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

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).