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

Authors

  • Vincenzo Zanardo MD,

    1. Vincenzo Zanardo is a Neonatologist and Aggregated Professor of Pediatrics; Giorgia Svegliado is a Fellow in Pediatrics; Francesco Cavallin is a Statistician; Arturo Giustardi is a Pediatrician; Erich Cosmi is an Obstetrician and Aggregated Professor of Obstetrics and Gynecology; Pietro Litta is an Obstetrician and Associate Professor of Obstetrics and Gynecology; and Daniele Trevisanuto is a Neonatologist in the Department of Pediatrics at Padua University, Padua, Italy.
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  • Giorgia Svegliado MD,

    1. Vincenzo Zanardo is a Neonatologist and Aggregated Professor of Pediatrics; Giorgia Svegliado is a Fellow in Pediatrics; Francesco Cavallin is a Statistician; Arturo Giustardi is a Pediatrician; Erich Cosmi is an Obstetrician and Aggregated Professor of Obstetrics and Gynecology; Pietro Litta is an Obstetrician and Associate Professor of Obstetrics and Gynecology; and Daniele Trevisanuto is a Neonatologist in the Department of Pediatrics at Padua University, Padua, Italy.
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  • Francesco Cavallin MS,

    1. Vincenzo Zanardo is a Neonatologist and Aggregated Professor of Pediatrics; Giorgia Svegliado is a Fellow in Pediatrics; Francesco Cavallin is a Statistician; Arturo Giustardi is a Pediatrician; Erich Cosmi is an Obstetrician and Aggregated Professor of Obstetrics and Gynecology; Pietro Litta is an Obstetrician and Associate Professor of Obstetrics and Gynecology; and Daniele Trevisanuto is a Neonatologist in the Department of Pediatrics at Padua University, Padua, Italy.
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  • Arturo Giustardi MD,

    1. Vincenzo Zanardo is a Neonatologist and Aggregated Professor of Pediatrics; Giorgia Svegliado is a Fellow in Pediatrics; Francesco Cavallin is a Statistician; Arturo Giustardi is a Pediatrician; Erich Cosmi is an Obstetrician and Aggregated Professor of Obstetrics and Gynecology; Pietro Litta is an Obstetrician and Associate Professor of Obstetrics and Gynecology; and Daniele Trevisanuto is a Neonatologist in the Department of Pediatrics at Padua University, Padua, Italy.
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  • Erich Cosmi MD,

    1. Vincenzo Zanardo is a Neonatologist and Aggregated Professor of Pediatrics; Giorgia Svegliado is a Fellow in Pediatrics; Francesco Cavallin is a Statistician; Arturo Giustardi is a Pediatrician; Erich Cosmi is an Obstetrician and Aggregated Professor of Obstetrics and Gynecology; Pietro Litta is an Obstetrician and Associate Professor of Obstetrics and Gynecology; and Daniele Trevisanuto is a Neonatologist in the Department of Pediatrics at Padua University, Padua, Italy.
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  • Pietro Litta MD,

    1. Vincenzo Zanardo is a Neonatologist and Aggregated Professor of Pediatrics; Giorgia Svegliado is a Fellow in Pediatrics; Francesco Cavallin is a Statistician; Arturo Giustardi is a Pediatrician; Erich Cosmi is an Obstetrician and Aggregated Professor of Obstetrics and Gynecology; Pietro Litta is an Obstetrician and Associate Professor of Obstetrics and Gynecology; and Daniele Trevisanuto is a Neonatologist in the Department of Pediatrics at Padua University, Padua, Italy.
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  • Daniele Trevisanuto MD

    1. Vincenzo Zanardo is a Neonatologist and Aggregated Professor of Pediatrics; Giorgia Svegliado is a Fellow in Pediatrics; Francesco Cavallin is a Statistician; Arturo Giustardi is a Pediatrician; Erich Cosmi is an Obstetrician and Aggregated Professor of Obstetrics and Gynecology; Pietro Litta is an Obstetrician and Associate Professor of Obstetrics and Gynecology; and Daniele Trevisanuto is a Neonatologist in the Department of Pediatrics at Padua University, Padua, Italy.
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Address correspondence to Vincenzo Zanardo, MD, Department of Pediatrics, Padua University School of Medicine, Via Giustiniani, 3 35128 Padua, Italy.

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)

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