Research suggests that having a caesarean section can result in an increased risk of complications, both during and after birth, including breastfeeding.

From providing personalised postpartum care, emotional support, wound care, newborn care to helping educate and support the mum and baby establish breastfeeding, a midwife’s role in helping mums through those early days is vital.

When it comes to C-section mums, this is especially true.

“Ask any midwife if they observe C-Section mums experience a higher incidence of breastfeeding complications and there’s most often a resounding ‘yes’,” says Helen Lyon, founder of Puremedic Health.

“In fact if we look to the evidence, there’s no surprises that research supports this long held observation.”

According to Lyon, analysis of birth data from 626,700 births in NSW between 2001 and 2008 found that women who gave birth by c-section were 70 per cent more likely to be diagnosed with a complication affecting breastfeeding.

Furthermore, the babies of women with breastfeeding problems were then 30 percent more likely to be hospitalised with gastrointestinal problems. 

“This study was published in the Archives of Disease in Childhood some years ago when the C-section rate in NSW was 26 per cent,” Lyon said.

“Newly published data from 2022 has shown that the C-Section rate has increased to 49.4 per cent of private maternity patients and 33.6 per cent of public patients.  Almost 40 per cent of births in private hospitals were elective caesareans, as opposed to emergency procedures.

“New mothers are administered antibiotic prophylaxis following C-section surgery and while we all know that antibiotics are required to prevent infection, they also diminish the levels of protective ‘good’ bacteria and well as ‘bad’ infection causing bacteria and compromise the microbiome.  

“Diminished good bacteria can lead to dysbiosis and health concerns for mum and baby, increased breastfeeding complications and gastrointestinal issues for the babies of these mums.”

Lyon said midwife support for breastfeeding and protecting the microbiome of mums and babies has never been more important as the c-section rate continues to grow.

“As the research into the effects of compromised microbiome health has on lifetime health, there are some important evidence supported actions that can been taken to mitigate the risks to the microbiome for C-section mums and their babies,” she said.

“Firstly, if possible, commence skin-to-skin immediately after birth. This simple action has been demonstrated in research to improve mum and infant bonding and wellbeing and breastfeeding outcomes and reduce the supplementation of infant formula in C-section babies.”

It’s also important for midwives to be across the latest guidelines for the treatment of mastitis, which is common among breastfeeding mothers.

“Mastitis is now considered as a spectrum of conditions and the protocol suggests among other recommendations, that strain specific probiotics originating from breastmilk, including L.fermentum CECT5716, represent a treatment option. 

“In addition, clinical research has demonstrated that supplementation with this same probiotic strain to infants born by C-section protects them from gastrointestinal infections by reducing the risk by up to 73 per cent.

“For mums who have antibiotics during the course of childbirth, including c-section mums, clinical evidence published in Breastfeeding Medicine has demonstrated that supplementation of L fermentum CECT5716 prevents the development of lactational mastitis, relieves pain and decreases the incidence of clinical mastitis by 51 per cent.

Puremedic are the makers of Qiara, the first probiotic in the world, originating from good bacteria in breastmilk, evidence based to improve health outcomes for breastfeeding mums and their babies. For more information visit www.qiara.com.au