Mode of Delivery and Breastfeeding Practices

Abstract

Introduction Despite the well-known benefits of nourishing infants exclusively with mother's milk, the rates of breastfeeding initiation, continuation, and exclusive breastfeeding during the first few months of infancy are less than ideal among US mothers. 1,2 Mothers' and infants' experiences during labor and delivery may affect lactation and breastfeeding outcomes. Vaginally induced birth has been associated with not initiating breastfeeding. 1 Furthermore, cesarean deliveries (c-sections) have been associated with lower initiation rates and shorter breastfeeding duration compared to undergoing a vaginal delivery. 3,4 This may be due to delays in mother/infant skin-to-skin contact, mother's post-surgery physical complications, and effects of anesthetics. 5−7 In addition to mode of delivery, other factors that may influence breastfeeding initiation and duration include challenges encountered during nursing, availability of support systems, mother's socio-cultural and economic situation, and the recommendations and attitudes of family, peers, and healthcare professionals. 8−11 Previous studies that have examined the relationship between mode of delivery and breastfeeding outcomes had either small sample sizes or were confined to a single geographic location. 12 Further, findings from studies examining mode of delivery and breastfeeding are inconsistent. 12 The purpose of the present study was to evaluate early breastfeeding practices, including initiation, exclusivity, and intensity of breastfeeding in the first 2 months of infant age among women who had an unplanned c-section, a planned c-section, vaginal induced delivery, and a vaginally but not induced delivery using a large, nationally distributed US sample. Further, we assessed relationships between breastfeeding support by family, peers, clinicians, resources of breastfeeding information and reasons for not initiating breastfeeding by mode of delivery. Methods Data were obtained from the Infant Feeding Practices Study (IFPS II), a longitudinal national survey administered by the U.S. Food and Drug Administration and Centers for Disease Control and Prevention that followed women from pregnancy to 1 year postpartum. The IFPS II data were collected between 2005 and 2007 using one prenatal and 10 postnatal questionnaires that primarily assessed infant feeding practices and infant anthropometric characteristics. Approximately 4900 women participated at the early phases of the IFPS II study. Although this is a national sample of women and their infants, it is not representative of the U.S. population of mothers/infants. In IFPS II, inclusion criteria required that the infant was born after 35 weeks gestation, weighed at least 5 lbs., was a singleton, and infant did not require hospitalization longer than 3 days following birth. 13 In the present study, we used information from the prenatal, neonatal and 2-month infant age surveys. The sample size for the current study included 2541 mothers and their infants who had complete data on the outcome variables considered in this study. Of the 2541 women, 418 never initiated breastfeeding. This group of 418 women was further analyzed to assess reasons for not initiating breastfeeding by mode of delivery. Abstract Background: We compared early breastfeeding practices, including initiation, exclusivity, and intensity among women who had an unplanned caesarean section (c-section), a planned c-section, vaginal induced delivery, and a vaginally but not induced delivery.