Breastfeeding after a cesarean is more difficult, but well worth the effort. The postpartum benefits are the same as for the mother who delivered vaginally: early bonding with your baby and the release of oxytocin to help the uterus contract for the mother, and the immunological benefits of colostrum for the baby.

Depending upon what kind of anesthesia you had for your C-section, you may need a little extra time before you physically feel able to hold and nurse your baby. If you had an epidural you'll be awake and alert sooner than if you've had general anesthesia. Once you are fully conscious and feel physically able to hold your baby, you can begin nursing. Ask your partner or a nurse to stay with you when you first start breastfeeding, in case you need help or get tired and need to hand the baby to someone else.

Your baby may be a little drowsy and lethargic, especially if you have had anesthetics for a prolonged period (e.g., you labored with an epidural for hours before the cesarean). You will need to encourage and stimulate him so he stays alert during breastfeeding (rub his back, change his diaper, talk to him, and try to make eye contact). The anesthesia will be out of his system within a day or two.

Don't be a martyr about pain relief. You have had major surgery and will need some pain medication in the first few days. You will also probably be taking some antibiotics to avoid infection, so take only those medications prescribed by your doctor. While these drugs do pass in very small amounts into your milk, they will not harm your baby.

Finding a comfortable breastfeeding position after surgery is a little more difficult, but through trial and error you will find what works for you and your baby. The side-lying position is often preferred in the first few days after surgery. Turn slowly on your side and put a rolled-up towel next to your incision (in case the baby kicks). A nurse or your partner should place the baby on his side next to you, chest-to-chest, directly facing your breast. You will need help to roll over when you want the baby to nurse on the other breast. The football hold is less comfortable immediately after surgery, but is often preferred a few days later. Rest the baby on a pillow, over your incision, and hold him along the side. Whatever position you use, remember: always be sure that the baby opens wide and latches on correctly to avoid sore nipples and ineffective milk transfer.

Some hospitals require, as a precaution, that all C-section babies be transferred for observation to the NICU immediately after birth. Healthy babies are usually reunited with their mothers within a few hours, if not sooner, and you can initiate breastfeeding then. Should your baby need to stay in the NICU longer for observation or treatment, ask about the availability of electric breast pumps and start pumping as soon as possible. This, along with pumping every couple of hours, will help stimulate your milk supply, prevent engorgement, and provide the valuable colostrum for your baby which can be fed to him in the nursery until he is able to breastfeed.