I want to put in my 30 ml worth here.  When a cesarean involves delay in
getting baby to breast, I often observe delay in the rest of the process.
When baby comes to breast and nurses well within the first few hours, and
then keeps on doing so, lactogenesis seems to proceed just as rapidly as
after a normal birth.  Likewise, when babies after vaginal births are
delayed in coming to the breast and nursing often and well, for whatever
reason, lactogenesis is delayed too.

With a cesarean, more staff attention is needed to ensure that baby has
access and mother is able to start breastfeeding.  But I look for the red
flags after CS just as I do after vaginal births, and CS per se isn't the
biggest red flag, it is all the other stuff, sometimes preceding, and almost
always following in the wake of, the CS.

I am consciously using the terms 'vaginal' and 'normal' birth to connote two
different things.  A normal birth in my book is always a vaginal birth,
while the converse, regrettably, is not true.

Rachel Myr, writing as a midwife now, in Kristiansand, Norway

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