Elective Cesarean Delivery: Does It Have a Negative Effect on Breastfeeding?

TLDR

Cesarean delivery is associated with reduced breastfeeding rates. The study aimed to compare breastfeeding rates up to six months postpartum among infants delivered by elective cesarean, emergency cesarean, and vaginal birth. The authors analyzed 2,137 term infants at a tertiary center, categorizing them by delivery mode (elective cesarean, emergency cesarean, or vaginal). Both elective and emergency cesarean deliveries were linked to markedly lower exclusive breastfeeding rates compared with vaginal birth, with no difference between the two cesarean types, likely due to difficulties initiating breastfeeding immediately after cesarean. Published in BIRTH, volume 37, issue 4, December 2010.

Abstract

Abstract: Background: Cesarean delivery has negative effects on breastfeeding. The objective of this study was to evaluate breastfeeding rates, defined in accordance with World Health Organization guidelines, from delivery to 6 months postpartum in infants born by elective and emergency cesarean section and in infants born vaginally. Methods: Delivery modalities were assessed in relation to breastfeeding patterns in 2,137 term infants delivered at a tertiary center, the Padua University School of Medicine in northeastern Italy, from January to December 2007. The study population included 677 (31.1%) newborns delivered by cesarean section, 398 (18.3%) by elective cesarean, 279 (12.8%) by emergency cesarean section, and 1,496 (68.8%) delivered vaginally. Results: Breastfeeding prevalence in the delivery room was significantly higher after vaginal delivery compared with that after cesarean delivery (71.5% vs 3.5%, p < 0.001), and a longer interval occurred between birth and first breastfeeding in the newborns delivered by cesarean section (mean ± SD, hours, 3.1 ± 5 vs 10.4 ± 9, p < 0.05). No difference was found in breastfeeding rates between the elective and emergency cesarean groups. Compared with elective cesarean delivery, vaginal delivery was associated with a higher breastfeeding rate at discharge and at the subsequent follow‐up steps (7 days, 3 mo, and 6 mo of life). Conclusions: Emergency and elective cesarean deliveries are similarly associated with a decreased rate of exclusive breastfeeding compared with vaginal delivery. The inability of women who have undergone a cesarean section to breastfeed comfortably in the delivery room and in the immediate postpartum period seems to be the most likely explanation for this association. (BIRTH 37:4 December 2010)