Last updated April 13th 2025
Congratulations! Preparing for a new baby is so exciting. When you start preparing for birth, you may take a prenatal labour and delivery class, you might read some books about labour and delivery or you might hit the internet to find out about what you can expect (like this blog!). I did a combination of all of those when I was pregnant with my first child and I’ve included some extra resources for you at the end of this post.
If you take a prenatal breastfeeding class (or are reading this right now) you might be surprised to learn that your labour and birth can affect the start of your breastfeeding relationship. It can help and encourage your breastfeeding relationship or it can create additional challenges. You can absolutely overcome these challenges when you are informed and supported by your birth and postpartum care team. But it’s still important to be aware of them.
When thinking about and planning for breastfeeding, it’s important to consider what you already know about breastfeeding and what your goals or desires for feeding your baby are. I would strongly suggest a prenatal breastfeeding class and also encourage you to build your breastfeeding support team prior to your baby’s birth. Research demonstrates support makes a HUGE difference in helping someone reach their breastfeeding goals.
Your breastfeeding support team should include an International Board Certified Lactation Consultant. They are the current gold standard of lactation care. Your team can also include your partner, doula, and a peer support group.
When learning about and planning for breastfeeding, it’s important to learn about labour and birth interventions and the impact they can have on the start of your breastfeeding relationship.
Sometimes, events unfold different than we had planned or hoped for. This can hold true for birth. You may find your birth going a different way than you originally planned which is why it’s so important that you’re informed.
Intervention free births are more likely to be followed by successful breastfeeding. However, we also know that when interventions are used it’s still possible to successfully breastfeed but that it may require extra support.
If you’re thinking “what are interventions?”
Interventions can be actions taken to initiate or speed up labour or the birth process. Some common labour and birth interventions include (but are not limited to) the following:
- Epidural and pain medicines
- IV fluids in excess
- Vacuum or forceps extraction
- Pitocin & other induction medications
- Cesarean section
You can plan ahead and choose none or some of these interventions in advance of delivery or you can make the decision(s) in the moment but whatever you do, you deserve to make informed decisions.
All possible labour and birth interventions should be discussed with your primary care provider whether that’s your midwife or your OB. This discussion needs to happen before you give birth. You deserve to be informed of the possible risks. That’s the only way you can make your own informed decisions.
So let’s talk a little more about some of the birth interventions and how they can affect breastfeeding.
Pain Medications
It’s important you give birth in whichever way is going to make you feel safest. For some, that means pain medications. If that’s what you choose, you should still know how it can affect breastfeeding so you can be prepared and get breastfeeding off to a strong start.
Labouring and delivering with pain medications such as an epidural, may have the ability to interfere with breastfeeding initially. Studies seem to show mixed results but a 2015 study by Kendall-Tackett et al. found that epidurals were associated with lower breastfeeding rates. However there are many moms who birth with an epidural and do have a successful breastfeeding experience. There are a LOT of factors that affect this.
Skin to skin is strongly encouraged to get breastfeeding off to a good start after birth. It regulates your baby’s temperature and nervous system. It releases oxytocin in both of you which helps your milk let-down/flow. A sleepy baby may take up to 1 hour to find the breast and latch. This is perfectly acceptable! There is no rush to immediately get them onto the breast. The medications will wear off in time. In the meantime, spend time getting to know each other.
Induction
Induction is medically started labour which happens for many reasons. Sometimes induction is started with artificial oxytocin known as pitocin which can possibly interfere with your body’s production of oxytocin which is required for your milk let-down. The evidence is not strong and honestly, is somewhat conflicting. Spending time skin to skin after birth will help support your body’s release of oxytocin.
There are many other medications that are used to bring on labour. They don’t appear to directly interfere with the start of breastfeeding. However, often when labour is induced, several interventions may follow (IV, pain medications because the contractions are stronger, instrument assisted delivery) which could then have an effect on the start of breastfeeding.
IV Fluids
IV fluids, while common practice for hospital based births, can inflate babies weight. This is because some of the fluid transfers into your baby’s body before they are born. This results in an incorrect weight because they are now carrying excess fluids.
Just like you will begin peeing out the excess fluids after delivery, so will your baby. Because your baby is peeing out the excess fluid, the “weight loss” can exceed what is considered normal. The hospital staff are quick to intervene with formula supplementation without first assessing how breastfeeding is going.
IV fluids may also worsen engorgement after delivery because your body is still working to eliminate the excess fluids while also increasing the volume of your milk. Excess engorgement not only creates discomfort for you, but it can make latching your baby difficult.
Physical Tools
Tools such as forceps and vacuum may cause some soreness and bruising in your baby and can affect how they latch. They may prefer one side over the other or one position over another. Spending time together skin to skin will help with their pain relief and support their ability to latch. Be mindful of which positions your baby feels most comfortable in (and ones you are comfortable in too!) and focus on those.
So how can you get breastfeeding off to a good start?
I would suggest you find intervention free birth stories (I loved this book when I was expecting). This can help you prepare for delivering without the use of interventions (if that’s what you want).
- Talk to your primary care provider about the use of interventions and the risks associated with each one. You should be presented with unbiased, evidence based information to make your decisions. If you’re wanting an epidural, talk to your care provider about getting uninterrupted skin to skin contact immediately after birth.
- You can get breastfeeding off to a good start by investing in a birth doula to help support you through your labour and delivery.
- Weigh your options about where you might be able to deliver (hospital, birth centre or home). If you want access to multiple interventions then hospital is the way to go but if you don’t, then a birth centre or home birth might be worth considering.
An excellent way to get your breastfeeding relationship off to a strong start is to take a prenatal breastfeeding class or work 1:1 with an IBCLC before birth.
What if I delivered with interventions and are now struggling or have concerns?
- Find a lactation consultant you trust to help you! You can click “book now” under my services to work with me
- Spend lots of time skin to skin. This means your baby is in just a diaper and you are undressed from the waist up. This will release oxytocin and encourage your milk let down as well as relax both you and your baby. This also supports your baby’s natural instincts to root and search for the breast and latch
- Learning how to hand express to protect your supply and encourage your baby to latch on
Additional resources:
- I love Evidenced Base Birth for evidenced based unbiased information
- This book is also excellent if you are expecting and want to inform yourself about the options
- Beyond The Bump Education is an absolutely fantastic Canadian resource for childbirth education including postpartum and breastfeeding
- Dr. Sara Wickam has a huge variety of evidence based resources for anyone. She is UK based
If you want to feel more prepared for breastfeeding your baby with your choice of interventions in labour and birth, my FREE Mini Prenatal Breastfeeding Class can help 👇🏼
References:
Campbell, S.H., Lauwers, J., Mannel, R., & Spencer, B. (2019). Core Curriculum for interdisciplinary lactation care. Jones & Bartlett Learning.
Kendall-Tackett, Kathleen., Cong, Zhen., Hale, Thomas W. (Aug 2015). Birth Interventions Related to Lower Rates of Exclusive Breastfeeding and Increased Risk of Postpartum Depression in a Large Sample. Clinical Lactation.6(3). DOI: 10.1891/2158-0782.6.3.87
Lothian J. A. (2014). Healthy birth practice #4: avoid interventions unless they are medically necessary. The Journal of perinatal education, 23(4), 198–206. https://doi.org/10.1891/1058-1243.23.4.198
Newman, J. & Pitman, T. (2014). Dr. Jack Newman’s Guide to Breastfeeding. HarperCollins Publishers Ltd.