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Indian Pediatr 2013;50: 1062-1063 |
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Is Cesarean Section a Barrier to Early
Initiation of Breastfeeding?
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CR Banapurmath, Sandeep Ramachandrappa, Guruprasad G
and *Sarayu B Biradar
Department of Pediatrics, JJM Medical College and
*Bapuji Child Health Institute and Research Center,
Davangere, Karnataka, India.
Email:
[email protected]
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Cesarean section is considered as a barrier for early initiation of
breastfeeding. We found that 65.2% of mothers initiated breastfeeding
within 1 hour of delivery. We found that there is no significant
difference between vaginal delivery and cesarean section in early
initiation of breastfeeding, (P = 0.35). We were successful in
overcoming this barrier by involving a lactation management counsellor
in supporting mothers in early initiation of breastfeeding following
cesarean section.
Keywords: Breastfeeding, Cesarean section,
Early initiation.
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This cross-sectional
analytical study was conducted between March 2011 to June
2012 in Bapuji Hospital, Davangere, Karnataka. To document
the prevalence of early initiation of breastfeeding in a
Baby Friendly Hospital among singleton deliveries and to
determine whether mode of delivery is responsible for
delayed initiation of breastfeeding.
A trained Lactation management counselor
visited the mothers daily in the postnatal ward and
counseled them about art of breastfeeding and its
advantages. Every mother, irrespective of mode of delivery,
was helped by the counselor and the nursing students to
initiate and sustain breastfeeding. Data acquisition was
done by the counselor by interviewing the mothers. Mother
and infant pairs were divided into 3 groups. Group A
included those mothers who initiated breastfeeding within 1
hour, Group B initiated feeding between 1-4 hours and Group
C included those beyond 4 hours.
There were a total of 1793 live singleton
deliveries during this period. Among them 917 neonates were
delivered by cesarean section and 876 neonates were
delivered vaginally. Group A included 1169 (65.19%)
neonates; among them 588 neonates were delivered by cesarean
section and 581 neonates delivered vaginally. Group B
consisted of 385 (21.47%) neonates. Among them 193 neonates
delivered vaginally and 192 neonates by cesarean section.
The reasons for delayed initiation of breastfeeding in Group
B were that baby was given late to the mother (n=81,
21.0%), mother was tired (n=73, 19.0%), baby slept
off (n=19, 4.9%), traditional belief (n=57,
14.8%), and mother thought milk is not coming (n=39,
10.12%). There were 239 (13.32%) neonates in Group C. Among
them 137 were delivered by cesarean section and 102 were
delivered vaginally. Main reasons for delayed initiation
being that 197(89.94%) babies were shifted to NICU for
various reasons, mother/baby slept (n=12, 5.1%) and
traditional belief (n=5, 2.1%), or mother was in ICU
(n=5, 2.1%).
In this study, initiation of
breastfeeding within 1 hour among vaginally delivered
neonates was 66.32% and by cesarean section was 64.12%.
There was no significant difference between the two modes of
delivery in early initiation of breastfeeding (P=0.35).
Most critical period for initiation of
breastfeeding is first 1 hour after birth [1,2]. WHO has
rated the percentages of breastfeeding initiation in the
first hour as poor (0–29%), fair (30–49%), good (50–89%),
and very good (90–100%) [3]. Early initiation of
breastfeeding is good (65.56%) in this study. Often, mothers
who have undergone cesarean section need extra help with
breastfeeding. Otherwise, these mothers on an average
initiate breastfeeding much later and terminate
breastfeeding sooner [3,4]. We conclude that with the help
of a trained lactation management counselor it is possible
to initiate breastfeeding early even among mothers delivered
by cesarean section.
References
1. Edmond KM, Zandoh C, Quigley MA, Amenga-Etego
S, Owusu-Agyei S, Kirkwood BR. Delayed breastfeeding
initiation increases risk of neonatal mortality.
Pediatrics. 2006;117:e380-6.
2. Evidence for the ten steps to
successful breastfeeding. Geneva: World Health
Organization;1998.
3. Infant and Young Child Feeding: A tool
for assessing national practices, policies and programmes.
Available from:
http://whqlibdoc.who.int/publications/2003/9241562544.pdf.
Accessed on 2012 October 17.
4. Nakao Y, Moji K, Honda S, Oishi K. Initiation of
breastfeeding within 120 minutes after birth is associated
with breastfeeding at four months among Japanese women: A
self-administered questionnaire survey. Int Breastfeed J.
2008;3:1.
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