healthy rates: higher rates of initiation and exclusive breastfeeding at discharge. and reduction of postpartum blood loss and neonatal hospital admission. ^{(Xu 2024, Zhang 2024, Zafran 2022}

Late clamping of the umbilical cord, compared to more immediate clamping of the cord, did not produce significant differences in the change in the level of maternal hemoglobin. ^{(from Preud'homme 2024, Purisch 2019)}

If an elective cesarean section was proposed, there is an indication of collection by manual expression of the colostrum from the 36th week of pregnancy. (NHS 2018)

Postoperative pain, inadequately controlled, can affect the start and the duration of breastfeeding. ^{(Hooda 2023, Roofthooft 2021, Hirose 1996)}

Data on the possible increase in the risk of type 1 diabetes in childhood after birth by cesarean section are contradictory. ^{(Clause 2016, Cardwell 2008)}

See below the information of these related products:

• (General Anesthesia) (Safe substance and/or breastfeeding is the best option.)
• Local and Epidural Anesthesia / Neuraxial analgesia (Safe substance and/or breastfeeding is the best option.)

See below the information of these related groups:

• ATC N01A: Anesthetics, general
• ATC N01B: Anesthetics, local